So, we’re going to talk a lot about capability and capability for policy implementation. To talk about that we need to be clear about what policy is and how capability for policy implementation is created.
So the first thing is - a policy is a mapping. It’s a mapping that says, “If this is the fact do this action.” So a policy is: If it is raining, open an umbrella. If it is not raining, don’t open an umbrella. That’s facts about the world that specify what actions to take when that’s the fact. Now, the complicated thing about policy implementation in a public setting is that often the fact has to be administratively created. What is the relevant fact isn’t necessarily the brute fact of the world. [throat clearing] It’s the fact as it is constructed into an administrative fact by the very policy-making apparatus itself. So let me give a concrete example.
A tax. If I have a property tax what a property tax says is “if the value of your property is this you’ll owe this much in tax.” But the value of your property is as it is declared and administratively adjudicated for the purpose of the tax. It may have nothing to do in fact with the value of your property for other purposes. But the tax authority both has responsibility for declaring and creating the administrative fact of the value of your property and then taking the appropriate action: Here’s how much tax you can collect.
Now, what happens is when organizations have low capability for policy implementation they often lose control essentially of the administrative facts and therefore the actions never follow. Not because the actions don’t follow with the administrative fact is but because the administrative fact itself becomes a fiction.
There’s a great example in a study that was done about trying to increase the attendance of the low-level healthcare workers -- the auxiliary nurse/midwives in the state of Rajasthan. They weren’t showing up to the sub-centers. And since they weren’t showing up people weren’t coming. Since people weren’t coming they weren’t getting the healthcare services they needed.
So … a team of and NGO working together with the government and a group of researchers designed a program that would say “we’re going to hire a new set of auxiliary nurse/midwives and these nurse/midwives will only get paid their full salary if they are not absent more than fifty percent of the time. So seems really clear. The nurses show up. If they don’t show up they don’t get paid their full salary. This should motivate the nurses to show up. If the nurses show up we’ll get people and the clinic will improve health status. All a very clear, logical chain.
What happened is by six months into the study period they found that the administratively declared absences of the nurses had gone way down so there was much less recorded absenteeism.
So you think “victory”. But the study team was measuring the physical presence of the nurses at the clinics at the same time. And, you know what? Presence of the nurses went down. Now you might think, “well, wait a second. Either the nurses are present or they are absent.” But that’s…you haven’t worked in a bureaucracy long enough. There is a third category, which is the nurse is not physically present. But she’s not absent – she’s declared that she’s not required to be there as part of other administrative responsibilities.
What had happened is once you put pressure on the nurses about the fact of their absence you created this whole secondary system in which the administrative fact was the nurse wasn’t absent. The fact of the matter was she wasn’t present to deliver healthcare either. And the whole program the gap between the facts on the ground as perceived by the actual users and the administrative facts as declared about the absence of the nurses diverged so that both presence went down and absence went down and you were actually in a worse situation because you had lost control essentially of the gap between the administrative fact which was now a fiction about actual presence and the facts on the ground that were relevant to the delivery of the service.
So the capability for policy implementation needs to be able to get your agents responsible for creating the administrative facts to declare the facts to be what is relevant for purposes of accomplishing the objectives of the policy.