An opportunity for strengthening systems

Against the backdrop of decreased foreign aid, rising nationalism and constant disorder, strong national systems are increasingly crucial. Devastating impacts from disruptions in essential services and programmes, including in healthcare and education, caused by the recent aid cuts show widespread fragility. They also show how ‘top-down aid’ – provided without efforts to strengthen the local workforce or build sustainable systems – only leads to dependency and short-term solutions. Countries need to maintain and improve their national services to foster resilience and sustainability. By strengthening systems, countries can be empowered to navigate future global political shifts and instability through self-reliance and adaptability.

‘Systems’ may sound mundane, but they are especially important for children’s well-being. Strong national systems ensure that children have access to quality healthcare, education and social services – crucial to their physical, mental and emotional development. Robust systems also promote equitable access to resources and opportunities, and provide the foundation for a healthier and more equitable future.

What are the barriers to a strong national system? There are many: insufficient funding, a shortage of skilled personnel and inadequate infrastructure; lack of coordination and integration among different sectors and services leading to gaps in service delivery; weak governance structures, lack of political will and inconsistent policies; cultural norms, social inequalities and resistance to change; inadequate data collection and analysis to name a few. Such barriers can hinder the ability to make informed decisions and monitor progress.

UNICEF works to strengthen systems. But as we enter a new world order, we cannot deliver on our mandate to serve children unless we make systems more home-grown and effective. This piece explores why systems are important, how they are configured and what it takes to make them stronger.

Why are systems important?

Systems are the interface between policy and practice. Effective systems deliver maximum impact for children. When working in harmony, the various systems create a multiplier effect. Systems are dynamic, adaptive and reflective. They are informed by assessments, research and data to drive improvement.

In today’s constrained fiscal environment, we must be ready to respond to government asks around systems building and strengthening, and to give advice on how to make them more effective, sometimes simply by making the most of the available resources.

Over the last several years, UNICEF’s actions in the field have led to great results for children, at output level. This means that we have achieved our targets. However, the results have not made equal progress at outcome level because the actions have not triggered systemic and sustained shifts.

A system must be ready to deliver at scale and in a sustainable manner. It should reach children throughout the state/region and country or have the potential to do so. The system should also be devised so that service delivery at scale is feasible for the long-term. For UNICEF, this means phasing out bespoke initiatives that are not scalable and investing wholeheartedly in initiatives that are.

A simple stress test of three questions can help to decide whether to stop or continue an activity.

1. Does this system have the backing of leadership in the country to become part of the eco-system across sectors?
2. Is there a long-term vision for this system being sustained within government structures and financing?
3. Is this approach already at scale, or can it be scaled in the future?

If the answer to any of these questions is ‘no’, then our plans should go no further. Of course, that does not mean the initiative is not important. But it does mean that it is not UNICEF’s role to implement it.

How are systems configured?

Thinking about a system, it can be useful to recall the story, “The Blind Men and the Elephant”, which illustrates the concept of limited perspective and the importance of understanding the whole picture. Very few people know what the whole system really looks like because people focus only on the part they encounter.

But as UNICEF we need to understand the whole system, the strengths and weaknesses – the whole elephant.

What it takes to make systems stronger

A government system is no different from any other workplace. As we support governmental actors to be strong leaders, we must advise them on how they can empower people within that structure to be productive. Evidence shows each team member must have:

• A solid understanding of own role and responsibilities within the system. This includes being well-equipped to take instructions and feedback from whoever is above, and to give clear instructions and feedback to whoever is below in the structure;
• Access to instructions and a feedback loop to channel improvements to the system and ways of doing business;
• Adequate information about the system specific to their area of responsibility, but also the broader system beyond their specific role;
• Clarity from the leadership, especially when it comes to common goals and ‘what success looks like’ for the system within which they are working; and
• Control over their domain of responsibility, and resources and skills to fulfil that role.

These may seem like basic things, but they are easier said than done. Without them, no matter how much money is invested in a given system, colleagues within the system will remain frustrated and demotivated.

Conclusion

All systems experience shocks and stressors. Some of these are slow and take a long time to erode the system, while others immediately and irreversibly destroy. For a system to survive, it needs the features listed above. But it also needs to welcome innovation. In the coming years, we will likely have to innovate a great deal, and innovate for solutions that can seem mundane but work in the practical ways essential to delivering results for children.