HKS Ash Center
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Publication Transparency for Development Project Intervention Design(Ash Center for Democratic Governance and Innovation)Guided by a set of design principles (detailed in the full intervention design report, which will be released shortly), the T4D intervention was co-designed to achieve two related but distinct goals: (1) to improve maternal and newborn health outcomes in the communities in which it is implemented and (2) to increase citizens’ sense of empowerment and efficacy in treatment villages. This brief details the resulting design.Publication An Approach to Small-Scale Mixed-Methods Experimentation; Transparency for Development, Phase 2(Ash Center for Democratic Governance and Innovation) Kosack, Stephen; Creighton, Jessica; Tolmie, CourtneyFaced with a promising but complex intervention, how can further refinement be evaluated? The typical approach is experimentation. Rigorously evaluated experimentation, for several centuries the province mostly of medicine and related research, is today a reality in a variety of fields of social science and practice. Its primary form, the randomized controlled trial (RCT), stems from its medical roots. By design, RCTs are a highly specialized instrument of inquiry: they seek reliability by focusing on a simple, singular causal relationship. Their relevance typically depends on the relevance of this causal relationship and whether it can be accurately represented and measured in one treatment or in a handful of modifications (or “arms”). But the growth of experimentation has brought randomized controlled trials into evaluations of complex interventions in policy areas like health care, education, water, or sanitation, which often occur at the group or society level, at a large scale, and the implementation of which can take myriad forms. For precisely evaluating the benefits of complex programs, RCTs remain the gold standard, frequently used when, for example, a health or education program is under consideration for scaling, is already being done at large scale but is of uncertain benefit, or is almost perfected save for a very specific design question. But often large-scale randomized controlled trials of complex interventions are inappropriate. For an intervention whose benefit is already widely accepted, they may be too expensive; for one whose benefit is uncertain, they may be too large-scale. When, for whatever reason, evaluation of a complex intervention is important but small-scale experimentation is more appropriate than a full randomized controlled trial, how might further refinement of that intervention be most rigorously and reliably evaluated?Publication Transparency for Development: Project Results & Implications(Ash Center for Democratic Governance and Innovation, 2021-01) Fung, Archon; Arkedis, Jean; Creighton, Jessica; Kosack, Steve; Levy, Dan; Tolmie, CourtneyThe Transparency for Development (T4D) project was launched in 2013 to try to answer these challenging questions and to make sense of a highly mixed evidence base. Ultimately, we sought to design research that could provide useful and actionable guidance to policymakers, donors, and practitioners alike seeking to improve the effectiveness of their work.Publication Transparency for Development: Intervention Design and Evaluation Approach(Ash Center for Democratic Governance and Innovation, 2013-05-27)This discussion paper outlines a recently started mixed method research program to assess whether, why, and in what contexts transparency and accountability (T/A) interventions improve health outcomes. The project is intended to advance the state of knowledge about the impact of T/A interventions on service delivery in several ways. First, we will develop a new T/A intervention, based on an initial theory about how T/A affects service delivery in different contexts as well as the range of existing work in this field, that is designed to be flexible enough to work across multiple contexts. Development of this intervention will leverage the local knowledge of embedded and capable local partners through an intensive co-design process. Second, we will conduct mixed-methods evaluations of this intervention in multiple sites: our research plan combines an initial phase in which we will evaluate its impact in two carefully selected sites, Tanzania and Indonesia, with both a randomized controlled trial and an integrated and extensive qualitative evaluation to understand mechanisms and the role of context; a cost-effectiveness analysis; and a second phase, which explores the generalizability of both our first phase results and the theoretical implications of them for mechanisms and the role of context. Third, these findings will provide the basis for development of a more nuanced and empirically grounded theory of the impact of T/A— both the different mechanisms through which T/A interventions seek to affect development outcomes, such as collaborative problem solving or community pressure, and the conditions under which these mechanisms should be expected to improve service delivery. All of these elements will be used to produce a range of new tools for practitioners of T/A as well as sectoral health experts assessing whether to add T/A interventions instead of or alongside more traditional health interventions.Publication Transparency for Development: Pre-Analysis Plan(2018-04) Bombyk, Matthew; Creighton, Jessica; Dixit, Akshay; Levy, Dan; Roots, LindseyThe goal of the analysis described here is to identify the effects of the Transparency for Development program intervention on a range of maternal health and community participation outcomes as well as intermediate or process outcomes. The plan pre-specifies the analysis that will be conducted, before comparing outcomes between treatment and control groups. It outlines the intervention, evaluation design, data sources, hypotheses and outcomes of interest, and the impact estimation strategy. By committing to pre-specified analysis plans we hope to minimize issues of data mining and specification searching. The pre-analysis plan serves the dual purpose of ensuring the endline data collection tools are sufficient for the planned analysis. This plan was written and submitted after baseline data collection and the implementation of the intervention, but prior to the start of endline data collection.Publication Transparency for Development: Evaluation Design Report(Ash Center for Democratic Governance and Innovation, 2015-02) Arkedis, Jean; Creighton, Jessica; Fung, Archon; Kosack, Stephen; Levy, Dan; Naimpally, Rohit; Tolmie, CourtneyThe Transparency for Development Evaluation Design Report describes the mixed methods evaluation design for the Transparency for Development project as of February 2015 – just before the start of the first data collection activities associated with the project (baseline data collection in Indonesia). Since the writing of this report, a number of changes have been made to the design. For the most recent details, visit t4dproject.org.Publication Encouraging Participation(Ash Center for Democratic Governance and Innovation, 2019-12-05) Kosack, Stephen; Bridgman, Grant; Creighton, Jessica; Tolmie, Courtney; Whitt, Preston; Fung, ArchonCan civic engagement that is encouraged by a development program be empowering and helpful for improving public services? Transparency and accountability or social accountability programs are a popular approach to improving the responsiveness and effectiveness