Governance Diagnostics: A Taxonomy

by Elmer S. Soriano

Kung gusto, may paraan. Kung ayaw, may dahilan.

This expression roughly means, "When there is a will, there is a way. When something is undesired, there is an excuse."

Policy in the context of devolved health services can be confusing because national agencies and local government units can blame each other for shortcomings. At the national level, the national agency may have a policy of health as a basic human right, and universal health care coverage. At the local level, mayors may claim autonomy over leading the municipal health system.

To help clarify the matter, Prichett and Sharma (2008) present a nomenclature that sharpens the discussion.

A policy is a mapping between states of the world and actions by an agent of an organization. This is true of a government policy or the policy of a retail store (“refunds only with a receipt”) or a fire insurance policy (an agreement on payments conditional on realization of states of the world).

A de jure policy or notional policy is a statement of the desired mapping from the states of the world without a complete specification of the way in which the policy will be implemented.

A de facto or realized policy is either a description of what will happen across
states of the world. The notional policy is one element of realized policy but realized
policy can either be very close to notional policy or realized policy may in fact have very little to do with notional policy.

A policy action is just one outcome of the implementation of a realized policy. A complete policy specification includes not only a description of the notional policy (the mapping from states of the world to actions) but also a coherent behavioral model of the actions of the agents responsible for policy implementation and a specification of the mechanisms influencing the incentives facing the agents.

The mechanisms of policy implementation include a specification of the operation
of the direct organizations of implementation, in particular the actual processes whereby states of the world are determined organizationally (e.g. who has authority to determine the state of the world, the processes and procedures to be used, how state of the world declarations can be contested internally or externally) and the background institutions that constrain the organizations in mechanism design (and the specification of background institutions with respect to one policy may include direct organizations of implementation). For instance, an organization may desire to have a policy in which its agents caught stealing are fired, a relevant background institution might be organizations which provide worker protection from dismissal which make this difficult or impossible. 

Capability (of the state broadly or a specific organization) can be defined as the ability to consistently produce actions by the agents of the organization across a variety of situations (states of the world) that comply with organizational policies and procedures and further the goals of the organization. This is as true of private firms as not-for profit organizations (from religions to universities to hospitals) as for government agencies. This needn’t involve mimicking the organizational practices of private firms—it can be accomplished in a variety of ways from high powered incentives to fear and intimidation to rigorous selectivity to sustained inculcation of the organization’s values (and likely some combination of all of the above).

Source: Pritchett and Sharma (2008)

In the case of the Philippine health policies defining tuberculosis care, there are a number of de jure or notional policies, namely: Kalusugan Pangkalahatan (universal health care), National Tuberculosis Program, and the devolution of health services.

However, the de facto policy is that devolution is a dominant notional policy, such that mayors have been given, in effect, the power to veto the Universal Health Care policy and the National Tuberculosis Policy. The fact that multiple-drug resistant TB is rising due to gaps induced by mayors, and this is allowed by DOH Regional Directors illustrates this de facto policy.

Source: Pritchett and Sharma (2008) http://www.hks.harvard.edu/fs/lpritch/NEW%20docs,%20ppts,%20etc/Implementing%20Growth%20Analytics.pdf

Varieties of Leadership Training and Development

by Elmer S. Soriano

Civika Leadership Institute has the opportunity of working with leaders in various organizational settings and currently has a number of approaches to help leaders grow.

In partnership with the Asian Institute of Management, Johns Hopkins University (JHU), Campaigns and Grey, and USAID, the Communications for Communicators School (www.c4cschool.com) is an in-service communications fellowship that combines the JHU P Framework for health communications, with AIM's Bridging Leadership and development management courses. Some 80 mid-career practitioners in the health sector enroll in a 6-month course which includes three classroom workshops with practicum work and coaching in between. Each C4C Fellow works on a health communications campaign and completes the P Framework cycle. Started by Yoly Ong, the C4C aims to scale up world-class in-service leadership training within the bureaucracy.

Also in the health sector, Civika Institute works with the Zuellig Family Foundation in implementing the Health Leadership and Governance Program covering over 600 LGUs. Interventions include training, coaching, program data management and facilitating development of the local social networks that support maternal health. This program draws heavily from the work of MIT's Otto Scharmer, Amartya Sen, and Ernesto Garilao's Bridging Leadership. There must be around 100 mayors who have already finished the course and over 500 staff of the Department of Health of the Philippines. 

