Bringing policy-makers closer to people

HOW do policy-makers know what effect their policies are having on the people they serve? For the past four years, an innovative Swedish International Development Cooperation Agency (Sida) initiative in Bangladesh has been trying to address this question. The Reality Check project has specially-trained field teams who visit and spend quality time with ordinary households living in poverty in different parts of the country in order to try to learn from them.
Billions of dollars of international donor money have in recent years been invested in improving basic services through health and education sector reforms. The Health, Nutrition and Population Sector Programme (2004-10) was a $3.5bn investment, and the Second Primary Education Development Programme (2003-10) has cost $1.8bn.
Each year, teams spend five days and four nights living with the same families, listening to their stories, and documenting their experiences of trying to access and use services from government, non-governmental and private sector providers. The data is written up into an annual report for policy-makers and widely circulated.
There are some good news stories emerging. Parents still believe strongly in the value of education for their children. Traditional birth attendants and community pharmacists often do a heroic job in meeting poor people's basic health needs, even when local conditions are harsh and resources scarce. Good leadership in a local school or health centre can make an enormous difference in the performance of these facilities. Effective and public-spirited individuals can create dynamic and responsive institutions -- even though such people, sadly, seem to be the exception rather than the norm.
In Bangladesh, with a population of around 160 million and only a rudimentary public health and education system that struggles to meet people's basic needs, there is still much to be done. Despite near universal primary education, overall quality remains low. While the government has emphasised a new ethos of "joyful learning," the culture of the classroom remains uninspiring. Boys in particular say they get little from classes, and often truant or leave.
Public hospitals and clinics often function poorly. They remain unpopular because they have very few useful services to offer and informal charges are imposed on people who try to access them. Their staff are often overbearing and rude. Some are little more than places for people to go just to collect free, often unneeded, drugs such as antibiotics.
Despite the poverty of these households, they are constantly trying to improve their position. They struggle to piece together a viable system of services using a combination of whatever public, private, nongovernmental and informal providers they can find. This patchwork approach makes it possible for many to survive, but is far from adequate.
The Reality Check helps get grassroots information up to policymakers quickly and simply, so that they can make course corrections or investigate in more depth using conventional monitoring, evaluation or research. For example, informants regularly report their dislike of the ineffective and bureaucratic school stipends system and support is now gathering for extending preferred school feeding programmes.
The Reality Check findings also challenge some conventional wisdom. For example, while some children do "drop out" of school due to economic pressures at home, more actually do so simply because school fails to engage their interest.
All this has potentially important implications for wider development policy. For example, in the face of badly performing public service systems, how do we reform them more effectively, and how do we better regulate private and non-governmental providers to help strengthen provision?
The Reality Check reminds us of the potential dangers of policy becoming too distant from the everyday world of ordinary people. Since 2005, donors' efforts to harmonise foreign aid may have helped to improve coordination and national ownership of reforms, but this has also moved policy further "upstream" and away from people. The "listening study" approach of the Reality Check, if it is done carefully and sensitively, offers a way to reconnect people and policies.
Not that it has been easy. We initially faced scepticism from donors and government. Some asked whether such story-based information was proper research; others said the reports were repeating things they already knew. Both criticisms were missing the point, which was simply to listen to people's voices more regularly and more carefully.
After four years, the approach is beginning to gain credibility. The World Bank issues our annual report to all its visiting consultants as required reading. As we finalise the fourth report for Bangladesh, the Reality Check approach is being adapted and used in other countries, such as Indonesia and Mozambique. With donors and governments now rightly under pressure to show "results," the Reality Check is a cost-effective and powerful tool.
The two new five-year health and education sector reform programmes that will succeed those recently completed have now been designed and will begin soon. The next stage is to launch the fourth Reality Check annual report (due to be published in September), feed in its findings and to keep learning about whether and how the Reality Check approach can make a difference.
The writer is Professor of Social Policy and Development at the London School of Economics and Political Science, and an Adviser to the Sida/Embassy of Sweden Bangladesh Reality Check initiative. He writes here in a personal capacity.