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Result-based Management Implementation for Outcomes:

An agenda for action in developing countries

Dr. Sohail Amjad1, Pakistan

Consultant Health System Design & Management

Abstract:

Managing for Development Results is an emerging, and increasingly important concept,

which focuses on monitoring of results and outcomes in the development process, rather than

inputs. In this direction, many developing countries have started to introduce Results-based

Management (RBM) in several key sectors and sub-sectors. The integration of results-based

elements into planning and formulation, as well as the monitoring and evaluation system are

increasingly becoming popular in developing countries and poses a new challenge to improve

performance for progress towards outcomes. The strategies devised and problems identified

for implementation in public sector have mainly focused on technical and organizational

bearers. Though technical rigor and organizational strengthening are at the core of RBM

implementation, yet there is another ‘determinant of performance’ which is human behavior

that needs attention for continuous improvement. Behavioral factors of capacity and

performance involve intangible concepts such as motivation, attitudes, and values that people

hold related to performance improvement. Influencing many of these behavioral factors along

with technical and organizational practices will be required to implement Result-based

Management. Therefore sustainable performance improvement is more likely to result from a

strategy that focuses in harmony on three determinants of performance in a continuum. This

paper analyzes the interaction among these determinants and proposes an agenda for action to

implement RBM in developing countries.

1 Dr. Sohail Amjad M.B;B.S (Pak), MA-HM (Leeds-UK), MA-HMPP (Leeds-UK), DPS (London) Certified in Health Economics (Leeds-UK,),Certified in HMIS (Leeds-UK) Public Health Specialist, Government of Punjab, Pakistan Consultant Health System Design & Management Email 1: [email protected], Email 2: [email protected]: (Work) 0092-51-2505591 (direct), Cell: 0092-333-5142947

Dr. Sohail Amjad Result-based Management Implementation for Outcomes: An agenda for action in developing countries

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mailto:[email protected]

mailto:[email protected]

Introduction:

As we know that Result-based Management (RBM) has a long history in developed world and

they have gained quite a range of experience in the implementation of managing for results.

This is a new concept for most of the developing countries and so they are expected to face a

number of challenges for its implementation. Though success stories of developed countries

are possibly not replicable immediately in this part of the world, yet we can learn from their

experiences to address these challenges. The challenges particularly identified in the

international literature point towards technical and organizational issues in terms of RBM

implementation. (Mayne 2006, Sharma 2006, World Bank 2003c). Therefore, the focus

remained on addressing these challenges mainly through technical and organizational

interventions for performance improvement. A wide array of tools and instruments has been

developed and new terminology coined but still progress is awaited. A lot of interventions

have been visualized and further experimentation is still on to rectify public sector

organizational in-efficiencies with mixed results. The reasons for poor progress are not only

technical or organizational but there is another group of significant challenges evident in the

implementation of RBM practices in developing countries. This paper will look into this new

group of challenges along with technical and organizational issues and will set a stage to

propose an agenda for RBM implementation in developing countries.

A Brief Overview of Management Practices in Developing Countries:

Handy (1985) describes an organization as an environment, in which ‘management’ directs all

available resources to achieve its explicit objectives/results. And good management practices

focus on efficiency and effectiveness to produce these intended results. The efficiency and

effectiveness emerge through integrated planning (Green, 1992), resource allocation (Gish,

1973), performance measurement, participatory evidence-based decision-making (Amonoo-

Lartson, 1996) and self-evaluation. And above all, a strong organizational commitment under

the umbrella of supportive national/provincial polices is the key to success. This is also the

core theme of Result-based Management.


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In order to better understand the organizational environment in relation to Result-based

Management and evidence-based decision-making, the current management structure and

functions should need to be reviewed in the public sector. In developing countries, limited

organizational practices for planning and management, responsibilities and authority for

decision making and lack of ‘information culture’ has resulted in poor performances at all

levels. These organizational practices stem from a number of factors including deficient

organizational support for performance appraisal using performance information. The

managers are given increasing responsibilities overtime (which pile up with new vertical

programs) without giving significant authority to perform these functions, thus creating

frustration and tension. Green and Collins (2003) have described three tensions that public

sector managers and planners face: changes in the system, the contradictions between public

interest and private gain; and changes in the forms of accountability. In public sector

management system, the ‘implementers’ are the key component of the system but at the same

time, the most neglected entity and are never part of the ‘corridor planning culture’ (Green,

1992). The targets are set somewhere else, budgets allocated on historical basis, routine

procurement & supplies arranged at higher tiers and mangers are only made responsible to

implement. Mills et al. (1990) has stressed to strike off some balance between bottom-up and

top-down decision-making processes and linking appropriately authorities with

responsibilities to ensure meaningful accountability (Conyers 1981, Collins 1989).

