The global challenges we face today are more complex, more demanding and increasingly, more interconnected than ever before. Shouldn’t the solutions we seek be more integrated, too?
Last month in New York, FHI 360 brought together a group of distinguished leaders from across the development community to advance the conversation about integrated development. In a panel discussion, titled “Does 1+1=3: Proving the Integration Hypothesis,” representatives from the United Nations, Bill & Melinda Gates Foundation, U.S. Agency for International Development (USAID), academia, international nongovernmental organizations and others offered diverse perspectives on the topic.
The discussion began with a deceptively simple question: What do we mean by integrated development? “We know when it’s lacking,” said Kiari Liman-Tinguiri, adding that while we need to move forward, we also need the solid evidence to show where and when synergy and integration work.
It is not as simple as co-locating projects and programs or layering related interventions such as polio shots and vitamin distribution, added other panelists. Mark Viso, CEO of PACT, noted that vertical integration is messy, is often difficult and requires tackling systemic issues, such as capacity. It is also critical to create an enabling environment and engage business and markets. University of Washington professor Judd Walson added, “It’s integrating staff, management and funding, and you don’t often see that.”
To Judd’s point, a major barrier to integrating approaches is that most funders today are not set up for integrated designs. USAID’s Tony Pipa called siloed funding a major challenge. Nevertheless, the agency is seeking ways to integrate across sectors. Maggwa Baker Ndugga noted that the Bill & Melinda Gates Foundation is also pursuing ways to integrate across or among some 16 sectors as a strategy for achieving impact at scale. The foundation has dedicated a team to integrated delivery that is partnering with FHI 360 to gather the supporting evidence to prove effectiveness where such approaches work and to design concepts and tools to support implementation.
There was a strong consensus among the panelists that integration requires authentic collaboration, not least because a more robust body of evidence and the ability to curate practical on-the-ground insights that support integrated approaches requires participation from partners across all development sectors.
A day earlier, former President Bill Clinton, speaking about the Clinton Global Initiative’s (CGI) next steps at the opening plenary session for CGI’s annual meeting, underscored the importance of partnerships, especially those that include the private sector. “We live in an interdependent world where social and economic problems soon collide, and therefore networks of cooperation will be the dominant mode of success in the 21st century,” he said.
If partnership is essential, what are the other ingredients for successful integrated approaches? Leith Greenslade, from the MDG Health Alliance, made the case that bottom-up, versus top-down, approaches are critical. This view was echoed by several panelists, including Judd Walson, who noted that the articulated needs of the end user — for example, a mother and her children or a community’s leaders —should be at the heart of program design and delivery.
I agree. Program design and delivery must be human centered, reflecting people’s needs, wants and social context. We need to look at innovative ways to engage people from the beginning and understand fully the ecosystem within which programs operate.
We also need to be intentional, purposeful and practical, carefully thinking through when and how we approach and implement integrated programs. As one panelist observed, they must build in considerations for unexpected shocks and stresses from natural or human disasters. Sequencing and timing integrated interventions is a critical consideration to intentional design. Ensuring cost-effectiveness with indicators that measure meaningful results is another.
Integrated development is an old topic. Frontline development workers have intuitively advocated integrated approaches for decades. However, our conversation in New York brought new and updated perspectives to this discussion and a renewed appreciation that even if our intuition tells us that integrated approaches are effective, we need rigorous evidence to show if, when, how and where they work best.
Our goal is to ensure we work smarter and are effective proponents of “good development.” The conversations in New York last month will help to advance how we make a meaningful and lasting difference in people’s lives. We live in a complex world where challenges are interconnected; the solutions must be, too.
View the panel discussion.