Today, as I take the reins as the new president and CEO of Results for Development (R4D), a global development nonprofit focused on health, education and governance, I am excited about what lies ahead. But I also feel a great responsibility to ensure that R4D continues to make unique and meaningful contributions as we work with partners around the world to help people in low- and middle-income countries reach their full potential.
To that end, I've been contemplating four questions that have far-reaching implications not just for R4D but for the global development community at large. These are important considerations to stay relevant (and effective) in a changing world—particularly as we face the complex challenges of achieving more nuanced Sustainable Development Goals to reduce extreme poverty and prepare a growing group of middle-income countries to “graduate” from development assistance.
1. How can we learn what actually works and solve practical implementation challenges to ensure wide adoption of effective practices?
Many in the global development community are focused on identifying potentially game-changing ideas, through a proliferation of challenge funds and other platforms to source innovations. And we struggle with how to bring good ideas to scale and encourage replication. We are also focused on evaluating the effectiveness of new ideas. Yet all too often, the results of these evaluations come too late to inform design and do not provide would-be replicators with practical ideas about how to implement. We as a community could do more to integrate innovative design with real-time testing of what works, and smart adaptation to different contexts.
At R4D, we are cultivating a number of robust and iterative learning methodologies that rely on identification of new ideas, collective peer problem-solving and systematic field experimentation. We are working to find better ways to ensure that all of these methods yield practical evidence about what works that can be easily used by implementers.
For example, we are working with leaders of innovative water, sanitation and hygiene (WASH) programs around the world to understand the barriers facing communities in accessing WASH services, connect local innovators to each other for peer learning, and leverage learning opportunities to help them increase their reach. We are working with three local partners on a global literacy initiative in India to design an experiment that tests several different approaches to encourage parents to read with their children to see which is most effective. And we are conducting a large-scale randomized controlled trial of an intervention that aims to decrease maternal mortality by encouraging community leaders in Indonesia and Tanzania to develop their own local solutions to this problem. This quantitative evaluation is coupled with rigorous qualitative ethnographic research designed to explore why and how the program is or is not effective.
2. How can we better support local change agents?
We believe local leaders must identify and own the solutions to their challenges, and recognize the incredible amount of energy and talent in countries where we work.
Local leaders tell us that they want:
- Easily digestible information about what works and practical tools for implementation.
- Better information systems that produce data to tell them whether their approaches are working and help them prioritize their future efforts.
- To connect with people around the world who are grappling with similar challenges, as a way to gain inspiration, motivation and practical ideas.
- To be able to request direct support tailored to their self-prioritized needs from global organizations that work shoulder-to-shoulder with them, as peers, offering ideas and tools gleaned from successful efforts elsewhere.
- We are learning that, with the help of a facilitator, implementers from different countries can collectively produce practical tools that can be adapted in their own countries and offered to others as global public goods. In addition, advances in technology have increased global social-connectedness, and this offers new opportunities for linking local leaders with information, data, tools, and each other to support their success.
At R4D, we are working to improve how we build lasting global human networks, led by local change agents and backed by digital technology, which promote the development and sharing of new knowledge. A good example of this work is the Joint Learning Network for Universal Health Coverage (JLN), which R4D helped launch in 2010. The JLN is a member-driven community of global health policymakers who work to remove barriers to achieving UHC. We also work directly with change-agents in specific countries when we believe we can help them achieve significant impact. For example, we are working closely with the governments of Ethiopia and Tanzania to scale up treatment for pneumonia, the leading killer of children under age 5 globally. With a small amount of support, these countries have the potential to save thousands of lives.
3. How can we break down 'sectoral' barriers that prevent us from effectively addressing key challenges?
Increasingly, I hear our partners around the world considering how to break down traditional silos that impede progress. For example, to support the comprehensive success of young children or adolescent girls, we need to recognize the interconnectedness of the problems they face—in nutrition, sanitation, health and education. These challenges often beg cross-cutting solutions. To that end, health systems can be an important first point of intervention on nutrition and education in early childhood, and schools can support adolescent reproductive health and menstrual hygiene programs that keep girls in school and learning. However, implementing multi-sectoral programs is a challenge when local governments and global development partners tend to organize funding and institutions by sector.
At R4D, we are working to break down our own barriers by bringing together our health, education, nutrition, and WASH teams to co-create ideas.
Another barrier is the disconnectedness between the public and private sectors. By definition, these two groups act independently and development partners often create separate programs to support governments and private innovators. Strong systems, however, are usually “mixed systems,” where governments engage private actors to achieve public goals. As a community, we need to focus more on this crucial intersection.
At R4D, we are committed to pioneering ideas for improving “mixed systems.” We support government health financing agencies to improve how they purchase care from private clinics and hospitals and promote better quality private provision. We also work with global private health provider networks to help them better address the goals of governments. We recognize that similar challenges and opportunities exist in other sectors, like education, where private schools proliferate and governments are starting to consider ways to harness private actors to ensure good outcomes for kids. We hope to develop “mixed systems” approaches that can be applied in health, education and beyond.
4. How can we ensure that lessons from what works in the field inform global development actors who make decisions about allocation of resources?
Most global development partners are in the process of evolving their approaches to a changing world, whether they are considering how to promote innovation and learning, or how to support countries transitioning away from aid. So it is crucial for our field to consistently synthesize the learning about what is working, and not working, for local implementers. This knowledge and experience of local change-agents needs to be front and center as global development institutions make key decisions about resource allocations, policies and development approaches to pursue.
R4D works both with networks of local practitioners and with consortia of global development institutions. We are working to increasingly find opportunities to translate lessons from the field to groups of development policy practitioners. For example, we have worked with a group of development partners to launch the International Development Innovation Alliance (IDIA), to support learning about how development partners can better promote the scale-up of innovations. And we seek out opportunities for our analytic work—economic analysis, policy analysis, and implementation research—to influence global agendas, as well as the policies and priorities of specific partners. Last spring, our analysis of global nutrition spending was used as evidence to argue for more resources to end childhood malnutrition. All of us in the field of global development can do more to ensure that global decisions reflect what will be most useful and effective at the local level.
Reflecting on these four questions, it appears that the field of global development can work to create better virtuous cycles, where networks of peers from around the world identify common challenges, co-design replicable solutions, systematically test them to see if they work, codify the results, and then widely share this new knowledge through human and digital networks. Ideally, local implementers and global development partners alike will use this knowledge to facilitate impactful results.
At R4D, as we work together with our partners to develop a cohesive vision for our next phase, we will consider how to create this type of virtuous cycle to achieve even greater results for the goals that we have prioritized, such as achieving universal health coverage, ending childhood malnutrition and pneumonia deaths and preventable maternal mortality, improving early childhood education, ensuring that every youth has the skills to succeed in life, and improving governance and accountability in countries around the world.