of health care, education, and other public services, but evidence of their effects is mixed. We ask whether participants in 200 randomly selected communities in Indonesia and Tanzania engaged with an experimental community-led scorecard program they were offered and whether they found the experience to be empowering and helpful for improving their maternal and newborn health care. Interviews, focus groups, and observations of program meetings before, during, immediately after, and two years after the program all indicate from complementary perspectives that in almost all communities, participants engaged in sustained and largely self-directed discussions about how to improve their care and tried the approaches they designed. Although their experiences were far from uniform and some grew skeptical of their efficacy, most who participated throughout eventually described their activities as having improved their care and as being as or more confident in their capacities to improve their communities than when they began. On average, their efforts were not sufficient to add significantly to measurable health outcomes in their broader communities two years after the program, relative to 200 other communities who were not offered the program. Thus participants’ perceptions of the efficacy of their efforts might stem in part from attribution bias. Yet the evidence also suggests that in a substantial minority of communities, participants had been willing to continue their efforts long after the program ended, and that their efforts had led to changes in their care that, although they may have had limited effects on average community-level outcomes or substituted for others’ efforts, were noticeable and memorable to them and others in their community. Altogether a wide range of observations and reflections all suggest that for most who participated throughout the program, the experience sustained or improved their perceptions of civic efficacy.Publication Transparency for Development Baseline Report(Ash Center for Democratic Governance and Innovation, 2016-09) Arkedis, Jean; Creighton, Jessica; Fung, Archon; Kosack, Stephen; Levy, Dan; Naimpally, Rohit; Roots, Lindsey; Tolmie, CourtneyThis baseline report describes the baseline data collection activities, baseline findings and revised primary outcomes for the impact evaluation of phase one of the Transparency for Development (T4D) project. The report is broken into five chapters. Chapter I describes the T4D intervention and evaluation, and situates the project within the broader context of the fields of transparency and accountability (T/A) and maternal and neonatal health (MNH). Chapter II describes the T4D data collection process, including a description of the survey tools, sampling strategy, and how data were cleaned and prepared. Chapter III presents the baseline findings for the T4D communities in Indonesia and Tanzania. It also describes how these findings were used to revise the evaluation design. Chapter IV details the T4D impact evaluation design. This chapter includes details on random assignment and verification of balance on observable variables between treatment and control villages, a listing of primary outcomes by research question, and the T4D impact estimation strategy. Finally, chapter V presents conclusions and next steps. This chapter is organized as follows: Section 1 describes the current state of MNH worldwide, and in Tanzania and Indonesia specifically. It explores the use of transparency and accountability (T/A) interventions to improve MNH and positions the T4D project within this debate. Section 2 provides a detailed description of the T4D intervention, including its underlying logic model. Section 3 describes the T4D evaluation, in which the impact evaluation (the primary topic of this report) plays a major role.Publication Insights from Transparency and Accountability Action Plans in Indonesia and Tanzania(Ash Center for Democratic Governance and Innovation, 2020-01) Creighton, Jessica; Arkedis, Jean; Fung, Archon; Kosack, Steve; Levy, Dan; Tolmie, CourtneyThis paper provides insight into community designed and led actions in Indonesia and Tanzania that were prompted by Transparency for Development (T4D), a six-year research project that explores whether, how, and in what conditions “transparency and accountability” or “social accountability” programs improve maternal and newborn health care. We find that all communities participating in the T4D program planned social actions, with the vast majority completing at least one action. We also find that the focus of the actions was diverse in nature, though participants in nearly every community planned at least one action aimed at educating members of the community. We compare actions designed in Indonesia to those in Tanzania and find a number of similarities and differences in the types of actions designed and whether the actions were completed. When analyzed from a social accountability lens, we find three trends. Firstly, the actions were overwhelmingly collaborative in nature. Secondly, the majority of the actions were short route, meaning they targeted the health facility or provider directly, rather than government officials higher up the accountability chain. Finally, when classified by accountability “type” we find that more than half of communities took a self-help approach, with only about a quarter pursuing solutions through social accountability channels.Publication An Aspirational Path for American Conservatism(Ash Center for Democratic Governance and Innovation, 2023-09) Goldsmith, Stephen; Streeter, RyanIn this working paper, Stephen Goldsmith and Ryan Streeter argue that the Republican Party is philosophically adrift, and it has been for a while. This is not only bad for the Party’s political future but bad for the country and its democracy by depriving voters of meaningful choice in ideas, they argue. The United States’ socioeconomic progress over the past 250 years, however uneven, can be attributed to the interplay of competing ideas on how to achieve progress. Central to the competition is how we understand individual rights and responsibilities, fairness and justice, and the definition of progress itself. When our political parties lose their ability to articulate governing principles and resort instead to defining themselves as the opposite of their enemies, the competition of ideas stagnates—and so does the condition of the country. Goldsmith and Streeter describe an alternative ideological path, aspirational conservatism, which is populist in spirit while rejecting the view that American institutions no longer offer upward mobility for ordinary individuals. It is pro-opportunity for grassroots doers and makers, such as shop owners, small-scale entrepreneurs, and new business owners with aspirations to grow. It is pro-worker in its focus on boosting wages by modernizing training, increasing access to the fastest-growing sectors for skilled work, and removing job barriers that have accrued over time. Additionally, it strikes a healthy balance by upholding the character and values inherent in American institutions and celebrating the diverse viewpoints and lifestyles that share those core values. The authors make the case for conservative governance that is respectful of its citizens, supportive of America’s underlying values, mindful that significant challenges remain, and aware that good politics and good policy require an effective government that helps individuals achieve their aspirations.