Focusing on health systems with Results for Development

Gina Lagomarsino is president and CEO of Results for Development. This post originally appeared on R4D's Insights Blog

Results for Development (R4D) is excited to share our new look, but we’re also delighted to share our refined organizational mission and focus, which is reflected throughout the new site.

At the heart of our new strategy is an ardent belief that prosperity begins with health and education. People cannot thrive and contribute fully to society when they’re sick or hungry or poorly educated. Strong self-sustaining systems are the key to achieving lasting and large-scale results in healthnutrition and education for everyone.

Working on systems is trendy in global development. But what does it mean in practice?

The global development community is buzzing about “systems” right now, and everyone has their own definition. Here at R4D, we think of a system as the people, inputs, institutions, policies and processes and how they interact to deliver key results, such as moms and babies who are well-nourished, children who are learning and thriving, and high-quality, affordable health care for all.

We believe that strong, well-functioning systems deliver results for everyone across a population, especially the most vulnerable. And instead of addressing one issue, they provide myriad benefits. A strong health system ensures that all kids are immunized, but it doesn’t stop there. It takes care of all of its people’s health needs over the course of their lives in an integrated and coordinated way. A strong education system not only ensures that school-age children are in school, but that they are learning the hard and soft skills required to be successful in work and life.

Strong systems engage in continuous improvement, introducing and scaling innovations to improve quality and access, and constantly measuring results and seeking feedback from citizens. Strong systems are self-sustaining — they don’t require ongoing long-term support from outsiders. And they’re able to weather shocks such as disease outbreaks, conflicts and natural disasters.

Systems change is desirable for many reasons, but it’s also complex. It involves well-considered design and lots of attention to implementation. It’s hard to measure, and it’s not a quick process. But we believe that an investment in strong systems is an investment in sustainable development. It’s why we’ve chosen this mission.

But we also know that external parties can’t lead systems change.

Listening to the needs of local change agents

Motivated local change agents — government officials, civil society leaders and social innovators — are the people who are already driving and must continue to drive reform in their own countries.  And supporting local change agents starts with listening. Over the years, we have engaged in deep conversations with our partners in many countries who are working to reform health and education systems to learn what they need most.

Our partners often know what they need to do, but they need help figuring out how to implement reforms. They need a source of external ideas and evidence to push their thinking. But they also want to better understand their own context — through the use of data, assessments of current capacity and the stakeholder landscape, including the perspectives of people who will benefit from the system. Successful reformers need to find ways to stay personally motivated through challenging situations. A network of peers, thought partners and supportive coaches can be invaluable.

We are committed to building those networks, offering our expertise and knowledge, and learning as much as we can about the “how” alongside change agents. And when we support specific countries or local organizations, we aim to synthesize and broadly share knowledge gleaned from these activities so that others can get results for development, too.

Embarking on a new journey

We’re are excited to embark on the next phase of our journey, but we also approach our mission with deep humility.

We are asking questions such as: How can we “build true capacity” in countries without creating parallel infrastructures and contributing to brain-drain? How can we best support the development of strong and lasting government, civil society and private sector institutions that are capable of continuous improvement over time? How can we ensure that an innovator or reformer can get connected to the most appropriate and effective advice and support for her most pressing challenge? How can we ensure that the most effective innovations are scaled within systems? And how can we better measure progress toward stronger systems so that we can learn what works and what doesn’t?

As we work to continuously improve our approaches to achieving results, we have challenged ourselves to address these important questions, in collaboration with other creative and thoughtful partners. We are excited to work with others who are thinking about these challenges. We invite your comments and ideas below for how to support change agents around the globe create self-sustaining systems for healthy, educated people.


Photo © Results for Development/Lane Goodman ; AGE Africa