Performance Measurement for Result-based Management:

Here, it is also useful to define what is meant by performance measurement. According to

Joseph et al (1992), “performance measurement analyzes the success of a work group,

program, or organization's efforts by comparing data on what actually happened to what was

planned or intended measurement.” The clearer our expectations of performance, the easier it

is to devise strategies for measuring results and building the capacity of these systems. In

many cases, performance of a system is narrowly defined as the production of good quality

services. But the ultimate objective of RBM is to take timely action towards achievement of

intended outcomes and impact. Therefore, performance of an organization should not only be

measured on the basis of the quality of services produced but also on evidence of progress


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towards outcomes. A vibrant ‘performance culture’ is one which links: goals, performance

assessment and performance management and these features together form an organization

capable of continual improvement through producing effective learning2.

Determinants of Performance:

Improving RBM practices in terms of information and services produced, utilization and

continuous improvement often requires interventions that address a wide range of possible

“determinants of performance.” These determinants are technical, organizational (Mayne,

2006) and behavioral. The sustainable performance improvement spiral for RBM is more

likely to result from a strategy that focuses on three fronts. Firstly improving technical

determinants e.g. RBM framework, developing tools and instruments for performance

measurement and improvements, technical guidelines, continuous review and evolution of

RBM design, building individual capacity for understanding and using RBM framework.

Secondly, strengthening the system/organizational context in support of RBM, through

providing appropriate authority for decision-making, clarifying roles and responsibilities of

different components of organizational structure, and then installing meaningful transparent

accountability matrices based on well defined operational policies. Lastly, behavioral

determinants are a strategy focusing on people, who are responsible for the execution of

organizational functions to achieve its objectives. These three components of the RBM

strategy can be used to identify opportunities for and constraints to effective and strategic

implementation of RBM practices.

While technical rigor is clearly needed for performance measurement and improvement (these

essential elements and skills are at the core of an effective and efficient RBM system), in

practice technical interventions alone do not always result in appropriate action on the ground.

The sound technical design does not guarantee that it will produce intended results and can

necessarily translate into adequate RBM performance. Too often managers and other staff are

not motivated to improve the performance as they are very happy with the status quo (Brett 2 Douglas Saltmarshe, Mark Ireland, J. Allister McGregor (2003) The performance framework: a systems approach to understanding performance management: Public Administration and Development, (pp445-456) Published Online: 19 Nov 2003 DOI: 10.1002/pad.292, at website: http://www3.interscience.wiley.com/cgi-bin/jhome/2821, retrieved on June13, 2006 at 3.30 pm.


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1993, Cassels 1995, Bennett et al, 1995). On the one hand, they are reluctant to adopt new

practices due to an ‘unknown fear of change’ which may affect their lives. On the other hand,

for instance, in public sectors that use normative rather than strategic planning, resource

allocation based on set formulas and activity-based performance appraisal do not provide any

incentive for improvement. Even the availability of accurate and timely data cannot guarantee

that evidence becomes the basis of decision making.

The situation can be improved by considering the two other dimensions of the environment,

i.e. organizational and the actions/behavior of decision-makers and implementers. The

environment particular includes the wider system that contains the staff as well as the

organizations (the ministry, management unit, or service-outlet) where staff works. The

organizational factors exert pressure and create or limit opportunities for performance

improvement. At the macro level, structural constraints, such as poor roads, lack of

telecommunications capacity, and insufficient quantities of appropriate human resources, lack

of domestic amenities for staff (Malcolm Segall, 2003), present very real obstacles to progress

towards outcomes (World Bank, 2003c). At the micro level, field assessments have shown

those organizational factors, such as lack of clarity about roles and responsibilities for

decision-making at district level; failure to actively distribute or introduce policies, norms,

and standards; and ambiguity surrounding the flow of information throughout the system has

a direct influence on performance (ADB, DFID and World Bank 2004, Omar 1997, Mills

1990, Gilson & Mills 1995, Conyers 1981). Therefore, it is argued that without an

environment that supports human resources and values performance, RBM cannot be

implemented effectively.

Thus, it is important to consider the role of human behavior in performance improvement.

The services are provided by people who play professional and personal roles in the system.

Although building the capacity of these people is essential for RBM strengthening, behavioral

aspects of capacity are often the most difficult to identify and confront in a meaningful way.

