System’s thinking in the context of development aid How to intervene in complex realities?

Objectives of the training I hope I will be able to amaze you, to get your interest, to explain something I cannot know what you or myself will reach with this training We are going to look into the tools for sector analysis, formulations and conception of interventions, management of programmes and projects, M&E, partnerships in the light of system’s thinking Do we know our job? (exercise)

What are systems? A system is a set of elements and their inter-relations

Exercise Animal Farm

Results? We are thought to think in elements (analytical mind) You saw mammals You saw mammals grouped by continents You saw an exception: the swan The swan is exception in 2 ways: not a mammal, not confined to one continent

Game over ? Recognising interrelations between elements is looking at another reality The elements are defined differently if put in their relation to other elements

Darwin : system thinker by excellence Survival of the fittest Survival through the most successful partner Evolution Genetics Not the lion but the virus kills… Ecology Bio-diversity

Other examples… The difference between a grain of sand and a heap of sand? Even if the elements are all equal…. A heap of spare parts or a car? From atoms, to molecules, to life….

The human being is a system

A small story about a lady in Niger ……

The person is more than her disease or organ By considering the person as a whole, the solution became clear You have to know the system (technical requirements): uncles are more important than parents in this African context The environment determines the system (see later)

Hegel, structuralism, health centres and primary schools “There is only truth in the synthesis, the whole, never in the elements” (Hegel) Claude Levi-Strauss: anthropology evolves from the study of an individual or an individual ‘tribe’ to discovering the common structures (relations, structuralism) A health centre produces health only if it can refer serious cases to a hospital Primary schools make more sense if pupils can go to secondary or technical schools afterwards

Not elements but their interrelations determine systems Traditional analytical thinking: always more and smaller elements System’s thinking: not the elements but their interrelations Context thinking, networks,

A system? No system if elements without ‘interrelations’ Recognising a system = recognising coherence, order within chaos

The 1960’s and ’70s: projects, projects, projects, ….. ??? Traditional projects denied the system in which they were operating Islands of nice realisations do not address the system’s failures

2010, Uganda, professional education…… Nursing Schools Two technical Schools Teachers’ School Paradigms changed? …..

2010, Uganda, professional education, sector analysis…… Ministry of Education Primary Education Secondary Education Technical education Education sector Health sector MoH Nursing schools

Burundi “Rehabilitation of paramedical schools” School for lab- technicians Private schools? 3 nursing schools Euros Ministry of Health Direction of HR 3 nursing schools HR management in MoH Institutional strengthening project Euros Euros Euros Support to health services in 1 province

Recapitulation: systems are defined by elements and their interrelations The interrelations make us understand the system’s dynamics Continuation: Systems and their environment

Systems and their environment Exercise: Bath tube: 2m by 0.5 m, height of water : 0.3 m Room T°: 20°C Warm water : 65°C; 5 L/minute / Cold water : 15°C; 10 L/min A good bath: 34°C Loss of heat: 100 Kcal / minute at 26°C, 500 Kcal/min at 34°C What is the most energy-saving way of filling your bath tube: Cold and Warm both at highest speed First cold as to prevent loss of heat to a maximum First hot water as not to overshoot I do not have enough elements to decide I am not intelligent enough to find the answer….

Systems and their environment Muslim communities in the West are more chauvinist than in their own country Health services cannot address child mortality without socio-economic development Poorer people in progressing societies are more optimistic than richer people in regressing societies There is much more homosexuality / tuberculosis in prison environment Jobless people have a higher risk to become criminals irrespective of their race or culture By the way: What is a structural problem? Antwerp community Muslim community Rwandese refugees in Belgium Belgium

Systems and their environment Systems are always part of a wider system: their environment Systems, sub-systems Systems are always defined in their environment So what?

Systems and their environment The environment determines the system The environment is more powerful than the system Systems are part of ever bigger systems: no clear boundaries / OPEN systems The boundaries are man-defined and should be functional and strategic (see before coherence..)

Sectors are complex systems The health sector The education sector The social sector? Capacity building ? Rural Routes, Rural dust routes and boats ?  Institutional strengthening in the X sector?  Rural transport? Transport? Public transport?

