In my five years at the Bank, I have learnt a number of lessons. One of the most important is that even though each practitioner brings specialist knowledge, that knowledge must be applied from an overall development perspective, for we’re trying to achieve development in imperfect settings where the gap between the ideal and the reality, between principles and practice, is often wide.
Let me spell out some of these lessons:
1. Anticipate issues but be ready for surprises
Development doesn’t take place by complete fluke nor is it a sure-shot thing that the efforts will succeed. While it is important to plan and plan well, things seldom happen as planned. It is seldom a smooth affair. While an intervention may have been designed keeping the context in mind, the context itself keeps evolving continually. So, it’s best to anticipate how things may evolve and prepare for it, but be ready for surprises as well.
For, just when you thought you’d helped a state government design a reasonable health insurance intervention factoring in the implementation challenges, and are ready to go, one single announcement by a central minister can derail your efforts, just because the state now wants to wait and watch, given that it prefers a central government grant over a loan from a donor. Dejected, you still talk to the state government to define your relevance in the changed context. It is important to recognize this from the start and set your expectations appropriately.
2. Understand the linkages and limitations
Development is a multidimensional phenomenon. A single intervention has its limitations, especially when so much needs to be done. While it is important to understand the various linkages and interconnections between development challenges, one has to demarcate what an intervention can and cannot do. A polio-eradication intervention, for example, may help limit the disease but may not completely eliminate it. Elimination may require an inclusive, multi-sectoral approach including the provision of better sanitation, preventive education etc.
Similarly, while benefiting the intended population, the intervention may also throw up a new set of problems and challenges. For example, improvements in household sanitation require people to store water in overhead tanks. But, these can in turn lead to the spread of mosquito-borne diseases such as malaria and dengue. Therefore, while sanitation improves, the risk of malaria may go up. So the linkages and the limitations of development intervention need to be kept in mind.
3. Development is the art of possible - not of perfection
The strength of the design of any intervention lies in the strength of its implementation. You may have a perfectly designed intervention, but if implementation is weak, it will not serve the objective. It is important to recognize this while devoting time and resources in designing an intervention on the one hand and getting it implemented on the other.
Parity must also exit between different components of the design. It doesn’t help much if one component is stronger than the other when both components must move integrally to deliver results. In health insurance intervention, for example, you may design a perfect system for collecting premiums and settling claims, but if the complementary intervention for strengthening health service delivery remains weak, there may not be much impact. The strength of the intervention is defined by the strength of the weakest link in the chain.
Click here to read part 2 of Lessons from the Field.