What can we learn from Nigeria’s handling of Ebola?

Just three months after the deadly Ebola Virus touched down in Nigeria, the country was pronounced “Ebola free” by the World Health Organization. In a country with a mobile population of more than 173 million, mixed progress in public health outcomes and challenges in government coordination and delivery, this is a remarkable case of delivery despite the odds, with international assistance playing an ‘arm’s length’ role and Nigerians taking the lead.

But it doesn’t always take a crisis to align the interests of politicians, institutions and the public like this. We recently attended the Overseas Development Institute’s ‘Driving change in challenging contexts’ event where participants presented several cases of how governments delivered despite the odds.

While there’s no clear formula for how to support governments in driving such reforms, a common set of principles and strategies is emerging. One of these principles is to support locally owned ‘pockets of effectiveness,’ which exist at the junction between reform champions and institutional capabilities where ‘politically feasible and institutionally realistic’ change takes place. Change is often non-linear and incremental but understanding how it happens and navigating through “the fog of complex systems, discovering a path as we go along” is key to success.

Technical specialists may ask whether this means that we should just sit back and wait for local reformers to show up to make change happen. We would argue that yes – changeshould be locally driven and owned; and no – we should not just wait and watch.

We shouldn’t throw the baby out with the bath water: technically desirable solutions remain an important part of the puzzle. But we also need to understand how change happens and support the will of viable reformers where it exists.

The evidence on how to do this through principles of flexible, problem driven and adaptive approaches is promising. Agulhas’ 2013 midterm review of the Budget Strengthening Initiative, which supports finance ministries in fragile states suggests that it’s been able to “deliver catalytic impact – that is, strategic results for modest inputs,” with lower costs than comparable programs. A recent review led by the DFID funded Legal Assistance Reform Program also demonstrates positive results.

These promising but small scale pilots attempt to break the mold of more traditional approaches. A steady flow of literature has pointed to limitations of governance frameworks that have traditionally emphasized importing one size fits all “best practice blue prints” from one country context to another. Former colleagues have noted that this has led to ‘isomorphic mimicry’ with changes in form rather than function and imbalances between expectations and actual abilities on the ground, resulting in ‘state capability traps.’

Over the past two years, the Nigeria country team has been carrying out a systematic attempt to “screen” new projects and learn more about “how” we succeed and fail through closing projects. The work suggests that “know your context” is just a first step.  At least three other principles appear to be equally important:

1. Recognizing that technical fixes are only part of the solution and that contexts are complicated and continually changing implies that we should approach our work with modesty. The Nigeria portfolio suggests that when projects take small steps, establish credibility and trust with local stakeholders early on and solve problems in realistic time frames, they seem to do better over time.
2. Breaking down the division between project design and implementation may help shift the emphasis from detailed preparation and Board approval to implementation and careful testing of delivery on the ground.  This might mean simplifying preparation to agree with counterparts on higher level priority outcomes and providing task teams with some freedom on how best to get there.
3. Paying more attention to real time monitoring, evaluation and learning. [[/tweetable]]As teams test a range of options, data and feedback become key to learning by doing. This would lead to better generation and use of applied knowledge – something that’s sorely needed given “the evidence the Bank uses to evaluate projects at completion is typically insufficient,” according to a recent IEG evaluation. Not good news for a global knowledge Bank.

We know that there are good and bad ways to say, design and build water pipes in urban centers. But the challenge is how to combine, alter and draw on these technical fixes in a way that ensures that they will be effective in diverse, local realities. The Ebola response is a great example of how this can be done.

This article is published in collaboration with The World Bank. Publication does not imply endorsement of views by the World Economic Forum.

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Author: Katherine Anne Bank Senior Governance Specialist in World Bank.