Behavioral factors of capacity and performance involve intangible concepts such as

motivation, attitudes, and values that people hold related to performance improvement, job


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performance, responsibilities, and hierarchy3. Influencing many of these behavioral factors

will require interventions that go beyond simple training and require change in human

resource management and development policies. Abraham and Ashler (2004) have examined

the impact of a set of independent intangible organizational elements and the interactions

among them on a set of organizational performance objectives through a survey in Israel.

They observes that organizational performance can be well explained by six intangible

organizational elements (managerial capabilities, human capital, internal auditing, labor

relations, organizational culture, and perceived organizational reputation) and the interactions

among them, which need to be taken into account in any cost effective development. To

further understand the complexity of this interaction, there is a strong need to have large scale

studies to demonstrate how organizational and behavioral elements, independently,

complementarily and interactively, affect the organization's performance.

Therefore, behavioral factors give crucial insight into the way in which staff performs, e.g.

the primary job of doctors at health facilities revolves around their role and responsibilities as

health workers or managers of health services. They see their other duties, such as disease

surveillance, stock keeping, and evidence-based planning and budgeting, as secondary to

providing health care. If expectations with respect to performance and achievements of

results are unclear to health professionals, their motivation and commitment to manage for

results can suffer. Failure on the part of supervisors or managers to provide feedback on

performance is another common disincentive to staff to improve performance. Any

intervention to strengthen the performance management that will not address the behavioral

factors such as attitudes toward the self-evaluation, use of information for improvement,

motivation4 and incentives for making decisions based on information will result in poor

quality services, under-utilization, poor accountability and decision making.

3 In Tanzania, it has become necessary to clarify organizational roles and responsibilities in order to translate technical guidance on analysis of disease surveillance data into routine health worker behavior. Job descriptions, responsibilities, and consequences for failing to act should be clear to data collectors, and they must have the tools necessary to complete their work. (personal communication with an international management consultant) 4 In Pakistan, the manager is suppose to write staff’s annual performance report called ACR (Annual Confidential Report) during first week of January each year. These reports are never written by managers regularly, and remain pending. The missing ACRs decline the staff from promotion on his/her turn. The managers are transferred, posted elsewhere or even die and this situation create a lot of trouble for staff to get their ACRs written/completed and submitted to the Provincial Department for promotion. One can imagine, how much de-motivating is this for staff?


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Thus in real scenario, all three i.e. technical, organizational, and behavioral determinants for

RBM should work together in harmony to achieve progress towards outcomes. These should

be connected to each other by a continuum. For example, on the technical-behavioral

continuum, if a trained health worker feels that s/he has not effectively mastered the necessary

skills, then the likelihood that s/he will carry out the required actions is reduced. On the

organizational–behavioral continuum, achieving competency in an action requires not just

knowledge and skills but a supportive environment as well.

Therefore, in proposing strategies and interventions to improve RBM implementation, a

telescopic view of the overall environment (technical, organizational/systems and behavioral)

including externalities should be taken to better analyze core and root causes of system’s low

performance. At contextual level policy and political scenario, at organizational level,

structure, functions, values, culture and relationships are important factors to formulate a

common understanding of Result-based Management.

The Way Forward—A Proposed Agenda5 for Effective RBM Implementation for

Progress towards Outcomes in Developing Countries:

Before describing an outline for RBM implementation in developing countries, it should be

acknowledged that each country is unique, with its own history, internal priorities, resource

availability and political ideology. What is an effective RBM implementation strategy in one

country may not be relevant or feasible in another. Thus imported models of RBM from

developed countries should be avoided. The stated objectives of RBM implementation are to

bring about changes in the development outcomes that will help meet national development

objectives while making the system functionally, organizationally, and politically sustainable.

As the specific national objectives vary from country to country, so will the RBM strategies

adopted.

5 This outline of agenda is drawn in response to a paper titled: “Challenges and Lessons in Result-based Management” published by Dr. John Mayne, Advisor Public Health Management at CoP MfDR forum. I extend my thanks for his encouragement to produce this paper.


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1. Fostering the Right Climate

The need for strong leadership and commitment at policy level. The commitment of

strong leadership for ongoing stewardship role for performance/result-based

management will be necessary for streamlining the processes and procedures. This

may include:

o Structured and targeted advocacy campaign e.g. policy analysis to focus on

results, performance measurement and accountability for results etc.

o Regulatory and legal framework to support result-based management. This

regulatory mechanism, having legislatory support must define the bottom-up

and top-down responsibilities for results with clarification of lines of

accountability to make RBM system effective.

o Promote consistency in policies (Omar 1997): Maintaining a consistent policy

direction is a difficult challenge in those countries, where frequent legally

mandated elections result in a rapid turnover among district/provincial

officials. At the central level ministers or secretaries may change too

frequently due to political interests. As a result, the policies promoted by an

incumbent party may change with the next election. This lack of continuity has

a negative impact on building a consistent reform process.

o Open dialogue to institutionalize Result-based Management

o Negotiate grants with compulsory RBM.

