From South Africa To Boston and Back

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Guest blog written by Nkere Skosana

From the moment I saw the advert on Twitter and read through the content provided, something just told me this is the real deal. I felt there was no way I could not find more about the course. It has always been my approach not to do any academic course for the sake of just obtaining a qualification but to engage in a course that speaks to real issues that we get confronted with as Public Servants on a daily basis.

The initial assignment already gave a hint of what was to come and the approach in terms of policy analysis and implementation. Breaking down the policy challenge in terms of who the critical stakeholders are, determining upfront what meaning of success one has to attach to its implementation was key. 

Getting to HKS, one was struck by the diversity of participants in the course from all walks of life and different continents. Amazingly, there were lots of similarities in terms of the challenges we encounter in our policy environments. The course turned out to be more than what I had expected. It was more interactive and practical and the wealth of experience and knowledge from the team of experts presenting was exceptional.

The course leader provided insights into experiences from different continents and the examples of real life situations and the kind of challenges encountered helped to us to realise that PDIA is not a theoretical but practical approach to policy implementation.

Some key learnings

One of the key insights from the course was the distinction between the Plan and Control policies which most institutions use and PDIA. The former may be useful in ensuring the achievement of policy products on time and within budget and this becomes the drill. PDIA on the other hand seeks to drill down to the heart of the problem, explore a variety of options and ensures that policy impacts are achieved which is what people mostly are looking for. 

Another take away from the course is the ability to note and acknowledge the different roles of key stakeholders in the policy implementation process. These are called authorisers and while traditionally we would automatically tend to think of high level bureaucrats only, the reality is that these are found at different stages and are key to implementation success. For instance, the secretary in the Director General’s office is key in ensuring that we obtain that critical signature and if we ignore their role and undermine it, we may not succeed in achieving it.

It is thus important to take note of such roles and how critical they are in the whole process. A practical example was shared in the course with the expedition to Mount Everest and how and where different stakeholders contributed to the success or lack thereof. Attention is brought in this case to the role of Sherpas in these expeditions who are native people of the areas around the Himalayan Mountains. They were critical in assisting many groups with carrying supplies to and from the mountain and were familiar with these treacherous routes.

With the actual bureaucrats themselves, it is key to ensure that they buy into the iterative approach and understand what it is likely to deliver. Not many people are interested in innovation as their interest is on delivering policy products. The iterative approach that PDIA uses may therefore be scorned upon and looked at sceptically largely because people are not easily receptive to change.

A number of insights were gained in the process of addressing my policy challenge. The first thing and most critical issue is the change to what I initially thought was my key policy challenge. As one drills down into the challenge it becomes evident what the scope and thrust of the problem is.

I set out to address the implementation of the National Strategic Plan for HIV, TB and STIs in South Africa which is a 5 year plan. This is led by a structure made up of different stakeholders such as government departments, labour organisations, business organisations and other civil society formations. It is called the South African National AIDS Council (SANAC) and through its secretariat leads the implementation of the country plan.

I then reviewed my challenge to rather focus on addressing one of the key challenges of the Plan which is to get people on anti-retroviral treatment. South Africa has the highest HIV prevalence rate in the world and getting people living with HIV on treatment is key. It is estimated that more than 2 million people known to be living with HIV are not receiving treatment.

This seemed like a narrower focus than the initial challenge of coordination and it was. As I unpacked who my authorisers would be and began engaging with critical stakeholders, it became clear that my institution – the Department of Social Development – though critical in the implementation of the National Strategic Plan as it leads one of the goals, was not necessarily the key stakeholder in the resolution of the policy challenge.

While I obtained authorisation to engage officials within the department and began engaging individually with different stakeholders, it became apparent that still the scope of the challenge was much wider and involves a lot more stakeholders outside of my department and would require further authorisation(s) from a variety of stakeholders amongst which is the department of health where critical statistics on treatment are held but also at a coordination level from the SANAC secretariat. Using the triple A change space it became apparent that there would need to be a lot of authorisation obtained from even external stakeholders and given how territorial some stakeholders can be obtaining acceptance may be a challenge. 

What also became critical was the issue of ability to carry out the tasks. The process requires a lot of time and in the process of addressing the challenge and seeking engagements with different stakeholders, I also needed to manage my own time at work which involves a lot of traveling. Finding a balance between doing this work and delivering on my tasks became a challenge. While the challenge is within the scope of work that I do, it being within the HIV realm, the challenge became the scope of influence and authorisation I needed.

The excitement that comes with realising that using PDIA methodology to construct and deconstruct the problem exposes one to new insights in terms of what we may have thought is the actual problem has actually motivated me to pursue the approach with the core team of officials from both national and provincial departments of social development to define what our actual niche is.

We have always lamented the lack of alignment between what the National Department of Social Development puts in its Annual Performance Plan (APP) as compared to what provinces put in their APPs on similar programmes even though provinces are delivery agents. I therefore intend using PDIA as a planning tool in our next engagement with provinces in February 2020 to chart our path for 2020 and beyond with this specific group of HIV coordinators. If it becomes successful as I anticipate it will be, it will allow me to engage our strategic planning unit to consider utilising it broadly in the department using our plan as a basis. I anticipate of course a lot of resistance but is we as a small unit could crack it, we should be able to engage other authorisers to consider its utilisation. 

On reflection, I should not have been a lone ranger for PDIA in my environment. I could have gotten in touch with a team from GTAC which has been exposed to it and together expand the community of IPPers. This will be my next steps including encouraging a number of my colleagues to enrol for next year’s course to build a local community of PDIA ambassadors. 

Resistance to change is not only common in the public service but is experienced in most institutions. It is therefore important to always be conscious of a variety of speed humps in the process of policy implementation especially as it pertains to authorisers. The road can sometimes seem lonely and it is therefore important to ensure that we exercise self-care to avoid burnout. 

This is a blog series written by the alumni of the Implementing Public Policy Executive Education Program at the Harvard Kennedy School. Participants successfully completed this 7-month blended learning course in December 2019. These are their learning journey stories.

To learn more about Implementing Public Policy (IPP) watch the course and testimonial video, listen to the podcast, and visit the course website.

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