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Science of Delivery

How do we Develop a “Science of Delivery” for CDD in Fragile Contexts?

Janmejay Singh's picture

Imagine you are a development practitioner in a country just coming out of conflict and you have just been put in charge of designing a community driven development (CDD) operation there.

After decades of war, you are faced with a country that has crumbling infrastructure, extremely high unemployment rates, weak local governance systems, perhaps even a vast population internally displaced or worse still, exposed to violence. Where do you begin fixing the problem? What would you prioritize? Do you begin by rebuilding and providing public goods, and hope that it would eventually re-establish the broken trust between the state and its people? Or do you directly tackle trust building first? Or perhaps you could do them simultaneously, but how would you go about doing that?

Policy learning with impact evaluation and the “science of delivery”

Jed Friedman's picture

The “science of delivery”, a relatively new term among development practitioners, refers to the focused study of the processes, contexts, and general determinants of the delivery of public services and goods. Or to paraphrase my colleague Adam Wagstaff, the term represents a broadening of inquiry towards an understanding of the “how to deliver” and not simply a focus on the “what to deliver”.
 

Learning from Data-Driven Delivery

Aleem Walji's picture

Given confusion around the phrase “science of delivery,” it’s important to state that delivery science is not a “one-size-fits-all” prescription based on the premise that what works somewhere can work anywhere. And it does not profess that research and evidence ensure a certain outcome.
 
A few weeks ago, the World Bank and the Korea Development Institute convened a global conference on the science of delivery. Several development institutions assembled including the Gates Foundation, the Grameen Foundation, UNICEF, the Dartmouth Center for Health Care Delivery Science, and the mHealth Alliance. We discussed development opportunities and challenges when focusing on the extremely poor, including experiments in health care, how technology is reducing costs and increasing effectiveness, and the difficulty of moving from successful pilots to delivery at scale.
 
The consensus in Seoul was that a science of delivery underscores the importance of a data-driven and rigorous process to understand what works, under what conditions, why, and how. Too often in international development, we jump to conclusions without understanding counterfactuals and assume we can replicate success without understanding its constituent elements.

A Data Guide to Sir Michael Barber’s “The Good News from Pakistan”

Jishnu Das's picture

Shanta’s blog reported on Sir Michael Barber’s approach to implementing service delivery or “Deliverology”. Sir Michael was back at the World Bank on June 6th to present “The Good News from Pakistan”, where he outlined the impressive changes in Punjab, Pakistan as a result of his leadership in delivering deliverology. As a discussant, with Dhushyanth Raju’s inputs (Dhushyanth is a Senior Economist in the World Bank's South Asia education team), I examined and triangulated the existing data. Despite my original excitement about the method and the results after reading the report, I am reluctantly forced to conclude that at the moment the data do not support the report’s claims (see my presentation). That’s not to say there’s no good news from Pakistan on education. Just the opposite in fact: the good news is the large increase in enrollment and learning that predated Sir Michael’s deliverology intervention. 

Deliverology and all that

Shanta Devarajan's picture

As a student of service delivery, I was delighted to read about Sir Michael Barber’s effort to conceptualize the implementation of service delivery policies—what he calls “Deliverology”—a problem many of us have grappled with for a long time.  These problems are widespread:  20 percent of 7th grade students in Tanzania couldn’t read Kiswahili (and 50 percent couldn’t read English); the latest ASER report in India shows that learning outcomes are declining while enrolment is rising;. Similarly, doctors in rural Senegal spend a total of 39 minutes a day seeing patients; in India, unqualified private-sector doctors (otherwise known as “quacks”) appear to provide better clinical care than qualified public-sector doctors.

The question is:  Can Deliverology in principle help solve these problems?  Conceptual approach.  Deliverology is based on the notion that traditional public-sector organizations are not geared towards delivering results—such as student learning outcomes or quality clinical care—for several reasons.  The organization’s goals are too many and too diffuse.  Frequently, the goals cannot be quantified.  For those that can be, there is very little real-time data to monitor progress towards the goals.  As a result, staff and management within the organization do not work towards these goals.  Rather, they may try to maximize the size of their unit or the budget under their control.

