Country Ownership and its measurement - Part 1

“To us, country ownership in health is the end state where a nation’s efforts are led, implemented, and eventually paid for by its government, communities, civil society and private sector. To get there, a country’s political leaders must set priorities and develop national plans to accomplish them in concert with their citizens, which means including women as well as men in the planning process. And these plans must be effectively carried out primarily by the country’s own institutions, and then these groups must be able to hold each other accountable.”

Secretary of State Hillary Rodham Clinton, June 1, 2012

I want to say a word about Country Ownership and its measurement, and notably how the paradigm of complexity (don't be afraid! I'll explain this with a pool table analogy; it won't hurt) is going to force us to try a little bit harder on this one. But first, why is there so much talk about 'Country Ownership' and its measurement nowadays?

There's a proper answer to that question, and then there's another one:

[1] Appropriate answer is: because we're in the era of the Paris Declaration, the Global Fund Country Coordination Mechanisms, and for us US-centric folks, USAID Forward, which I think is a great step forward (OK - you'll never know whether I mean it, but actually I do). In fact, just read UN, DfID, French Cooperation, GAVI, even IMF and Bank statements, the Abuja and other declarations. There's no getting around Country Ownership (CO). The concept and the intention are here to stay. We all agree.

[2] The less satisfying but nonetheless truthful answer is that emphasis on CO at this juncture is an implied recognition that we, sorry capital "We" (from the multilateral, to the bilateral, from the donors to the implementers, from the DAC countries to ODA recipient countries) have essentially failed to respect this principle from roughly the birth of the UN (1945), or the birth of US international development assistance (1949-1950) until not so long ago. No need to point fingers. We tried our best. Some folks said it mattered, but there was a lot to do, and you know how things go. We had to get the job done. And the tension between 'getting the job done' and 'respecting CO' is still with us. PEPFAR I was launched in 2003; the Paris Declaration was right smack in the middle of its implementation (2005), and by 2009, we were in PEPFAR II with CO front and center in intentions, strategies and priorities. On an overlapping timeline, the Global Fund started in 2002 with the stated principle that it would "work on programs that reflect national ownership and respect country-led formulation and implementation processes." Its inception saw a few cautions raised about the possibility of conflicts between the principle of CO and performance-based funding (not the principle of PBF, which as a mantra was inseparable from CO, but the reality of it), and the 5-year evaluation came out with the walking-on-eggs finding that CO was "in need of review." I don't think there was a 10-year evaluation. Hum. (I'm not pointing fingers; I was there, and don't get me started.)

So, we're all learning and trying to take CO seriously, but we're struggling. And of course, it's tempting to think that it's just not our fault... it's their fault. We're progressively getting clear on the fact that they (the countries, the partners, the governments) need to have ownership, so we can transition out. Given that you can't manage it if you can't measure it, we're now in the business of measuring ownership.

So what are we talking about?

PEPFAR reasonably looks at ownership as a multidimensional concept including:

1- Political will and ownership

2- Institutional ownership (an earlier version included community ownership as well)

3-Capacity

4-Mutual accountability

Let's start with a few observations, before moving to measurement.

First observation: ownership is part of ownership -- twice. I'm not disagreeing with the concept, just pointing out that not only is ownership multidimensional, but apparently it's also multi-level. To the Complex Adaptive Systems (CAS) geeks, yes, we're talking about nested or inter-related sub-systems.*

Secondly, capacity is part of ownership. Sharon Arscott-Mills and I once ran a game at the CORE Meeting called "name your theory". We gave participants literature references, and they had to combine the words "capacity", "ownership", "performance", and "sustainability" in as many logical statements as possible. We found out that you can pretty much randomize the order of the words and come up with a theory that is backed by literature. Joke aside, capacity is part of ownership pretty much to the same extent that ownership is part of capacity. This is interdependence or co-linearity between variables. And it makes sense: if you don't have capacity, how can you own the responsibility for something? But if you don't care and own something, since governance and leadership is part of capacity, how much capacity do you really have to sustain it? (See what I mean about naming your theory?) There's a dynamic tension here. We're not talking about building blocks, but maybe something like electrons and protons, dancing around to form an atom.

Finally, it's very appropriate -- actually brilliant -- to have included mutual accountability in this model. This demands a relational element of analysis when considering ownership. No man and no institution is an island. Even our capacity is built through and on relations. And a country is built on many, multiform, diverse relationships*. How could a country own anything, without the sharing of, if not a common goal, at least compatible aspirations?

These observations now set the stage for the particular predicament we're facing with measurement of ownership. But a 900 word blog is already too long. So, this will have to be for part 2.

Speak of a Da Vinci Code cliffhanger...

Eric

* at this point, CAS geeks are drooling about fractal patterns. Just leave them alone; they can't hurt anyone.