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.
Our two units (World Bank Institute and World Bank’s ICT Unit) focus on integrating technology and innovative processes into World Bank-supported programs to tackle global challenges — from youth employment, food security, and climate change to water, sanitation, health, and education. This has made it clear to us that there are no blueprint solutions. Even when we know what works in one context, we need to adapt and adopt solutions and pay close attention to implementation as a science (some call it an art).
But let us spell out some principles that emerged in Seoul that we hope will be welcomed by development practitioners.
1. The importance of framing the right problem cannot be overstated. Too often we are hammers looking for nails and don’t address the actual causes in our interventions. If we’re working on symptoms rather than underlying causes, we’re unlikely to succeed and likely to frustrate our partners and beneficiaries.
2. End-user preferences matter. We shouldn’t assume we know what “users” want or need (whether they are patients, students, or water users) without asking them and allowing them to make informed choices. Too often we over-supply what people don’t need (e.g. prostate surgeries in the United States) and under-supply what they want (a better quality of life).
3. Complex problems don’t fit neatly into sector-specific boxes or correspond to the way experts and expert-led institutions are organized. Places like the World Bank have practices dedicated to health, education, water, and transport, for example. But the challenge of youth unemployment is about education, labor markets, private sector development, and access to finance. It doesn’t fit neatly into any one box and requires multi-disciplinary and multi-stakeholder teams to identify binding constraints and leverage strengths from government, the private sector, and civil society to ‘unblock’ them.
4. All delivery is data. Technology, and mobile phones in particular, have reduced the cost of data collection, analytics, and visualization. We can leverage this information to make better decisions faster and create feedback loops with our ultimate beneficiaries. The World Bank has always been a data-centric organization, but these new tools for collecting and making sense of data can allow us to become a data-driven organization.
5. Implementation matters and requires adaptive execution. Leadership teams must be able to change direction when necessary and use “learning by doing” and “doing by learning” approaches to fail fast, fail small, and fail forward. Development challenges require technical and adaptive skills. Technical specialists tend to under-value process expertise, iteration, and the challenges of implementation. Successful implementation is about turning art into science by building practitioners’ capacity to learn faster, iterate, and change course when needed.
Traditional development models capture knowledge when it is too late to apply lessons to live projects. We need ways to develop and challenge our hypotheses while we execute and be less concerned about the accuracy of our original hypotheses. We need to try many things, look for positive deviants where they exist, and better understand why some results are better than others despite similar circumstances. What are we not seeing and what could we learn if only we admitted we might be working with misinformed assumptions? Can we be rigorous without being rigid and open without being undisciplined? And this requires evolving the “knowledge agenda” to what conference participants called the “do agenda.”
Development needs a much more robust learning-by-doing approach to solve vexing challenges with (rather than for) clients. This requires humility and the courage to admit what has not worked. What if we could publish an annual learning from failure report and use failure as an opportunity to iterate and improve outcomes? What if our data was open for all to see throughout project implementation, recognizing that solutions can emerge from unexpected places? Why can’t we assemble multi-disciplinary teams with expertise in areas which include behavioral science, technology, and impact evaluation to work with sector experts on the hardest delivery challenges?
We need to create a community and a movement to address the most extreme poverty on the planet. The World Bank cannot do it alone, and so we invite partners to join us in a more open, rigorous, and client-centric effort to solving the world’s hardest problems. Are you up for it?
- World Bank Institute
- health care
- mHealth Alliance
- Dartmouth Center for Health Care Delivery Science
- Grameen Foundation
- The Gates Foundation
- Korea Development Institute
- world bank
- Science of Delivery
- Private Sector Development
- Labor and Social Protection
- Climate Change
- Korea, Republic of