What Is Science and What Is Delivery?

Aleem Walji's picture

Having just returned from Dartmouth and meetings with the Center for Health Care Delivery Science, I’ve been thinking about the phrase “Delivery Science.” World Bank Group President Jim Yong Kim’s use of the term in recent speeches is related to using evidence-based experimentation to improve poor health, education, water, and basic service outcomes in the developing world.

Reflecting on this, I think, in many ways, “science” and “delivery” are distinct and need to be understood as different but reinforcing principles. So let’s break it down.

IT maven Nandan Nilekani explains Unique I.D. system to reach India's masses

Merrell Tuck-Primdahl's picture

What breakthrough will involve barefoot banking for millions of people, allow welfare and other benefits to be electronically transferred to some of the poorest people in the world and be scaled up in a few years time to reach 1 billion people or more? The answer is 'Aadhaar', the Hindi name that the Unique Identification Authority of India has given to the massive project that will provide unique I.Ds to 600 million by 2014 and eventually to the entire population of the country if all goes as planned.

Reconciling the two “sciences of delivery”

Adam Wagstaff's picture

Last week on Let’s Talk Development, I asked what the term “science of delivery” (SOD) means. I suggested that SOD is about moving from thinking about “what to deliver” to “how to deliver”.  We know, for example, the interventions that cut child mortality (bednets, vaccinations, breastfeeding, etc.) but these interventions reach too few children, and the trick is to get them delivered to more. Much of the Bank’s analytic work, policy dialogue and lending work has focused precisely on how to reform policies and programs to ensure the interventions that are needed to improve development outcomes actually reach people. Much of this work merits the term “science” – it makes use of an explicit “theory of change” in the form of a results framework that reflects the latest social science, and builds on rigorous empirical evidence that compares actual outcomes with an explicit and plausible counterfactual.

So what exactly is the “science of delivery”?

Adam Wagstaff's picture

The World Bank’s president, Jim Kim, has now made two major speeches outlining his vision for the institution – one at the Annual Meetings the other at Georgetown University on April 2 ahead of the upcoming Spring Meetings.

Several themes are emerging. Two are easy to grasp and likely to resonate strongly with Bank staff and stakeholders: “ending poverty” and “boosting shared prosperity”. For years the Bank has seen fighting poverty as its mission. It has made major contributions in the areas of measuring and monitoring poverty – Bank staff have authored many of the world’s most-cited publications with poverty in the title. The Bank’s work at the country level has always had a strong anti-poverty focus. “Ending” poverty – rather than merely “fighting” it – is a natural next step. The idea of “boosting shared prosperity” also resonates. While economic growth is still seen as the principal driver of poverty-reduction, the goal has always been pro-poor growth – a concept that links naturally to the idea of “shared prosperity”.

Time to Put Institutions at the Center of Community Driven Development (CDD)?

Janmejay Singh's picture

Community driven development (CDD) has been a key operational strategy supported by the World Bank for more than a decade – averaging about $2 billion in lending every year and now covering more than 80 countries. By emphasizing empowerment and putting resources in the direct control of community groups, CDD’s rapid spread stems from its promise of achieving inclusive and sustainable poverty reduction. Yet despite its popularity, evidence on whether these programs work still remains limited and scattered. Recently, two significant efforts have been made by the Bank to pull together the different strands of evidence there is on CDD and provide a summary picture of what we know and what we don’t (please see What Have Been the Impacts of World Bank Community-Driven Program? and Localizing Development – Does Participation Work?). The reviews find on the positive end that CDD-type programs, when implemented properly, do well on delivering service delivery outcomes in sectors like health and education, improve resource sustainability, and help in constructing lower cost and better quality infrastructure.