Sector definitions A sector is a complex sub-system within a society / country It is not a natural entity but humanly defined: it exists only in our conception. The boundaries are open (“Open systems”) A sector is defined by its elements, their interrelations and by the environment in which it is defined

Reducing sectors for more coherence in development aid? OECD: Reduce N° of sectors for more coherence, efficiency, division of labour Only if sectors are defined coherently Only if sectors are defined commonly (by partner country?) Sometimes increasing sectors can lead to more coherence Inter-sectoral interventions are inevitable OECD should talk about coherence within system’s thinking rather than of reducing sectors (Reducing sectors = indicator of coherence = objective on itself : see further)

Projects / development interventions are part of a Complex System Socio-Economic and Political Environment The Sector Projects

Environment is often left implicitly.. Fg = G X m1 X m2 x² P = m X g X h K = 1/2mv²

Marchal Plan Environment is often left implicitly..

Marchal Plan

Marchal Plan for Africa? Budget support for Africa?

Marchal Plan Marchal Plan for Africa? Budget support for Africa?

Environment is often left implicitly.. PBF in Rwanda or Burundi Every project defined by (some) elements Every evaluation based on logical frame Corruption… Private sector in health in Belgium and in Africa ……

Recapitulation: Every system acts in its environment which is more powerful and actually determines the quality of the system Continuation: Systems behaviour: a dynamic equilibrium

System behaviour: dynamic equilibrium Apparent chaos, complexity….

System behaviour: dynamic equilibrium Regulating factor: Negative feedback Systems seem to live a conservative life No linear causality, no cause-effect reasoning possible Law of diminishing returns

Investments of an intervention Results / impact Resistance to change Negative feedback

Law of diminishing returns Over-financing of elements possible, even likely Concentrating on one problem always wrong Ex: investing in tuberculosis or in health care including tuberculosis? Investing in primary schools or in the education sector? Searching the optimal effort level per problem

Law of diminishing returns Important problem - vulnerable problem? Relativism, for everything also the opposite exists Priorities change over time (see further) Unpredictable results offer new opportunities Opportunities = creativity = flexibility

System behaviour: Positive feedback? One can destroy a system…..

Down to earth: A landslide Financial crisis: vlinder-effect

Recapitulation: Systems behave autonomously and tend towards a dynamic equilibrium. They resist change Continuation: Changing systems – working with systems

Changing systems? A little story, a little demonstration The man who wanted to go to work in less time “Mulan” at war… A glass on the table Tunisia…..

Changing systems? A lot of effort, no apparent change, but:  System under tension  Systems change in a discontinuous way

Kuhn and scientific revolutions… Inputs and quantitative changes System under tension Paradigm under tension Environment ready for system to change Balancing system Qualitative changes Change of paradigm New dynamic equilibrium

Changing systems? Systems tend towards a dynamic equilibrium Systems adapt to their environment: changing the environment is often changing the system Systems need consistency, perseverance, long-term efforts to change Systems should be attacked from different and strategic angles at the time Systems do not change in a linear way: no input – output – outcome – impact Quantity and quality changes By the way: what is a strategic intervention / action?

Changing systems? Does the man reach his work earlier? Strategic « entry points » Perverse effects…

Does the man reach his work earlier? On foot he has to walk 10 km at 5km/hr By car he would drive at an average speed of 60 km/hr But he has to travel over 12 km But so many other people had the same idea, he is driving only at 20 km/hr because of traffic jam.

Changing systems? Uncertainty Managing complex systems: decisions in uncertainty Decision = working hypothesis Managing a decision = testing the hypothesis Managing multiple decisions = action-research Management in uncertainty: – Better a bad than no decision – Recognising opportunities – Dynamism

Changing systems? Formulation and 5 year planning? Logical frame? Strategic SMCL decisions? Baseline studies?

Recapitulation: Development aid = changing systems. Systems do not change easily, among other things because of the powerful environment in which they behave Continuation: Action- research : tool by excellence for working in / with systems

Changing systems? Action Research….