Tie up loan/grant with RBM: A loan could be tied up with RBM approach for the

particular program/project through MoUs. Ultimately this will ferment the whole

system.

o Release of loan/grant installments with achievement of timeline

targets/benchmarks.


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Initiate policy dialogue on integration of common outcome programs: Advocate

integration of vertical programs, which are contributing towards same

outcome/impact. Mostly these programs are donor-driven, and authority lies at the

central level and districts are made responsible for implementation. (If RBM is based

on developing partnerships, then it will be the real test of RBM promoters).

o Build effective partnerships and coordination for RBM6: The effective

partnerships and coordination for aid alignment to government strategies,

priorities and systems to support the country’s development and management

for results will be required. Therefore, a strong legal, institutional and

management framework for effective partnerships, utilization of resources and

a strategic capacity building agenda are critical to ensure sustainable

development. New and more effective partnership arrangements between

governments and their external partners are necessary to link downstream

assistance to local governments to upstream development of the national

reform framework and to help manage a gradual and strategic approach to

implementation of the reforms.7

o The Sector Wide Approach8 (SWAp) is another example of developing

partnerships among government and development agencies, which agree on the

policies and medium term plans for development of the sector or multiple

sectors, including the allocation of resources for the medium term, and funding

is provided within this framework. The SWAp, with pooled funding offers an

easier and more efficient way to provide support to decentralized public sectors

than would a project approach. This approach has shown a lot of promise to

improve the performance at central and district levels (Paul Thornton 2000,

6 Partnership Group for Aid Effectiveness (PGAE) (2004) ‘Harmonization and Alignment for Greater Aid effectiveness in Vietnam’ Report 2004. In Vietnam, the donor community and the Government have agreed that the ultimate objective is to align operations to Vietnam’s own strategies, priorities and systems. Working toward this objective, strengthening Government’s public administration capacity and systems are crucial and donors are currently providing assistance in this regard. 7 Leonardo G. Romeo (2003) The role of external assistance in supporting decentralization reform, Public Administration and Development, Published online (pp89-96), DOI 10.1002/pad.262 website: at http://www3.interscience.wiley.com/cgi-bin/jhome/2821 retrieved on June 14, 2006 at 4.10 pm 8 The term ‘Sector Wide Approach’ is relatively new, emerging from experience in the health sector. The concept is well explained in the Guide to SWAps for Health and Development by Andrew Cassels (1997). For more details, see reference.


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http://www3.interscience.wiley.com/cgi-bin/jhome/2821 retrieved on June 14, at 4.10


Nabarro et al, 1998) and provide an opportunity for RBM implementation at

least in a few public sectors.

o Promote unified information system for M&E at all levels—information

collection is very expensive—save resources through collaboration9

Promote and Strengthen decentralization policies in public sector: It has been

argued that decentralization achieves popular participation, removes administrative

and institutional constraints on management (Mills A et al. 1990, Rondinelli et al.

1983, Rondinelli 1983, Mills 1994, Collin 1994). The Johannes Jütting et al (2004),

while exploring the impact of decentralization on poverty reduction in nineteen

countries, has recommended that decentralization serves the poor by its effects on

governance, participation, responsiveness to local needs (Faguet, 2002), and efficiency

of public-service delivery (Litvack and Seddon, 1999; Lieberman; 2002).

Furthermore, based on a rigorous review of the literature, the Von Braun and Grote

(2002) also come to the conclusion that decentralization serves the poor, but under

specific conditions10. The decentralization, when accompanied by legitimacy of

decision-makers (Smith, 1985), and legal framework, creates local political

accountability of service providers and enhance governance (Blair, 2000, Manor,

1998). Therefore, it is argued that decentralization provides a conducive environment

for the implementation of RBM to enable to progress towards outcomes.

o Get started through phased approach for RBM implementation—countries

where district (local) governments are in place through decentralization are

fertile locations to start. Autonomous and Semi-autonomous bodies are other

options11.

