Background and Objectives
2nd Professional Forum Health and Social Protection
Bonn, 13.-14. January 2011
‘Health and Social Protection: The Political Economy Dimension‘
1. Background
Over the past few years political economy issues have come increasingly to the forefront of the discourse within the international community. The way how political power is secured and exercised in partner countries is regarded as a key issue for understanding how development processes evolve, and how incentives are generated which enable or block development oriented behaviour of actors. Also, development partners have been recognized to be political actors who - by providing resources to selected groups - change the dynamics of the political process.
This type of political thinking also influenced the ‘good governance’ agenda. Newer types of governance analysis place greater emphasis on understanding the core governance issues in a country, such as interests, resources and power of actors and their relations. They adopt incremental approaches in fostering governance, thus focusing more on ‘good enough governance’ and on the change feasible under given political circumstances. Thus, newer approaches to governance take into account political economy issues.
More recently, there is growing recognition that political economy is also an important dimension of sector work, both at policy and operational levels. It is crucial for the articulation of policy goals, their implementation and the outcomes of a particular sector.
Progress in pro-poor health reform has not been encouraging. The analysis shows that this is only partly a function of the technical complexities but rather one of specific political economy issues, in particular the asymmetries of power and the particular incentives and disincentives facing the winners and losers, including service providers, politicians and the bureaucrats who often dominate policy-making (Batley, 2004).
With regard to public service delivery for the poor, the WDR 2004 drew attention to the accountability relationships between citizen, policy makers and service providers. Re-aligning these accountability relationships has since been a popular operational entry point for better governance and service delivery. Approaches to strengthen the demand side of governance, the ability of citizens and clients to demand better policies from their governments and better services from their service providers have increasingly come into focus. In Uganda for example, communities routinely monitor the service quality of their health centers and give feedback to the staff. This initiative was evaluated with ‘robust’ methods. The results indicate that this intervention did not only significantly improve the quality but also the results of the health services that were delivered (Björkmann, Svensson et. al. 2007).
With the change in aid modalities towards SWAP, PBA and budget support, the spectrum for working on governance issues has widened, ranging from high-level political dialogue, conditionalities, investments in better institutions or capacity development of demand side actors. Donors and think tanks have developed a whole arsenal of methodologies and instruments to guide this work.
Still, there are many open questions: How can donors meaningfully and without intrusion engage with partner countries on these issues? How do we, working in a partner country as an advisor of an international development organisation, act in a politically intelligent way? Which entry points to chose for a politically informed sector programme: sector policy reform, supply side interventions or strengthening citizens’ demand for good governance? Where is the space for improvement within the given circumstances and which rhythm of change should be adopted?
As for many other actors, the potentials and limits of the the political economy paradigm as well as the newer governance frameworks are not yet fully explored for German DC. To date, there are a number of promising experiences and practitioners claim that they have always managed the political dimension of their work. However, in the fields of health and social protection, GDC has not yet engaged in a systematic reflection on the relevant terminology, frameworks, assessment methodologies and intervention areas.
This is why the forthcoming professional forum on political economy shall provide an opportunity for exchanging views and experiences for GIZ and German DC more broadly.
2. Objectives of the Forum
The objectives of the forum are:
(1) Explore concept and practical relevance of a political economy perspective for sector reform, improved services and better outcomes;
(2) Discuss different types of analysis, ways of engagement at policy level and operational entry points in the social sectors, incl. supply and demand side;
(3) Exchange on case examples and experience from participants, on the lessons learned so far with political economy approaches;
(4) Reflect on how to strengthen GIZ’s and GDC’s contribution by better defining its role in the political context of its work, and how to develop, adapt and improve its tools accordingly.
Contributions and discussion will be documented in forum proceedings for further use in GIZ’s discussion on how to better integrate frameworks, methodologies and approaches in its work.
