PDIA in Practice 1: The Big Stuck and Capability for Policy Implementation

Camila Lobo: Welcome to part 1 of the Practice of PDIA: Building Capability by Delivering Results Podcast series. This 12-part series, based on a video series used for our PDIA online course, will walk you through the PDIA or Problem Driven Iterative Adaptation approach to solving complex development problems. More than 1,500 development practitioners in 90 countries have used the PDIA approach. 

In many developing countries the capability of the state to implement its policies and programs is a key constraint to improving human development. In today’s podcast, we have with us Professor Lant Pritchett who will discuss the big stuck and the capability for policy implementation. 

Welcome Lant! You coined the phrase “the Big Stuck.” What do you mean by that? 

Lant Pritchett: So in the previous video, we talked about the process of development as a four-fold transformation where societies and countries get better in four different dimensions: their economy gets more productive; their polity gets more responsive to citizens; their societies have more equal treatment and; they acquire greater administrative capability. The purpose of this administrative capability is to be able to provide a better life for the citizens of a country. 

We are going to focus throughout this course on administrative capabilities. This is a course about how to build administrative capability. Why are we focusing on administrative capability? because we feel that administrative capabilities are what we call in the big stuck. Meaning people have been attempting to build capability of states and of state organizations and the administration of public policy for decades and decades and decades. No one has ever imagined that state capability wasn’t an important component of development and many things are being done but when we look at the results are we really getting the results out of those things? 

Well it turns out, when you measure, as best one can, both the levels of capability that countries have today and their progress, it looks like we’re not getting to the levels of capability we want with anything like the pace we want. In fact, over the last 12 years most of the developing countries of the world have seen their measures of government capability retrogress rather than making progress. If you are retrogressing and you ask how long will it take us at our pace of progress to achieve a capable state, that’s capable of delivering policy implementation to improve human well-being? If you are going backwards, the answer is it’s going to take you forever. It’s like you’re still in reverse and headed the wrong way the trip will take forever. So in many countries of the world, in more than half, progress is negative it’s retrogress. Then most of the remaining countries in the world are in either states in which capability is very very low in which case these are failed or flailing or fractured or all kinds of f words states. Then there’s a set of states that are making very slow progress so even though progress is positive in order to achieve even a minimal threshold of capability of the type that developed countries enjoy even that at minimum threshold it would take them more than a hundred years to get there. 

We find that very few countries in the world today are on a pace to have adequate capability for their states in less than a hundred years. The purpose of this course is to accelerate that progress and get countries out of the big stuck and into state capability.

Camila Lobo: Thanks, Lant. I have heard you say, “you need to ask the Doctor Phil question.” Can you please explain to the listeners what that means? 

Pritchett: Now, what’s the Dr. Phil question? It is a cultural reference. So in a popular American daytime television show, there’s a self-help psychiatrist that takes calls from callers and answers their questions. Now the typical structure of a Dr. Phil call is a person calls with a problem and they say, oh this is happening in my life, or I have this trouble with my work, or I have this trouble with my son or daughter or have this trouble with my spouse and they describe their trouble. Then Dr. Phil’s first question is, “what are you doing about it?” if you say you have trouble, certainly you are trying to solve the problem and then they list all the things they’re doing it’s not like people are passive and not trying to solve their problem. Then this is the important Dr. Phil question. Dr. Phil says, “how is that working out for you?” now the obvious answer is that if you’re calling in your problem to a daytime talk show self-help psychiatrist, it’s obvious that whatever it is you’re doing is not working out for you. Life generally might not be working out for you, but that’s beyond the scope, but Dr. Phil’s question is very important, “how’s that working out for you?” 

So when you start talking about building state capability, many peoples response is we are doing that, we’ve got this training program, we’ve got these qualifications, we’re undertaking this organizational form, or doing lots of things to build state capability. But as you start into this course we want you to think to ask yourself the question how’s that working out for you? 