9 Vietnam Australia Monitoring and Evaluation Strengthening Project (VAMESP), Discussion paper on M&E in Vietnam titled “Development of a Monitoring and Evaluation System to Support Poverty Reduction and Growth in Vietnam,” published at CoP MfDR forum highlights experiences of integrated M&E system in Vietnam. The paper was prepared by Cao Manh Cuong, John Fargher, Cao Thanh Phu, Nguyen Linh Chi. 10 The authors recommend that these conditions should be analyzed within a framework that tackles political, fiscal and administrative decentralisation simultaneously, while also taking into account different country specific conditions and different types of decentralisation policies. For further reading see reference Von Braun and Grote (2002). 11 Kiyoshi Yamamoto (2006) Performance of semi-autonomous public bodies: linkage between autonomy and performance in Japanese agencies, Public Administration and Development, Published Online: 17 Jan 2006 DOI: 10.1002/pad.369, http://www3.interscience.wiley.com/cgi-bin/jhome/2821 retrieved on June 14, 2006 at 4.40 pm


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o On the one hand, district assemblies can be encouraged to provide regulatory

framework backed-up by local legitimate decision-makers for result-based

management12. On the other hand, good practices at district level should be

used as an evidence for advocacy to policy-makers. Thus bilateral approach to

establish a legal framework for RBM will become a reality.

o Start with pilot test and after fine tuning scale up through sectoral action plan

or National Action Plan (NAP).

o Bring RBM out of project/program shell—introduce in selected public sectors

especially those involved in social services e.g. Health, Education and

Population/Social Services sector. In these sectors, short-term outcomes are

easy to measure both quantitatively and qualitatively. There are fewer

requirements for capital infrastructure development. As mentioned above,

SWAp can provide a good platform based on partnership for effective

implementation of RBM, especially in those countries, which have now

realized the deprivation of the communities to access to enhanced social

services.

o In public sector, it is usually not possible to allocate resources for non-routine

data collection. Thus, rationalize the existing Routine MISs through

improvement and then use for RBM. It will help in sustainability13.

2 Continuous Technical Support to evolve RBM System

o Adopt simple RBM design matrix—avoid complex multipurpose or multilayer

log frame matrices.

o Build consensus on use of common terminology for performance measurement

and technical guidelines. 12 In Pakistan, the District Governments have authority to hire and fire staff on contract based on performance. This is not applicable to regular employees, which can only be reverted back to Provincial Government for repatriation anywhere in the province. For the last 10 years, all staff is hired on contract basis and regular appointments are banned. The contracted staff has been given an incentive to be regularized after two years of contract service, provided their performance is highly satisfactory. 13 In Pakistan through a recent JICA funded study (the author was member of the study team), National HMIS has been rationalized and District based Health Information System (DHIS) visualized for performance improvement of the devolved District Governments. The system typically focused on reducing data burden and promoting its use at district, provincial and national levels for management decisions.


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o Implementations of user-friendly simple unified tools and instruments for

performance measurement and avoid duplication of data collection.

o Develop capacities for regular review of RBM system and incorporate changes

based on emerging needs. The national and local level capacity building will

be a key to successful implementation and sustainability.

o Strengthen appropriate linkages of performance with management systems.

3 Setting Realistic Expectations for Results-Based Management

See, Plan, Do (SPD) Cycle: The introduction of ‘See, Plan, and Do’ cycle in

decentralized public sector management can provide the real platform for setting

realistic targets and expectations for RBM.

See Plan

Do

o This iterative problem solving approach is a

classic methodology for performance

improvement and quality assurance. As a first

step in the cycle, “See” assesses the current

situation to identify needs and opportunities for

improvement. This “See” step of the cycle

includes the total process of information

generation by the system, its transmission, processing, analysis, presentation

and interpretation.

o The “Plan” step specifies the performance objectives and targets, methodology,

activities and person responsible for achieving the targeted improvement. This

“Plan” step is linked to and dependent on the “See” step.

o The “Do” step is the actual implementation of the planned activities in given

time. Lastly, the “See” step is carried out again to monitor and evaluate

progress and the appraise performance.

o Thus ‘SPD’ cycle will increase organizational ability to act on performance

gaps and deficiencies for continuous improvement.


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Develop and implement operational policies for RBM.

o Outdated operational polices based on colonial era should be revised, and

rationalized for RBM. This will require changes in the civil service rules,

outdated administrative procedures and unity of command by eliminating

diffused and cross cutting lines of accountability (Gilson et al, 1994).

o Where operational policies are updated, should be implemented. It is important

to note that operational policies for HRM & D are usually available but due to

poor implementation lead to de-motivation and frustration among staff. And

this is a single most important factor responsible for exit (brain drain) of

skilled and experienced human resources from public sector (Yan Wang, et

al.).

o In the absence of clear guidelines, continuous monitoring and an adequate

supply of financial and human resources, decentralization processes are more

likely to have a low impact and can, to a certain extent, provoke inequalities

between regions in the same country (Mouzinho et .al.).

