Governance Week in Review

This Week in Review by Robbie Lawrence is part of the Wikiprogress Governance Series

‘Good governance is the foundation on which a society is built, and thus it is indispensable for the development of a country.’ Dirk Niebel, German Minister for Economic Cooperation and Development

As you all know we are focusing on Governance this month, so today’s Week in Review will provide you with an insight into a number of key reports (and a video!) related to the subject. The article includes overviews of the current Wikichild Spotlight, UN Habitat’s State of the Field in Youth-Led Development, UNDP’s Global Consultation on Governance and the Post 2015 framework and Beth Noveck’s Ted Talk, ‘Demand a more open-source government’.  

First published in Nairobi last year, UN-HABITAT’s State of the Field in Youth Development sheds light on how youth are positively impacting communities around the world. As part of wider series, this particular report stresses how young people can be beneficial to communities, and how local, national and international governments can implement, engage and support youth and youth led initiatives. ‘State of the Field’ then goes further and identifies youth led organizations that need more support, financial and otherwise, that could in the future make the most difference. This framework of initiatives was first put in place at the World Youth Congress in October 1999 and since then has expanded to a global form of youth led participation.

Developed by UNICEF and Save the Children, Children's Rights andBusiness Principles provides a comprehensive framework for understanding and addressing the impact of business on the rights and well-being of children. While most businesses are aware that 'children are our future,' the voices of young people are often ostracized when it comes to the corporate sustainability movement. The Children’s Rights and Business Principles are built on existing standards and practices and help to explain the opportunities for business of investing in children.  

The UNDP is currently running a global thematic consultation on governance in the lead up to the post-2015 framework. Similar to Wikiprogress, Wikigender and Wikichild online discussions, this is an open forum for individuals, policy makers, NGOs, UN staff and other stakeholders to discuss how governance can be used to tackle the most pressing issues (inequality etc) facing the post-2015 panel.  Make your voice heard!

The Human Development Report 2013 examines the noticeable transition in global dynamics catalysed by the fast-rising new powers of the developing world and its long-term implications for human development. The report series provides an overview of health, education and basic living standards across the world so that governments and decision makers can make more accurate and comprehensive decisions to boost progress.

What can governments learn from the open-data revolution? In this striking talk (below), Beth Noveck, the former deputy CTO at the White House, shares a vision of practical openness - connecting bureaucracies to citizens, sharing data and creating a truly participatory democracy.

We look forward to bringing you more Governance related articles in the coming weeks!

The Wikiprogress Team

What’s driving the quiet revolution in basic healthcare?

This article by Romina Rodriguez Pose, ODI, is part of the Wikiprogress #health series.

Rarely a day goes by when the news is not filled with both warnings about possible epidemics and more encouraging tales of medical breakthroughs. And yet, while these often extreme perspectives occupy the limelight, more nuanced and in-depth understandings of how and why things are working in certain countries and not in others remains relatively unheard.

Health is a key component of ODI’s Development Progress project, which for the past three years has been documenting national-level case studies (on what is working in development and why), enabling us to reflect on how far we have come in addressing basic health issues around the world and uncover hidden stories of progress.

The project’s first-round health case studies explored progress in Bangladesh, Eritrea and Rwanda and were carried out between 2009 and 2011. The second round, currently underway, has two focus areas: maternal health (with case studies in Nepal and Mozambique) and neglected tropical diseases (NTDs) (Sierra Leone and Cambodia).

Maternal health is intrinsically important because people’s prospects in life depend on it to a large extent. It is also a proxy for the capacity and strength of health systems and government’s ability to deliver core services. NTDs are of particular interest as they disproportionally affect the world’s poorest and are dependent on and can accelerate progress in a range of other development areas (poverty, nutrition, water and sanitation, women’s empowerment, education).

Although these countries represent very different local contexts, we can identify clear and consistent factors driving progress across them all:

• Strong leadership and sustained political commitment have been key to pushing through reforms and engaging populations in development processes. Progress is not possible without the prioritisation of health within governments’ agendas.

• Bottom-up approaches invoking social mobilisation and community participation were the cornerstone for progress in all three case studies in the first round, and preliminary findings from Nepal and Sierra Leone support this trend. Community participation and involvement in health service delivery have not only helped alleviate staff shortages, but also proved extremely effective in accessing hard-to-reach populations, bringing services closer to the community while at the same time allowing for behavioural change. They have also transformed community members from being passive recipients to being active participants in their own development and wellbeing. Among other things, the empowerment of women and their increased decision-making power in health matters has been key in both Bangladesh and Nepal.

• The role of donors has been instrumental, not only financially but also through the provision of evidence of successful schemes in similar countries. All the countries studied are heavily dependent on external funding, but all have mechanisms to ensure funding is aligned with national planning (e.g.implementation of health sector-wide approaches has helped governments shape health policy, strengthen delivery and make health financing more predictable and flexible). Balancing government ownership of a development agenda with outside help can be challenging but is essential to ensure commitment and sustainability. Ownership varies across the countries studied, with some governments acting more strongly than others in responding to priorities on the development agenda.

• Both demand- and supply-side interventions have been put in place and contribute towards progress in health in these countries. Community health insurance schemes (e.g. mutuelles de santé in Rwanda) and removal of users fees (e.g. free health care for pregnant and breastfeeding women and children under five in Sierra Leone) have boosted demand for health services by removing financial barriers for underserved populations. From a supply point of view, rewarding health service providers for their performance incentivises them and enhances their commitment to working to higher standards in the delivery of services, although strong controls and quality checks need to be in place.

Despite the high levels of progress these strategies have attained, challenges remain. For instance, the provision of health services has relied widely on community involvement and voluntarism. Despite volunteers being rewarded in terms of respect shown by members of their communities and by the few incentives in place (e.g. provision of mobile phones, T-shirts etc.), keeping them motivated is becoming increasingly challenging. In the same vein, progress has been possible as a result of the financial flows provided by donor countries, which puts sustainability in question, as aid budgets in the developed world are under threat. As such, there is still a need for countries to mobilise internal resources in order to reduce their dependence on aid.

The bigger picture, however, should put a spring in our step. We can state, without doubt, that progress in health care is happening and reaching the most underserved populations in the poorest countries in the world. The increasing body of evidence documenting how progress has been achieved in some settings provides a great opportunity for policymakers from countries facing similar challenges to get inspired by successful strategies and best practices that have worked elsewhere.