Improving Planning and Policy in Pakistan
22 Feb 2017: Seminar at MoPD&R on how we can improve planning and policy making in context of Health & Nutrition. The seminar was based on the Outcomes and Conclusions of the Brainstorming Session on Policy Priorities for Health & Nutrition held at PIDE Friday 17th Feb 2017. An Executive Summary and outline of points made at the seminar is listed below. Somewhat more detailed minutes of the Brainstorming Session are also given at bottom of linked page: bit.do/azmpdr1
A Brainstorming Session on policy priorities for “Health & Nutrition” was held at PIDE on 17th Feb 2017, with the goal of identify the major issues that we urgently need to address in this sector. Participants from Planning, PIDE, PPAF, SUN Network and Shifa Medical College attended the meeting (List attached below). An executive summary of actionable items arising from this discussion, and subsequent seminar on the same topic, is presented below for necessary action.
- The body of the planning process is sound, but the spirit of serving the people is missing. This is as essential as petrol to run a car. We need to encourage the development of this spirit among bureaucrats, who should see themselves as “public servants” in the true meaning of the word. A seminar on this topic was delivered by Dr. Asad Zaman, VC PIDE, at the Planning Commission on 21st February as a model of the effort that needs to be made in this direction.
ACTION PLAN: Member Communications + Our own Communication Strategy Person should brainstorm on initiatives that need to be taken, to promote the spirit of public service everywhere in general, and in PIDE and Planning Commission in particular.
- There is a strong tendency to ignore and criticize existing on ground projects as failures, and start fresh projects without studying the ground realities, and the causes of success and failure of earlier projects. Buildings cannot be constructed if everyone abandons previous structures, and starts putting bricks down on a new location. This tendency needs to be combatted in the following ways.
- Quite often, there are successful planning interventions, but we do not learn from them, and replicate them at large scale. Just being able to transplant best practices would achieve marvels in developments – we do not need to borrow models from outer space.
- Quite often, failures are just one small step away from success, and they are abandoned or neglected. Large amounts of effort need to go into an evaluation of existing projects, with the goal of tweaking them to improve their performance.
- We need to do a thorough job of evaluating existing projects, ensuring completions of PC-IV and PC-V for at least the larger projects. This is essential to learn from experience. As it is, we keep repeating the same mistakes
ACTION PLAN: A systematic failure is the expectation (never fulfilled) that those executing the project will themselves evaluate the project. This creates the wrong incentives and ensures the perpetuation of current state of affairs where no projects are evaluated, and no lessons learnt from experience. In the future, simultaneously with the approval of the PC-1, an independent body of auditors and evaluators should be hired to report on the performance, and to produce the PC-IV and PC-V. They should be paid directly by the Planning Commission out of funds reserved in the PC-1 for this purpose. For major ongoing projects, we need to implement this right now: fund an independent audit group to (a) suggest how we can improve efficiency of the project and (b) create the PC-IV evaluation forms, with the idea of documenting the experience, so that we can learn from it. Again, it would be of great importance to involve the stakeholders in this evaluation – those involved in service delivery as well as those who are recipients of the service being provided. PIDE is prepared to facilitate this process. Money for evaluation should be built into the project PC-1 and should be released directly to the auditors, instead of asking project executors to hire auditors, or to do self-evaluations. A SEPARATE TASK FORCE should identify major success stories in projects, and devise strategies to replicate best practices across the board.
- A major problem identified was lack of ownership of the projects, and a very paternalistic attitude, a leftover remnant of the colonial bureaucratic tradition. Instead of letting communities take the lead in identifying their own problems and finding means to solve them, we wish to do it on their behalf, which results in lack of ownership. We should strive to ensure that the PC-1 projects are planned and initiated by the communities being served, and provide them help with this process.
ACTION PLAN: Current PC-1s have provision for ensuring that community being served has some input into the project but this is not taken seriously in evaluation of PC-1s. We need to insist on community participation in the preparation of PC-1s. In addition, some change of rules is required to enable and empower communities to originate their own PC-1s for projects with the assistance of relevant ministries.
- Behavioral psychologists have identified a major source of irrational human behavior: our tendency to find free offers irresistible. Whenever foreign donors come in with strange projects, we don’t look gift horses in the mouth, and agree to do whatever they suggest on the false assumption this is a free gift. Millions are wasted, and certain types of debt traps are created because we too eagerly accept gifts without close examination.
ACTION PLAN: A sophisticated evaluation of all projects with foreign donors using independent auditors is required to ensure that we don’t allow donors to test experimental medicines and treatments on our children. This can be done along the same lines as in the previous actions plan.