o Develop an integrated performance measurement system based on clear

guidelines and operational policies by involving staff in the process. After all,

they are the ones who directly contribute to the input, output, outcome,

performance, process, and every necessary aspect of the organizational

operation. The staff’s participation is one of the best ways to create a positive

culture that thrives on performance measurement. Their participation creates

ownership, which increases loyalty and commitment and enhances

accountability.

o Though decentralization process does mean the loss of responsibilities and

authority linkages for one or another, yet actually this is a new sharing of them,

so that system’s overall response capacity increases. In this way, centre and

decentralized unit take up new roles and responsibilities. Furthermore, the

effective implementation of decentralization process depends not only on the

greater or lesser degree of decentralization; it also implies new and appropriate

definition and clarification of roles, functions and authority relations of each


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level. Therefore, ensure clarification of roles, responsibilities, authority

linkages and accountability matrices for the implementation of change

(Thomason et al. 1991, ADB, DFID and World Bank 2004, Mills 1994, Shah

1998, Blair 2000, Gilson & Mills 1995) and making RBM a reality on ground.

Decentralized local planning system and develop sectoral corporate plans.

o Develop capacity to perform these tasks at all levels. It will require planning

manuals, guidelines, training and reference material.

o Tolerate ‘bitter sip’ of spending to establish baseline performance/benchmarks

for future comparisons.

o District (local) governments should be encouraged to develop their 3-5 year

strategic sectoral plans with annual rolling plans within national/provincial

policy guidelines/and or strategic plans (Green 1992, Faguet 2002). This will

help local governments to negotiate with national/provincial government for

more resources.

o Each department under the local government should prepare their own

departmental annual plan and negotiate with local government for resources.

Such plans should not be restricted to recurrent expenditure

statements/projections and flexible to meet the operational managerial needs.

o Revitalize intersectoral collaboration from local government platform.

Currently, such practices are common feature in a few district government of

Pakistan through monthly district coordination meetings and district

development meetings14.

o A result-based in-build M & E Plan should track the progress at all levels. In

this way, performance will have some meaning for implementers.

14 The author has four years experience of attending these meetings in a district, where he was manager (Medical Superintendent) of the District Headquarters Hospital in Pakistan. The local government’ head (District Nazim) and District Coordination Officer (Civil Service Beaurocrate) were always very enthusiastic to call these meetings, and this certainly improve some coordination among different departments. (personal experience and communication with other colleagues)


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o Introduce processes to review performance, identify gaps and address solutions

through simple organizational interventions e.g. monthly and quarterly

performance review meetings, brain storming, and action planning etc.

o Quarterly or twice a year meets with public representatives and present

departmental performance based on data. This is very important especially at

district/local level.

Remove disincentives to performance information collection and use.

Reporting data collected to higher levels without being used for local decision-making

is a great disincentive for staff. Therefore;

o Strengthen systems for reporting and use of performance data. This will

include monitoring and evaluating service delivery against intended targets,

focusing on enhanced local accountability and assisting managers in their

evidence-based decision making.

o Institutionalize monthly performance review meetings at service delivery and

district department level.

o The quarterly performance review meetings are suggested at sectoral and

national levels. This will enable comparison among different implementing

units within the same sector and across the sectors. The head of implementing

units should also participate in these review meetings. This will further

enhance personal and organizational accountability and improving the

performance of RBM. The problem identification approach and taking action

accordingly will not only encourage the staff but also improve the data quality.

o Data quality assurance mechanisms: Introduce simple and less time-intensive

tools for DQA mechanism with clear responsibility to staff15. Good quality

data improves its utilization, which further ensures the data quality.

15 The author has posted his experience on CoP MfDR forum, which describes an innovative use of LQAS tool for data quality assurance.


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Linking budgets (resources) with plans and management.

o Resource allocation decisions and linkages with plans and management are

real test of the policy-makers. These linkages should be strengthened through

performance management and sharing data and information with decision-

makers.16

o Systems for identifying and setting objectives, performance indicators and

targets, and linking them to financial resources allocations and other inputs,

using a participatory decision making process that involve local politicians and

civil society.17

o Develop necessary tools, skills and capacity for these tasks.

Institutionalize popular participation.

o After all, the logic behind decentralization is not just about weakening the

central authority, nor about preferring local elites to central authority, (Bardhan

and Mookherjee, 2000b) but it is fundamentally about making governance at

the local level more responsive to the felt needs of the large majority of the

population.

o Therefore, community participation which is one of the pillars of development

strategy should be organized and involved in local planning and managerial

decision-making. The performance of local governments and community-

based organizations can be considerably enhanced when these agencies work

in partnership with one another. Thus meaningful interventions to empower the

communities to participate in decision-making and M&E activities should be

implemented and institutionalized.

