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LFA is one of the many structured models for strategic planning and it is the most common approach in international development cooperation projects (Slides). SIDAÂ´s LFA manual and presets sustainability along with relevance and feasibility as a crucial factor for projects success. The manual suggests that sustainability is covered by the LFA in the risk and assumptions analysis sections and also in the inclusion of a plan of exit. Sustainability is also presented logically in association to the overall results since both aspects relates to the long term impact of the project. All the few points made by the LFA manual concerning sustainability seems legit however discussions about how to secure it is limited.
Lopes and Theisohn presents a rather comprehensive discussion of the sustainability issue and from their inputs, suggestions for improvements to the LFA manual would be made. The focus of improvements would be in time span for the project development, local ownership, leadership, incentives discussions and countryÂ´s accountability.
Lopes and Theisohn discuss capacity development in the light of making it sustainable. The discussion is grounded in international cooperation and partnership experiences where improvements are needed in the understanding of the development process. Therefore LFA manuals used by different organizations should struggle to be more explicit in the discussion of sustainable development process. They also present two models with the difference between capacity building and capacity development whereas in the first case external knowledge bypasses the existing capacity and in the second case the existing capacity is upheld through knowledge. From that point of view it is clear that in the capacity development model sustainability, local ownership and effective leadership would be easier to achieve.
Lopes and Theisohn make it clear that any sustainable process takes time and requires involvement of individuals, institutions and society. Unfortunately countries and even donor organizations have short term plans where quick fixes and outputs results are delivered. Perhaps longer projects with a focus in capacity development would have long term results that could reflect sustainable development.
LFA process includes stakeholders in the problem and objective analysis and also in the stakeholder analysis. Even though stakeholders are involved in the LFA process, ownership and leadership is not clearly discussed. Lopes and Theisohn clear demonstrate that stakeholders' values and their own development model ought to be respected and in that way self-esteem would be improved. Also the learning process has to be considered a voluntary process that requires self and organizational commitment. Power unbalances, vested interests and mindsets should be challenged through communication and open dialogue (whenever possible) and transparency should always be sought after. The country priorities and demands should not only be respected but also determines the projects that are going to be in place. Furthermore, if national systems are not well structured they should be strengthened but not surpassed. Those points if made clearer would definitely enrich the stakeholder contribution to the LFA process and would culminate in fully local ownership. Leadership discussion is another aspect that could be explicitly required in the LFA manual considering its fundamental role in development and transformation. Lopes and Theisohn show the importance of leadership in the context of either high capacity or low capacity scenarios where in the first a poor leadership could ruin the process and in the second a sound leadership could promote good results.
A discussion of the use of incentives could have been required in the LFA manual (perhaps in the activities analysis section) since positive incentives could foster capacity development and even control corruption and negative incentives could lead to brain drain (therefore capacity reduction) and discourage local initiatives thereby local ownership.
Lopes and Theisohn discuss the difference between capacity building and capacity development whereas in the first case external knowledge bypasses the existing capacity and in the second case the existing capacity is upheld through knowledge. It is clear that in the capacity development model sustainability, local ownership and leadership would be easier to achieve.
Countries governmentÂ´s accountability and transparency should be discussed in the LFA process. Accountability should refer not only to finances but also to management, planning and services delivery. Transparency should be sought after and stakeholders should follow the monitoring process to learn from the results and therefore to require adjustments.
Experiences from the group assignment highlight that even when following SIDAÂ´s LFA manual aspects like ownership and leadership can be surpassed or just taken for granted and not therefore not discussed properly.
Lopes, Carlos and Theisohn, Thomas (2003), Ownership, Leadership and Transformation: Can we do better for Capacity Development?, Part A, UNDP/Earthscan Publications, London and Sterling, Virginia, pp. 17â€157, 140 pages.
Sida (2004), The Logical Framework Approach, 2004, 40 pages
Question 2 (6 points)
Reflect on possible issues of relevance for the development of good or better governance in your field of interest (i.e. Public Health). Base yourÂ reflectionÂ on the course literature, including the articles.
Good governance: transparency, responsibility, accountability, participation and responsiveness
Question 3 (6 points)
From the theories of leadership I would like to present the Leadership as Trait as the theory that I least like and Situational and Contingency Theories as the one that I like best.