If in fact it is working out for you, you could probably drop out of the course right now because if you believe what you’re doing is in fact producing effective results and are building capability you probably don’t need our course. For the rest of you, you need to ask yourself, if my country has been sixty years as an independent country and still has basic problems with public administration, whatever the techniques you thought you were going to use to get to high capability probably isn’t working out for you, and you need something new. What we’re going to provide you with over the extent of this course is something new, something that’s different and a different way of addressing the capability issues you are facing.

Camila Lobo: You always manage to get a point across in such entertaining ways! So, if capability is in a big stuck can you explain to our listeners how the capability for policy implementation is created?

Pritchett: So the first thing is – a policy is a mapping. It’s a mapping that says, “If this is the fact do this action.” So a policy is: If it is raining, open an umbrella. If it is not raining, don’t open an umbrella. That’s facts about the world that specify what actions to take when that’s the fact. Now, the complicated thing about policy implementation in a public setting is that often the fact has to be administratively created. What is the relevant fact isn’t necessarily the brute fact of the world. It’s the fact as it is constructed into an administrative fact by the very policy-making apparatus itself. So let me give a concrete example. 

A tax. If I have a property tax what a property tax says is “if the value of your property is this you’ll owe this much in tax.” But the value of your property is as it is declared and administratively adjudicated for the purpose of the tax. It may have nothing to do in fact with the value of your property for other purposes. But the tax authority both has responsibility for declaring and creating the administrative fact of the value of your property and then taking the appropriate action: Here’s how much tax you can collect. 

Now, what happens is when organizations have low capability for policy implementation they often lose control essentially of the administrative facts and therefore the actions never follow. Not because the actions don’t follow with the administrative fact is but because the administrative fact itself becomes a fiction. 

There’s a great example in a study that was done about trying to increase the attendance of the low-level healthcare workers — the auxiliary nurse/midwives in the state of Rajasthan. They weren’t showing up to the sub-centers. And since they weren’t showing up people weren’t coming. Since people weren’t coming they weren’t getting the healthcare services they needed. 

So … a team of and NGO working together with the government and a group of researchers designed a program that would say “we’re going to hire a new set of auxiliary nurse/midwives and these nurse/midwives will only get paid their full salary if they are not absent more than fifty percent of the time. So seems really clear. The nurses show up. If they don’t show up they don’t get paid their full salary. This should motivate the nurses to show up. If the nurses show up we’ll get people and the clinic will improve health status. All a very clear, logical chain. 

What happened? 

What happened is by six months into the study period they found that the administratively declared absences of the nurses had gone way down so there was much less recorded absenteeism. 

So you think “victory”. But the study team was measuring the physical presence of the nurses at the clinics at the same time. And, you know what? Presence of the nurses went down. Now you might think, “well, wait a second. Either the nurses are present or they are absent.” But that’s…you haven’t worked in a bureaucracy long enough. There is a third category, which is the nurse is not physically present. But she’s not absent – she’s declared that she’s not required to be there as part of other administrative responsibilities. 

What had happened is once you put pressure on the nurses about the fact of their absence you created this whole secondary system in which the administrative fact was the nurse wasn’t absent. The fact of the matter was she wasn’t present to deliver healthcare either. And the whole program the gap between the facts on the ground as perceived by the actual users and the administrative facts as declared about the absence of the nurses diverged so that both presence went down and absence went down and you were actually in a worse situation because you had lost control essentially of the gap between the administrative fact which was now a fiction about actual presence and the facts on the ground that were relevant to the delivery of the service. 

So the capability for policy implementation needs to be able to get your agents responsible for creating the administrative facts to declare the facts to be what is relevant for purposes of accomplishing the objectives of the policy.

Camila Lobo: Thank you for listening to part one of the Practice of PDIA podcast series. Tune in to listen to part two where we discuss the techniques of successful failure. To learn more, visit bsc.cid.harvard.edu.