16 Sally Brownette (2006) Discussion Paper published on CoP MfDR forum: Completing the Circle: Towards an Integrated Performance Management Framework. This paper argues that developing and transitional economies may gain significant benefits by applying an integrated performance management framework. She describes an integrated performance management cycle under resource constraints settings and linking planning and budgeting systems with service delivery and accountability. For further reading refer to website. The information was retrieved on June 15, 2006 at 9.30 pm at: https://copmfdr.adb.org/QuickPlace/mfdr/Main.nsf/h_F3549AEC6B28460E4825717F000E1466/753D39ACAA6E5E4F4825717F0025CB45/?OpenDocument17 Collaborative Africa Budget Reform Initiative (CABRI) (2004) Country Case Studies: Budget Reform Seminar 1-3 December 2003, Pretoria, South Africa


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o Develop capacity of community for meaningful participation. The technical

language of professionals should be avoided and communication must be

simple and understandable.

o Community participation provides access to decision-making and may be used

for some vested interests by the local political elites. Therefore, clear

procedures and mandate with objectives should be in place to avoid confusion

and empowerment of specific local groups.

Develop capacity to perform these important tasks at all levels.

o A ‘cascade training’ option through master trainers at each district (local)

government level will be feasible initially. The capacity to update training

material continuously and keep it relevant for RBM must be instilled at all

levels.

o An integrating human resource development into programmes of capacity

building and public sector reforms can bring combined individual and

organizational change.

4 Getting the right incentives in place for performance improvement

Recognize organizational good practices: Apart from incentives to recognize

individual performances, the evidence-based resource allocation is probably the best

incentive for organizational best practices. The staff involved in provision of services,

collection and reporting of quality performance data is motivated if organization uses

that information for resource allocation. This will ignite a continuous cycle of

performance improvement, thus continuously contributing to RBM.

Staff performance appraisal: The provision of financial incentives for personal

performances has always been remained a difficult option in public sector

management. Therefore;


17

o Initiating some loan schemes, in-service training opportunities, trophies,

recognition in departmental news letters and appraising through performance

certificates will go a long way to support the RBM implementation. The

performance appraisal framework needs to be more flexible in differentiating

very high performers, at the same time devising a strategy for the improvement

of staff who slack in performance.

Negotiate with local government for performance incentives: Promoting

decentralization policies for public sector management can set the stage for

(performance) result-based management. The decentralized units are always more

enthusiastic to learn to improve ‘management of change’.

o Negotiation with local government authorities for performance incentives18 for

staff and organization is another suitable way to promote performance

improvement. It is easy to get commitment and stewardship from local

governments than central commitment and support for new initiatives (ADB,

DFID and World Bank 2004). The skillfully presented evidence (data) to local

governments for support will be more useful for performance improvement.

Purchaser-provider split19 arrangement and Performance linked contracts (PLC):

Purchaser-provider split concept refers to a services purchasing strategy to promote

'managed competition' and to reward those service providers with the best

performance in terms of cost, quality and client satisfaction (World Bank, 1993). This

separation of service provider and purchaser is in contrast with the historically

organizationally integrated system, and has attracted widespread interest in both

developed and developing health systems. The idea of ‘managed competition’ is based

on 'consumer choice health plan' (Enthoven 1988) that encompasses a system of

18 A structured method of evaluating and rewarding the performance of employees in the Maldives public service based on quality of work, job knowledge and performance has been introduced. The reward came in the form of annual salary increments and promotions. 19 Mills (1998) describes that there are certain basic prerequisites for such system to run effectively. These include availability of multiple services providers, wide information base regarding local needs and demands, managerial skills and capacity to undertake contracts and above all decentralization of powers to lower administrative tiers.


18

competing prospectively paid limited provider plans which operate in the context of

government-instituted structure. The overall purpose of such arrangement is to

enhance the operational and allocative efficiency, (McPake and Ngalande Banda 1994;

Mills, 1998) service responsiveness and cost-containment of the service delivery

system.

o The district/local government may be provided with ‘global budget’ by

center/province and then it should enter into purchaser-provider split

arrangement with district services departments (e.g. health, education, social

welfare, and population etc) through pre-agreed service package for delivery to

the population of district.

o The minimum performance targets need to be set based on base-line

information. Then it will be straight forward for local government to monitor

the performance of managers and other staff.

o On achievement of targets, rewards and remunerations should be provided to

the department for apportionment and distribution.

o The managers entering into contract with local government should be hired

from open market through performance linked contracts (PLC), and market-

based remuneration package. The public sector managers should also allow

competing freely for PLC20 under purchaser-provider split arrangement.

