Using PDIA approach for sustainable and integrated health system strengthening in Nigeria

Guest blog by Aisha Allamin Daggash

My expectations for the IPP Online Program when I signed up was to gain insight into strategies and frameworks that will support my work in getting government to be more effective and efficient in implementing innovative, integrated and sustainable solutions for health systems strengthening in Nigeria. However, this course has exceeded my expectations in combining leadership management and the PDIA, which has equipped me with the right resources, knowledge and skills to build the teams and networks required to succeed in the work that I do.

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The Brilliant Citizen and the Economist: Learnings from Leading Economic Growth

Guest blog by Esther Adegunle

Brilliant Citizen: My dear Economist, I have not seen you in a very long time. What is going on?

Economist: I had a baby about 3 months ago. Also, I was engaged in a program at Harvard Kennedy School (HKS).

Brilliant Citizen: Wow, congratulations to you and the family. You mean you were attending a training after giving birth?

Economist: Thank you. It was quite an intensive one. I am thankful for my support system, they made it possible for me to attend. Also, the training was online, so I did not need to travel.

Brilliant Citizen: Oh, that is good. Did you say Harvard, the one and only Harvard?

Economist: It was facilitated by Harvard Kennedy School. It was a 10-week course on Leading Economic Growth.

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Infusing fresh blood using PDIA in Nigeria’s Blood Services

Guest blog by Adaeze Oreh

When I signed up for the Harvard Kennedy School Implementing Public Policy programme, I thought I knew quite a bit about my policy challenge! I was applying to the programme basically to figure out new concepts and get new tools that would help me as Director of Planning for Nigeria’s Blood Services agency implement those ideas my organisation already had about solving Nigeria’s blood safety problem. You see, my country has a population of over 200 million people and for decades has been bedevilled by a frustrating lack of ready availability of safe blood to meet the country’s needs. This gap has contributed immensely to high maternal death rates, and the large number of children who die before the age of five. As an organisation, we had some ideas in our toolbox to address this, and I hoped IPP under Matt Andrews and the HKS faculty’s guidance would provide the magic bullet for implementation. I was not prepared for the level of insight that the course would provide.

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African Soccer and a Country’s Capabilities to Compete

written by Matt Andrews

I wrote a blog post earlier this week asking if an African country has what it takes to win soccer’s World Cup. Some people asked why I chose that topic—and especially why I took the time to write this longer paper about it! 

The reason is simple. I work on public policy, mostly in developing countries, where many governments try to improve their peoples’ well-being by helping their economies compete better in the world, especially for things like talent, capital, and market access (for exports). These governments are trying to develop the capabilities to compete and I am constantly asking what those capabilities are. 

Soccer gives us a window into identifying the capabilities needed to compete. Like economic policy, sport has a public good feel to it, brings nations into regular competition, and is the subject of many officials’ promises to win. So, I wondered if a view on how well African countries have been competing in soccer could help shed light on the capabilities needed to compete (in any international competition). 

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Independent Evaluation of PDIA Application in Africa

In April 2017, we began our engagement with the Collaborative Africa Budget Reform Initiative (CABRI), an intergovernmental organization based in South Africa, to design and launch the Building Public Financial Management Capabilities (BPFMC) Program using the PDIA approach. In this program, CABRI’s member countries could apply for a team of 5-7 members to work on their locally nominated PFM problem for the period of 7-months. The training included online modules, an in-person framing workshop, virtual progress updates, and an experience sharing workshop at the end of the program. Each team was paired with a coach from CABRI who held regular check-ins to motivate and support them.

Teams from Ghana, Liberia, Lesotho, Nigeria, Sierra Leone, South Africa and The Gambia, participated in the inaugural program from May to December 2017. At the end of the program, the teams made significant progress: they developed a deeper understanding of the root causes of their problems; developed capabilities and confidence; financial reporting rates went up; budgets were prepared faster; and virements and arrears decreased. 

In April 2018, we began a second iteration, this time offering the program in both English and French. Teams from the Central African Republic (CAR), Côte d’Ivoire, Ghana, Lesotho, Liberia, and Nigeria, participated in the program. The Bill & Melinda Gates Foundation, a funder of the program, commissioned an independent evaluation to assess the application of the PDIA approach in the African context.

The evaluation included desk research, baseline and midline surveys of participants, interviews and observations from the framing workshop and experience sharing workshop, field visits to CAR, Lesotho, and Liberia, and interviews and observations from a review seminar, five months after the conclusion of the coaching support from CABRI.

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Embracing flexibility to untangle longstanding policy issues in Nigeria

Guest blog by Tabia Princewill

As a Special Assistant to the Speaker of the House of Representatives in Nigeria, I have experience working in a large, complex bureaucracy and I decided to take this course to learn how to deliver results within a space where state capability has been weakened over the years and where competing political interests often negatively impact the organization’s capacity to produce positive outcomes. I came into the course with a number of assumptions about who holds authority within a structure and I was happy to learn how to challenge traditional notions about the usefulness of top down approaches as well as plan and control methods. My expectations were thus met and mostly surpassed: our supportive team of instructors made learning thought-provoking and fun drawing from global examples of building state capability.

