PDIA Course Journey: Solving the Problem of Blood Transfusion in India

Guest blog written by S. Subash, Vimala Devi Vidya and J. Ravishankar

This is a team of physicians working as District Blood Transfusion Officers for Tamil Nadu AIDS Control Society (TANSACS) living in India. They successfully completed the 15-week Practice of PDIA online course that ended in December 2018. This is their story.

We enrolled into the PDIA course without knowing what it was and what we needed to do. But the Project Director of TANSACS encouraged us, gave us objectives that we were struggling with and directed us to engage with this new tool/approach. So one fine day, we joined the ride on “Practice of  PDIA 2018F” with our objective to solve – How do we address the problems faced by Government blood banks, in acquiring 20% of blood units collected by private blood banks in Tamil Nadu, India.

Government blood banks in Tamil Nadu are facing a shortage of blood units and acquiring 20% of blood units from private blood banks was a strategy to increase the blood stocks. But private blood banks were not willing to part with blood units as it was money for them. They either did not report their blood donation camps or under-reported their collection in camps. Either way, the Government blood banks were suffering from increasing demand and a reducing donor pool.

We started with a 6 member team and early on, we learnt about the big stuck faced by countries aiming for development. The book “Building State Capability” became the bible for the next 15 weeks. We learned new terms like Implementation gap, Isomorphic Mimicry, Premature load bearing and Transplantation. Some of our team members could not spare the time and energy needed for PDIA and bowed out. And this was the ‘first lesson learnt’ for us and we rallied and reinforced ourselves that we will fight to the finish, like plotting the map of 1804!

We found that the problem we were facing belonged to the typology ‘Implementation intensive service delivery’ which was not wicked hard category. We came to know that success of a leadership is not for the face of the leader but through multi-agent leadership. We formed the team norms and started our group activity of engaging our problem. As we constructed and deconstructed our problem and formed our first fishbone diagram, we found that there were many sub-causes that led to our problem. Continue reading PDIA Course Journey: Solving the Problem of Blood Transfusion in India

PDIA Course Journey: Littering in Bangalore City

Guest blog written by Sridhar Pabbisetty, Deepthi MR, Manivannan Ponniah, Salma Fahim.

This team is made up of a Public Policy and Sustainable Urbanisation expert, a Public Relations Officer, Bangalore Electricity Supply company, and two civil servants. They successfully completed the 15-week Practice of PDIA online course that ended in December 2018. This is their story.

Bangalore, the capital city of Karnataka is dubbed as the IT city and Garden city alike. Residents of the city have called it retired-persons’ paradise. Over the last 15 years, the city has become a booming hub for IT companies which have not only brought in infrastructural development, but also has expanded leaps and bounds in terms of income. While the city saw rapid development on one side, it also began seeing heaps of garbage being generated and hit a roadblock when it came to managing its solid waste.

The city’s municipal corporation is called Bruhat Bangalore Mahanagara Palike  is responsible for managing the city’s waste. BBMP decided to set up a solid waste management wing. This would help in managing solid waste of the city. Here are a few numbers to take into consideration:

1.         Bangalore generated 57,00 MT of waste every day
2.         Almost 1200 MT is unaccounted for
3.         This comes to about 22% of the total waste!
4.         Even though the BBMP has 30,000 cleaning workers, this is the state of affairs.

As we began understanding our problem, we got deeper insights about the demon we were dealing with. Littering is a cultural problem in India. People lack basic civic sense, irrespective of class. This leads to heaps of garbage strewn around on streets and street corners. Besides there are not adequate number of dustbins placed by the Municipality nor is the system of collecting the garbage from these public bins very effectively monitored. It is a problem with immense political and economic dimensions, we as a team decided to focus on one crucial sub component of ‘littering’ to work on.

Continue reading PDIA Course Journey: Littering in Bangalore City

PMRDF: an Innovative State Capability Experiment in India

written by Salimah Samji.