5 Setting Outcome Expectations

Under controlled conditions of a project/program, it is easy to set outcome

expectations but at a national/provincial level, this requires much more than a few

technical interventions. A regular sectoral and national policy analysis and review to

20 Though purchaser-provider split is an ‘imported model’ from developed countries, yet has great potential for performance improvement and has been tested in the developing world during last decade with mixed results. During 1997/98, the model was pushed by DFID and pilot tested in two districts along with two tertiary hospitals in Pakistan. The author was member of Provincial Decentralization Contact Group (PDCG) and closely watched the implementation process. Mid-term evaluation showed some progress and improvement in services delivery. The implementation was terminated by new government in 1999, and devolution was proposed to decentralize eleven public sectors instead of only health.


19

set/fine tune outcomes within a long term strategic plan will be necessary for to ensure

realistic outcomes and success.

• This will require strengthening of planning capacities and establishing in-build

M & E system with rationale performance indicators based on monitoring

needs of different levels. (World Bank 2003c, Ebel et al. 2002)

• Support for developing manuals, training material and planning guidelines.

Now the question arises that outcomes of a multiyear program are set at national/and

or provincial level and local managers are responsible for the implementation of the

programs. The lower tiers are monitored for the achievement of outputs, so their key

focus remains on operational management. Thus developing performance linkages

among national, provincial and local levels through pre-agreed criteria and then

installing an in-build M&E system will be a challenge. Here again a rational and

meaningful information system can support to meet the challenge.

As we know, outputs are necessary deliverables required to progress towards

outcomes, and outcomes ultimately contribute towards impact. Thus, Performance

Monitoring Working Groups (PMWG) may be established at national and provincial

levels for performance monitoring and measurement and membership could be drawn

from key stakeholders. Thus,

• Implementers (district/local) should be accountable for outputs and their

performance will be measured based on these deliverables by

provincial/regional PMWG.

• Provinces/regions should be accountable for immediate outcomes to national

PMWG.

The establishment of management teams in different public sectors/departments has

also been promoted to improve the transparent and evidence-based decision-making

(Gilson et al. 1994, Collins 1994, Amonoo-Lartson et al. 1996, Gilson & Mills 1995).


20

But somehow, such teams are taken as a threat by managers at all levels to their

authority and designated powers. Decentralization provides an enabling environment

for management teams and this opportunity should be utilized for RBM. Under this

scenario, responsibilities, authorities and accountabilities can easily be linked to each

other through operational policies and use of performance information (Blair 2000,

Mills 1994, Shah 1998, Cassels 1995).

6 Research and Learning:

At this point, it is strongly emphasized that research is one of the most powerful tool

to generate theory and theory become useless if it is not translated into practices.

Repeated practices are basis of experience and there is no shortcut to experience! So

RBM approach should evolve as a practical approach with blend of experience and

academic literature.

Conduct operational research in diverse settings and share the findings and experience.

Strengthen the CoP MfDR forum for continuous exchange of knowledge.

Feedback research into RBM practices.

Develop practical linkages with multilateral and bilateral international forums to share

their experiences on RBM.

Thus adopting the three prong strategy (technical, organizational and behavioral

determinants) to implement RBM in developing countries based on following key points

will be effective:

Instilling values that indicate the critical role of performance information in system’s

performance

Building capacity for performance management through an integrated approach to

develop the system

Clarifying and linking roles, responsibilities, duties, job descriptions, job functions, and

job performance.


21

Reducing or eliminating behavioral and organizational obstacles hindering performance

measurement and improvement e.g. use of information including physical barriers e.g.

lack of roads, telecommunication, computers and the political, managerial, and human

context like hierarchy, communication, rewards and punishments; the overall culture or

value attached to performance measurement and improvement.

There is no fixed prescription or manual equally applicable to all developing countries for

RBM implementation. Therefore a range of strategies and interventions21 are proposed to

select suitable mix of interventions based on country context. One strategy with varied

combination of interventions may be useful for a country but may have negative effects in

others. Therefore we must be very careful in designing a program for RBM implementation

for a specific country through wide consultations and analysis.

I invite all the honorable members of CoP forum to provide their valuable experiences

and inputs to improve this manuscript.

21 The agenda proposed above for action does not necessarily differentiate between technical, organizational and behavioral strategies and interventions for RBM. For the discussion purpose, it is more useful to segregate ‘determinants of performance’ to understand deep root causes, but in reality these are closely knitted with each other. Thus any broad strategy must address all three determinants in a dynamic continuum. Therefore each strategy described above has elements of proposed solutions/interventions for all three determinants of performance. An organizational intervention must be complimented by technical and behavioral interventions for its successful implementation and vice versa.


22

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