This IPP journey was the unexpected deus ex machina which enabled me to remain productive and hopeful during the COVID 19 pandemic. Despite these unprecedented and incredible circumstances, I gained a real boost by absorbing new tools and perspectives. Some key learnings for me were the “4Ps” (perception, projection, people and process) because this helped me deeply connect with the core of what I needed to do: disappoint political elites at a rate they can absorb and enable a more inquisitive mindset in my work environment so that new stories, new viewpoints and narratives can be heard, instead of the usual practice of allowing ourselves to be locked into one fixed way of thinking.

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Tackling high rates of poverty and low growth among MSMEs in Nigeria

Guest blog by Member Feese

My key learning from the Leading Economic Growth course is how to effectively define a challenge / problem using the 5-whys technique and not use the solution to define the problem. For instance, the definition of my first economic problem was lack of transportation infrastructure in Nigeria, however, I discovered that that definition was narrow and did not identify the main problem of why transportation infrastructure was lacking. Using the 5-whys technique, I was able to redirect my challenge to tackling high rates of poverty and low growth rate among Micro, Small and Medium Enterprises (MSMEs), the binding constraint, concentrating on transportation infrastructure. If poverty and growth rate are addressed, transportation facilities will improve.

According to the Nigerian Bureau of Statistics, the level of poverty in Nigeria is currently about 40% of the total population, 83 million people, with MSMEs contributing a large portion of that figure. MSMEs are a primary source of jobs, accounting for about 96% of businesses and 84% employment (PWC, June 2020). However, the economic climate faces challenges of poor infrastructure, unfriendly business environment, high incidence of informal sector, etc., which adversely affects the MSME sector. More specifically, the current COVID-19 pandemic has impacted negatively on the sector, which has affected household livelihoods across the country.

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Pay attention to the problem!

Guest blog by Gabriel Aduda

My initial attempt at being part of the very first edition of the Implementing Public Policy Program in 2019 was fraught with challenges, due to my work schedule. At that time,  I was responsible for organizing national events in the Presidency, Office of the Secretary to the Government of the Federation and also saddled with organizing the Transition to second term of the Buhari Administration and the Democracy Day 2019 on 12th of June; an activity that was significant, as it was just a few days away from the second term swearing in of Mr. President. The thought of me heading to Boston to attend the physical kickstart of the program at the same period was clearly unthinkable and my boss simply said to me without looking up at me across his table “.I am sure you have deferred your course at Harvard” to which I replied without arguing “on it sir” and I went off to drop Amber a mail…. the rest is history.

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How PDIA helped me build Nigeria’s poverty alleviation plan

Guest blog by Tayo Aduloju

The HKS Implementing Public Policy Executive Program appealed to me because I was looking for an alternative to planning and control styled approaches which I had learnt, known and practised for most of my career and considering the challenging problems I faced daily at the Nigerian Economic Summit Group, I needed a capacity upgrade. The IPP has been a significant deviation from many the other Executive Programs at the HKS I have attended: it underpinned learning by doing; its iterative and group learning dynamics was useful in debating broad-based, cross-multidisciplinary applications and experiences that were very useful in exploring how I applied session insights to real-time problems. My most profound learnings were in the areas of understanding complexity and the importance of construction and deconstruction process. The Fishbone Diagram took on a whole new meaning!

My Implementation Challenge was to design, develop and gain consensus on National Poverty Eradication and Social Protection Plan. My problem was to tackle the complex challenge of lifting 100 Million multi-dimensionally poor Nigerians out of extreme poverty in a decade. My Core Team was a Federal Government inaugurated Poverty Eradication and Social Protection Technical Working Group.

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Fast-tracking Nigeria’s economic recovery

Guest blog by Member Feese

When I registered for the course my conception of public policy was the public definition – a course of action developed by a government in response to public problems. However, I was pleasantly surprised when the course began. I realised that public policy is not only for government but for all citizens that want to make a positive impact in society.

I came into the course with a goal to developing a policy that will help to reduce the level of poverty in the Nigeria. Nigeria is one of the most resourced countries in the world, in terms of human and endowments, yet with a high poverty rate of over 40.1 percent of total population being classified as poor in 2019 (National Bureau of Statistics). This translates to over 82.9 million Nigerians estimated to live below the poverty line. With the current COVID-19 pandemic, the figure is projected to have increased astronomically especially among Micro, Small and Medium Enterprises (MSMEs), due to production slowdown, movement restriction and lockdown which resulted in supply chain disruption.

To address this challenge I knew I wanted to focus on infrastructure however, I was not sure of where to begin. I avoided focusing on capacity building and access to finance as they have been done numerous times and failed to reduce the level of poverty. The government, corporate institutions and individuals have spent resources training entrepreneurs and linking them to funds to start or expand their businesses. However, the cost of doing business has consumed a large portion of the funds. The Nigerian society is plagued with poor infrastructure such as erratic power and water supply and poor transportation facilities which affects the productivity and profits of MSMEs. As a result, I identified the need to address infrastructure.

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