Taking Ideas to Scale

1. Taking Ideas to Scale Steve Reifenberg University of Notre Dame February 12, 2013

2. Taking Ideas to Scale • Human Development conference and discuss Thursday’s essay • A bright spot -- ORT : A simple solution? • Going to scale with ORT: A simple solution? • Development Advisory Team prep

3. Map courtesy of Wikimedia Commons. • West and East Pakistan are created in 1947, in independence from Great Britian • East pakistan – war for independence 1971

4. “A Simple Solution?” • Beginnings of BRAC: Bangladesh, 1972 • Oral Rehydration Therapy (ORT) • BRAC Founded in Bangladesh in 1972 after liberation war… by time of the story it has 200 employees

5. The “simple solution” OR “A pinch of salt, a fistful of gur” Photo showing the pouring of an ORS sachet into a bottle. Source: CDC Public Health Image Library Photo by mcfarlandmo. Some rights reserved.

6. ORT OTEP (Oral Therapy Extension Program) • Field experiments – • More failures than successes • The “simple solution”? • “Teaching is not the same as learning” • Incentive program… based on what?

7. Scaling Up • Multiplicative • Uptake by government or other NGOs at policy level • Additive • NGO gets bigger reaches more people Effectiveness (it works)<–> efficiency (it’s cost-effective) Relationship with public sector?

8. ORT in practice “Pilot, perfect, scale up” • Pilot: Sulla Thana • Training 20 ORW’s (Oral Rehydration Workers) • Perfecting • Monitoring implementation • Revising methods • Scaling Up • Extending pilot community to the entire country of Bangladesh

9. ORT Worldwide • Map of widespread treatment for diarrhoea: http://rehydrate.org/ors/ort.htm

10. “Small is beautiful, but big is necessary” • “Do we remain small and beautiful, or do we scale up and take the consequences?” • How do organizations grow and stay nimble? • the mantra “pilot, perfect, scale up.”

11. “Our mission is to empower people and communities in situations of poverty, illiteracy, disease and social injustice. Our interventions aim to achieve large scale, positive changes through economic and social programs that enable men and women to realize their potential.” Focus on impact in the communities – build this evaluation into the projects. • Monitoring – effectiveness and uptake • Research and Evaluation division established in 1975 --- used effectively from the beginning • Innovations Laboratory • Training – evaluate and use rewards as incentives.

12. BRAC • Today – 100,000+ employees • 11 countries: Uganda, Tanzania, Sierra Leone, South Sudan, Liberia, Haiti, Afghanistan, Pakistan, Sri Lanka and the Philippines – with an office in the US • Estimated 126 million people affected by BRAC. • 2013 Global Journal ranked BRAC #1 development NGO in the world • (others in top 10 include PIH and Acumen Fund)

13. BRAC: Themes across all activities • gender equality • respect for the environment • inclusivity

14. Argentina: Ethical leadership development, Centro de Investigación y Acción Bangladesh:Promoting opportunities for people with disabilities, BRAC Chile:Impact of volunteer service organizations, América Solidaria (U.S. base) Colombia: Alternative sustainable rural development, Witness for Peace (WFP) Haiti: Examining models to support sustainable housing, Engineering2Empower (E2E) Kenya: Community engagement development models to support Maternal and child health, Ford Family Program, Notre Dame India: Improving child nutrition and development in the Wayanad District in northeast Kerala, in collaboration with the Indian Institute of Management Global: Advancing a social movement on “From Aid to Accompaniment”, Partners in Health Development Advisory Teams

15. Taking our cue from BRAC… • Focus on impact • Research and Evaluation • Pre and post survey & evaluation of expectations and impact: • identify students learning goals • evaluate contribution to organizations

16. BRAC • Microfinance • Health • Education • Agriculture, Livestock and Poultry • Empowerment and Livelihoods for Adolescents • Training • Research Evaluation • Monitoring and Auditing • Partnerships

17. Microfinance programs in 9 countries • BRAC’s Microfinance program, one of the oldest initiatives of its kind in Bangladesh and also BRAC’s largest, was launched in 1974. • The program now covers all 64 districts and provides a range of financial services to the poor, including credit and savings programs • Focus began on self-employment, now working towards small enterprise development Photo by James Zwier. Some rights reserved.

18. Village Organizations Organizing the poor is at the heart of our work. Our Village Organizations (VOs) - each with 30-40 women - act as platforms for poor women to come together, access services such as microfinance, exchange information and raise awareness on social, legal and other issues concerning their daily lives Photo by Mark Knobil. Some rights reserved.

19. Health, Nutrition and Population program operates in 8 countries in Africa and Asia • Essential Health Care (EHC) is the foundation of BRAC’s health program combining promotional, preventive and basic curative services.  • EHC revolutionized the primary health care approach in Bangladesh, with EHC being implemented in 64 districts, it reaches millions with low cost basic health services through the frontline community health workers – 95,623 ShasthyaShebikasand 10,008 ShasthyaKarmis. • The community health workers (SS and SK): • - are local women recruited and trained - use a door-to-door approach • - partner with the government and private health sector • bridge the gap between the community and the formal health systems Photo courtesy UK Department for International Development. Some rights reserved.

20. Empowering Adolescents • ELA - The Employment and Livelihood for Adolescents (ELA) program combines livelihood and life-skills training with credit facilities to help improve the quality of life of rural adolescent girls and young women – ages 14-25. • ELA village organizations: 20 to 30 members who obtain credit to generate income either with the help of family members or on their own.

21. Education • BRAC has built the largest secular, private education system in the world, with over 700,000 students enrolled in BRAC primary schools. • Bangladesh • Afghanistan • Pakistan • Uganda • South Sudan • Philippines

22. Importance of Training • BRAC believes that training is a key element of the development • focuses on people and their participation. • Training as an essential element of BRAC's intervention strategy. • Created a “Learning Division” to address its own training needs as well as that of government and other non-government organizations.