Least liked: Leadership as trait (also known as the great person theory)
This theory was important for the evolution of leadership theory and research since it was used as basis for critique and reflection about the meaning of leadership. It was especially important in the 1900-1940 where from observation most leaders were for example taller men. From that observation the idea of an innate leader with specific physical features (like age, gender, height and ethnicity) and specific personality trait was constructed and supported. Honesty, integrity, intelligence and adaptability were also some other characteristics expected from those natural born leaders. In that theory the teaching of leadership would be possible only to those with the predisposition to be a leader. The observations made in the beginning of the last century did not take into account the influence of social norms and culture over the same aspects that were considered important by the theory. Newer theories would rather now focus on what a leader do than what a leader have to avoid the influence of those social norms and culture.
This theory is historically interesting but in my opinion it is outdated and not adequate anymore to the discussion of leadership. This idea of innate leadership maybe perhaps still exists although the concept of improving abilities and skills in that area is nowadays at least as strong as the innate idea. Many changes in social norms and culture have happened and what this theory is proposing as important characteristics to leader is not only outdated but also offensive to some groups, e.g. women. Furthermore history shows us that some leaders would appear to have those necessary characteristics such as honesty and integrity and in the end turned out to be impostors and charlatans.
Best liked: Situational and contingency theories
Situational and contingency approaches (HousesÂ´s path goal theory from 1971, revised in 1996 and Hersey et. al.Â´s situational leadership model from 1996) are grouped together because despite some differences those are not enough to characterize different schools of thought. They are supported by the observation that the leaders emerge out from the situation. Both situational and contingency approaches focus on factors outside the person who leads although they also require some characteristics from the leader such as flexibility and adaptability. Main appointed contingencies for leadership relate to the employees and to the environment. In the employees side it relates to their skills, experiences and personality what culminates in their willingness and readiness to follow. In the environment side the nature of the team and the type of work required is mentioned but also the emergent contingencies related to politics, regulations and opinions such as gender and sustainable management.
It is important to stresses the importance of these approaches to the leadership discussion and evolution, especially in the context of trait and behavioral theories. The recognition that the context is continuously changing and that leadership style should therefore accompany those changes is quite appealing to my logical reasoning. The main critique to these approachs are about the actual ability and willingness of people to change themselves. It is probably more common to a leader to try changing the contingencies than to change themselves.
Clegg, Stewart, Kornberger, Martin and Pitsis, Tyrone (2011), Managing & Organizations. An Introduction to Theory & Practice, Sage, London, 568 pages (selected)
Question 4 (6 points)
Effectiveness means "producing or capable of producing a desired effect" (dictionary). The actual definition of effectiveness would be the same for the three different areas of HSO although each of them would claim different things as the desired effect. That mismatch between what is the desired effect for each area results from the fact that these different areas of HSO would have different principles, goals and success measures, structure and work modes. In the policy domain for example a success measure could be raising equity. In the Management domain success could be recognized as efficiency and in the service domain it would be the quality of the services and a good standard of practice that would be considered as the desired effect of the organization.
In the perspective of Health Care Organizations it is easy to see that those different domains are really looking for different effects although perhaps the overall outcome should be obvious - health.
A variety of conflicts and ethical dilemmas would arise from the existence of these three different areas of HSO since they are very different in principles, structure, goals and work modes. Kouzes and Mico describe in their Domain Theory that each domain would have a separate identity, with different points of view, different norms and different rhythms of change. It is easy to perceive discordance between them and also a struggle for power and control.
The first point for conflict would be the different goals and the measures of success. It is closely associated to the different identity of the areas with an absence of a shared reality. Different domains would not have a common vision of the organization and therefore there will be lack in coherence. Ethically issues related to which goal is more important can arise. For example: is it equity (policy domain) or is it quality of service in the health care sector meaning life and death (service domain)?
The different point of view from those different areas would determine a different focus in the process and sometimes the information necessary for the performance of the other domain activity would be selectively ignored. This focused perception of each domain could lead to conflict but also can raise the necessity of preserving each domainÂ´s integrity.
