Hvad vi kan lære af vellykkede bistandsprojekter

Hedebølge i Californien. Verdens klimakrise har enorme sundhedsmæssige konsekvenser. Alligevel samtænkes Danmarks globale klima- og sundhedsindsats i alt for ringe grad, mener tre  debattører.


Foto: Kevin Carter/Getty Images
Laurits Holdt

Ny britisk rapport undersøger fire vellykkede bistandsprojekter, for at finde ud af hvorfor de lykkedes. Det handler bl.a. om at bistanden hjalp med til at skabe overensstemmelse mellem det, der var besluttet og det der foregik i praksis.

LONDON, 7 June 2013 (IRIN): There should be many reasons for governments to improve public services like water, healthcare and sanitation; these services make citizens happy and politicians popular. But too often, conflicting systems, confusion about roles, perverse incentives and other constraints block desired improvements. What, if anything, can aid agencies do to help?

A team from the London-based Overseas Development Institute (ODI) identified four cases – a Tanzanian water project, a Ugandan governance programme, and, in Sierra Leone, a governance initiative and health worker programme – in which outside assistance was believed to have made a positive difference. The projects were then examined to see what they had done right.

These were not big-picture projects. Although fundamentally about governance, most of them stuck to practical, low-level interventions.

The Tanzanian project mapped water-points and their use, and coached councillors and local committee members about their rights and responsibilities.

The Ugandan programme similarly sensitized people about their rights.

In Sierra Leone, one programme provided advisory teams to a handful of government ministries, and another established a system of rewards and sanctions to improve health worker attendance, supplying – in the words of one ODI report – “the grease that keeps the system running.”

Heidi Tavakoli, the lead researcher, said, “Aid projects tend to want to start by revising the regulatory framework within which they and governments have to work. But much less attention is given to getting existing systems working a bit more effectively. All these activities largely focused on bridging the gap between what’s on paper and what actually happens in practice.”

Opportunity knocks

All the interventions took advantage of unique windows of opportunity.

In Sierra Leone in 2007, the government had just been voted out of office, in part because voters were frustrated by its lack of progress in improving service delivery. The new president, Ernest Bai Koroma, promised that within six months all young children and all pregnant and lactating women would get free health care.

The British Department for International Development (DFID) was prepared to help fund this programme, but wanted to ensure its money would not go to absentee, or “ghost”, workers. The political urgency of the pledge gave DFID leverage to insist on reforms.

In Tanzania, youth groups were becoming increasingly vocal about the local government’s poor service provision. Media coverage on the issue was proliferating, and rivals to the dominant political party had begun to emerge. Suddenly, officials and politicians had more incentives to make the water supply system work.

At a meeting in London to discuss the ODI research, attendees debated how best to spot and exploit these windows of opportunity.

It is not easy, said Andy Ratcliffe, from the African Governance Initiative. “We have risk registers for projects. In a fit of wonkery, we thought perhaps we ought also to have an opportunity register, but we found that was very, very difficult.”

Marcus Manuel, of ODI, said maintaining a local presence is essential. “If you are not there already, if you are not there for the long-term, you won’t spot the window of opportunity when it occurs. And if you are not there with some money, the window will have closed again by the time you have raised the funds!”

Politics

Læs hele artiklen: http://www.irinnews.org/report/98193/greasing-the-wheels-of-public-service-delivery

Læs mere om rapporten ”Unblocking results: using aid to address governance contraints in public service delivery” fra Overseas Development Institute: http://www.odi.org.uk/publications/7469-governance-politics-aid-service-delivery

Hent rapporten (PDF – 52 sider): http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/8409.pdf