Le Cycle de Management ÉvaluationProblème Identifié Solution Proposée Application de la Solution

Définition du Management Processus Cyclique / Continu Prise de décisions Mise en œuvre et suivi Approche systémique

Schéma global de management Évaluation Analytique (E.A.) Décisions Empiriques (D.E.) Évaluation Opérationnelle (E.O.) Instructions Opérationnelles Écrites (I.O.) Supervision Cercles de Qualité Supervision Cercles de Qualité Expérience ; Connaissance de l’Environnement Modèle d’un Système de Santé Science Rapports de Recherche

Les Décisions Empiriques Expérience ; Connaissance de l’Environnement Modèle d’un Système de Santé Science Décisions Empiriques (D.E.) Évaluation Analytique (E.A.) Évaluation Opérationnelle (E.O.) Instructions Opérationnelles Écrites (I.O.) Rapports de Recherche

Dynamique de la Prise de Décision Le Droit à la Décision / le pouvoir de décision Gérer les décisions, pas les problèmes Gérer les décisions, pas une décision Les décisions sont empiriques: la peur pour la prise de décision Les décisions ‘à la marge’

Instructions Opérationnelles Écrites (I.O.) Supervision Cercles de Qualité Expérience ; Connaissance de l’Environnement Modèle d’un Système de Santé Science Évaluation Analytique (E.A.) Décisions Empiriques (D.E.) Évaluation Opérationnelle (E.O.) Rapports de Recherche

La Relation entre les Instructions et les Normes Les normes expriment quantitativement la qualité qu’on voudrait atteindre (seuil minimal, seuil optimal) Les normes sont souvent nationales et ne sont pas adaptées à un terrain particulier Les normes n’indiquent pas ‘le comment’ et ont tendance à ne pas tenir compte des autres activités

La Relation entre les Instructions et les Normes (2) Les instructions sont spécifiques à l’environnement dans lequel elles doivent être exécutées et tiennent compte des autres activités à mener Les instructions contiennent des stratégies pour atteindre les objectifs et éventuellement la norme Les instructions sont dénudées de ‘l’argumentation’ (= pourquoi de l’IO)

Évaluation Opérationnelle Expérience ; Connaissance de l’Environnement Modèle d’un Système de Santé Science Évaluation Analytique (E.A.) Décisions Empiriques (D.E.) Instructions Opérationnelles Écrites (I.O.) Rapports de Recherche Évaluation Opérationnelle (E.O.) Supervision Cercles de Qualité

Évaluation Opérationnelle (2) « Est-ce que l’infirmier fait ce qu’il est sensé de faire? » « Est-ce que l’infirmier fait ça correctement? » Si « OUI »: instruction de bonne qualité, évaluation analytique possible Si « NON »: chercher le pourquoi et prendre des mesures conformes

Évaluation Analytique Expérience ; Connaissance de l’Environnement Modèle d’un Système de Santé Science Décisions Empiriques (D.E.) Évaluation Opérationnelle (E.O.) Instructions Opérationnelles Écrites (I.O.) Évaluation Analytique (E.A.) Rapports de Recherche

Évaluation Analytique (2) Est-ce que la (les) décision(s) a / ont abouti au résultat escompté? Si « OUI » ou « Partiellement »: Comment on peut s’améliorer davantage (gestion des décisions!!!) ? Si « NON »: Qu’est-ce qu’il faut faire maintenant?

Relation entre Management et Recherche RECHERCHE- ACTION MANAGEMENT ExpérienceModèle de santé Science Décision Empirique Instruction Opérationnelle Évaluation Opérationnelle Évaluation Analytique

Critères d’une vraie recherche action La RA émane et fait partie d’une gestion poussée d’un système : pas de RA dans un système non-géré Dans une RA la prise de décision est fondamentale, et basée sur des connaissances de terrain et scientifiques comme sur un modèle du secteur explicit Une RA gère la décision, pas le problème La RA vise d’abord le changement local de la réalité avant de vouloir produire des résultats de recherche: ACTION

Critères d’une vraie recherche action Il faut dans chaque RA distinguer une évaluation opérationnelle et analytique La conclusion d’une RA doit influencer de nouvelles décisions La RA vise dépasser le système local

Some practical examples AR on Vitamin A AR on emergency evacuation system AR on integrated Family planning services