Other point of conflict could be related to each domainÂ´s norms. Since each one has different norms a specific behavior could be accepted in on but not in the other. That would lead to lack of cohesiveness and the separation of areas would be strengthened.
Power and control would have a different balance in the HSO. Domains often would not work in collaboration but au contraire they will tend to fight for the control of the HSO. In other types of organizations managers tend to have more control than in HSO. In HSO, professionals from the service domain tend to require autonomy and self-regulation. From the health care organizations it is clear how medical doctors and nurses would highly oppose attempts of the management domain to set up mechanisms to regulated services. On the other hand policy domain frequently tries to play management roles what finds resistance from the managers.
The responsiveness to change is also different among those different areas of the HSO. The policy domain would react to demands of the political arena; the management domain would respond to the economic sector and the service domain would react to cultural aspects. Frequently those different demands would require different responses. Each domain would resist from external threats (coming from the environment or from the other domains).
To discuss the types of change strategies I would follow Kotter and the slides from Introduction to change management (Bengt). Kotter suggests eight steps to transform an organization. From those I can highlight some of them (in bold letters) that I found relevant for an HSO. I will also group them under the headlines pressure for change, a clear shared vision, capacity for change and actionable first steps.
Pressure for change: according to the domain theory HSO areas have completely different identities. It is therefore important to establish a sense of urgency for change among all the three domains. In order to achieve that there is a need to form a powerful guiding coalition with influent representatives (leaders) from each domain.
A clear shared vision: considering that each HSO area has its own perspective of the organization and its goals, it is clear that this step is crucial and extremely important in those organizations. Conflict management and strong leadership would allow the creation a common vision and to communicate this vision.
Capacity for change:
Actionable first steps: a plan to create short-term wins could work perfectly in a HSO since its different domains have such a different view of goals and success measures. To have short-term achievements in the organization could lead to team work, coherence and cohesion.
Kouzes, J. and P.R. Mico (1979), Domain theory: An introduction to organisational behavior
in human service organisations, Journal of Applied Behavioral Science, Oct 1979, 15:449â€469, 21 pages
Kotter, John P (1995), Leading change; why transformation efforts fail. Harvard Business
Review, March - April 95, pp 59 - 67, 10 pages
Question 5 (3 points)
An organizational SWOT analysis has the perspective of the organization in focus. In the case of a health sector SWOT analysis the perspective is not explicit and clear. It could be understood from the perspective of any of the sides involved (policy makers, managers, professionals, patients/users and community/society). The perspective is very important since internal and external factors ought to be determined.
The SWOT analysis can be used to provide a Force-Field analysis where forces for and against change are determined. From the SWOT analysis if you take strenghes and oportunities as driving forces and weaknesses and threates as restraining forces you can see how those factors works in the unfreezing phase of the change process.
SWOT analysis is an instrument that helps organizations determine important factors, increase information and reduce uncertainty. As an instrument it can be used uncritically and without a clear balance between the weight of opportunities and threats and strengths and weaknesses. So erroneously a weak opportunity may seem to balance a strong threat. Also the instrument may change the focus of the organization from strategic planning to only determine a list of pros and cons.
Question 6 (3points)
Change and innovation are linked. Change is something that happens and can be managed. It relates to the transition from one state to the other. Innovation is what can be done to cope with the change or to promote a change. Innovation in the perspective of an organization creates processes, products and/or services that has an impact on the organization
Ethics and morals are terms frequently used as interchangeable although there are important differences between them. Ethics is the rules or standards for deciding a proper conduct (what is right and wrong).Â It is more in the philosophical and analytical arena. Morality is the standards for behavior that exist at some point in time. It refers to individuals' character and behavior in a certain society.
A group is two or more people that work for a common goal without having a deep agreement between them. Results are not dependent on all members since there is no shared responsibility or accountability for the outcomes. In a group people can think in a way they wouldnÂ´t by themselves (group thinking) and also it can have negative group dynamics.
A team is two or more people working together to achieve a common organizational goal with a deep agreement between the parts. Individuals share responsibility and accountability for the outcome. Teams should be developed to reach independency and efficiency. Goals, roles and rules should be made clear and functional in a process.