In the broader field of local governance, we had the wonderful opportunity to launch the Governance Innovation Lab with the Galing Pook Foundation. Galing Pook has been an award-giving body for the past 20 years, Galing Pook Foundation now aims to catalyze the replication of innovative practices. Dr.Eddie Dorotan, it's Executive Director, has wisely invested in developing a TV series on innovations on local governance which can now serve as the material for various courses in governance.

We also had the opportunity of co-convening the Digital Strategies for Development Summit in October of 2014. With five thematic streams and over 300 participants, it was a well-attended summit that served as an ASEAN platform for knowledge-sharing on technology-enabled development.

Our most recent offering now is the Resiliency Leadership Innovations Fellowship which combines Scharmer's U-Lab course on EdX with the knowledge on resiliency leadership. Starting with 10 Fellows, we aim to deepen our offerings in the resiliency leadership and governance space.

Nodal Governance: Unleashing the Potential of Global Citizenship

by Elmer S. Soriano

Is it possible to have governance without government? 

The idea of public leadership untethered from the bureaucracy has a lot of potential especially in contexts where government has been crippled by disaster, and where government is not trusted under normal circumstances.

Imagine a set of a few million professionals: doctors, nurses, engineers, managers, realtors, etc. collectively organizing themselves to get work done for a certain cause. That is exactly what happened when Supertyphoon Yolanda struck in 2013.

The thought of massive destruction and death aroused powerful feelings of kinship among Filipinos abroad. The Supertyphoon was a powerful frame that allowed individuals to recognize needs far bigger than any mayor could handle alone, and it was from within this mindset that old boundaries blurred and individuals acted beyond the confines of their job descriptions and stepped up to work collectively to rebuild devastated communities. 

The article #YolandaPH (Haiyan): Filipinos worldwide heed call to action by Rappler lists dozens of organizations mobilizing thousands of individuals just days after Haiyan struck.

The term "nodal governance" has been used by Burris et al as "a variety of actors operating within social systems interact along networks to govern the systems they inhabit."

"...that any collectivity can be understood to be an ‘outcome-generating system’ (‘OGS’) whose workings are generally too complex to be fully understood. Inhabitants develop forms of governance as a strategic adaptation to complexity. Our theory posits that governance in such systems is substantially constituted in nodes — institutions with a set of technologies, mentalities and resources — that mobilize the knowledge and capacity of members to manage the course of events. Nodes are normally but not essentially points on networks, but networks are a prime means through which nodes exert influence.

Source: http://www.temple.edu/lawschool/phrhcs/salzburg/Nodal_Governance_Article.pdf

The movie Fire in the Blood describes an OGS in the context of global HIV work. It shows how networks adapt and how complex dependencies emerge as nodal leaders and nodal governance is generated.

Translation Failure in Climate Change

"Storm surge" was a new term for most mayors who were warned about the impending supertyphooon Yolanda. For many mayors, strong typhoons were a common experience so they interpreted the warnings as just another typhoon.

This is one tragic case of translation failure. Meteorologists communicated technical warnings in earnest, but local leaders and policymakers decoded it wrongly. The correct technical term "storm surge" communicated by the meteorologists were not understood by those who needed to act on those signals. 

The Zuellig Family Foundation has developed an interesting tool for converging what Catacutan (2009) refers to as Political Knowledge, Scientific Knowledge, and Local Knowledge. 

The photo below is a mayor's health governance dashboard used by Philippine mayors in targetting their governance interventions in the area of maternal health.

It has six columns, corresponding to the Six Building Blocks of health systems by the World Health Organization. These columns are anchored in the evidence-based, scientific knowledge promoted by WHO. The cells within the columns are color-coded red, yellow, and green, corresponding to the signals in a traffic light. Each cell corresponds to national and local initiatives institutions that contribute to maternal health. It includes elements such as social mobilization called Barangay Health Summits.

A mayor merely has to look for the red and yellow cells in this dashboard in order to prioritize. He recieves leadership coaching so that he can act on the technical and adaptive challenges indicated by the yellow or red cells. A coach then walks the mayor through the technical and adaptive issues, decision criteria, dependencies, and procedures in order to convert a cell from red to green. 

Climate change induces such translation gaps because new technical signals have to be disseminated and communicated to leaders. Leaders have to learn these technical signals in order to respond accordingly.

Translational medicine or translational science focuses on delivering knowledge from the research lab "bench-to-bedside", in the case of health research. This is also applicable to the work of resiliency and disaster risk reduction.

Sources:
 Catacutan (2009)