Governance and organisational development

Good governance and organisational development is about creating institutions that last, establishing a culture of openness and trust and, above all, bringing about change that can be sustained in the long term.

In developing countries, governance may mean ensuring that resources are being used for the right purposes. Taking steps to increase probity can help eradicate corruption, eliminate bad practices – and, of course, reduce waste. In Bangladesh, our multi-methodological approach to examining fiduciary risk in the health sector combined quantitative research with focus groups and discussions with key informants. This gave us the opportunity to root out examples of bad practice, but also to celebrate and share what was good.
 

Establishing independent oversight can mean bringing about cultural change. The idea that healthcare quality should be independently monitored is well-established in developed countries, but less so in developing countries. Gaining buy-in to and support for the creation of an independent body can be challenging, and illustrates one of the underpinning principles of our ethos – that theoretical solutions, no matter how well they work on paper, are only useful if they are politically viable. A deep understanding of the environment and culture is essential to achieving lasting change.
 

Effective organisational development means building capacity and encouraging ownership of change. Capacity-building isn’t just about training; but training is an important part of developing organisations’ own ability to change the way they work. Without ownership, though, there is a risk that knowledge and skills will not be embedded within the organisation. An effective alternative is to transfer responsibility for training to local institutions – and individuals – over time.