Anyone who has ever worked in India knows how hard it is to implement programs. The sheer size of the country makes it impossible for anyone but the government, who is the only one with infrastructure and reach, to provide public services to its citizens. Currently, every district administers typically 100+ development schemes. Each scheme has its own rules, regulations, reporting, and funding. Districts are continuously burdened with new schemes and more work without the requisite resources. They are often understaffed and have few (if any) skilled functionaries to be able to do their job. The reality is that 90% of the time is spent on routine day-to-day management leaving no time for strategic planning or experimentation.

To address the capacity and implementation gaps in backward districts which are isolated and less developed, the Ministry of Rural Development launched the Prime Minister’s Rural Development Fellowship (PMRDF) in 2012. The aim of the fellowship was to provide catalytic support to the district administration to help improve the delivery of programs and to develop a cadre of committed development professionals. The eligibility criteria was a minimum of a four-year degree from a recognized university. The fellows were to work for 2-3 years under the supervision of the District Collector, and paid INR 75,000 ($1,210) per month with a 10% increment each year subject to performance. That is a very generous amount. The rationale was to attract younger people who were passionate about development and willing to go to remote areas, but could not afford the low wages. In essence this was a way to bring in new blood into the system.

816 applicants were shortlisted from a total of 8,560 applicants for a group discussion and a personal interview. 156 fellows were selected to work across 82 districts in 9 states. Each state decided on the placement of fellows with 1-3 per district. Currently there are 137 fellows from the first batch and a second batch has just been selected. For more details see the TEDx talk.

Some of the challenges faced during the implementation of the 2012-13 PMRDFs include:
  • Building the trust of the States/District Collectors: When the program was initially announced, it was viewed suspiciously by some (i.e. was the center sending monitors to the states/districts?). Many meetings were held to explain and clarify the objectives of the program and to bring the states on board.
  • Ineffective use of the fellows: Depending on the District Collector, some fellows were welcomed and given a lot of responsibility and authority to experiment, while some others were used as glorified executive assistants – which is also understandable given the lack of human resources at the district level.
  • Lack of authority to issue instructions or to sanction funds: The fellows are not part of the government bureaucracy and therefore have no signing authority and cannot issue orders to lower level functionaries. As a result, they need to go to the District Collector with all those requests leading to time delays and inefficiencies. To address this, the state of Andhra Pradesh has delegated a budget head specifically for the fellows.
  • High monthly salary is attracting applicants who are not necessarily passionate about development: This has been an unintended consequence and they have tried to be more mindful in the interviews for the 2nd batch of fellows.
  • What happens after the fellows leave? One criticism is that they are building temporary capacity. To address this, the second batch will be offered one year of public service after their fellowship. However, this issue remains a challenge.
Here are some testimonies of the fellows, for more read their profile book or visit their blog.
  • “I still remember an incident from my initial days, when a village welcomed and garlanded me saying: We are receiving our first government official in our village after Independence.
  • “… working with the field staff in implementation of these schemes was not always easy. My efforts at convincing them and the higher authorities did not yield fruit every time. The convergence of different schemes has also been a challenge as each scheme has different criteria for beneficiary selection and process of implementation. However, struggling with these issues every day helped me understand the minutest details of these schemes and the complexities involved in the development sector.”
  • “This last one year as a PMRDF has helped me develop both personally and professionally. It has given me a chance to work and interact with people at every level of the hierarchy, starting with the panchayat secretary and going up to state officials.”
  • “The last one year has been a period of immense pleasure, satisfaction, frustration, learning and un-learning … There were difficulties: sluggishness, winning the trust of various actors and bringing them onto common platform to get the ball rolling, getting bogged down with too many operational formalities needing to continuously establish yourself within the system. I learnt that things will happen if there is strong will. I learnt of a number of unsung heroes who keep things going—unappreciated and unrecognized—but making a difference each day with their integrity.” This comment is a great illustration of Matt Andrew’s multi-agent leadership paper, Who really Leads Development?

The PMRDF is a work in progress with a lot of learning, iterating and adaptation. There are no easy solutions when you are working on implementation intensive programs. It will be interesting to see what other lessons are learned from this dynamic experiment of trying to solve capacity issues at the last mile of service delivery.