I’ve been reading up on development economics and theory, and an oft-discussed question is, “Why is X doing so poorly, given Y?” Less often asked is, “Why is Y doing so well, given Z?” Which is surprising — in the private sector, looking for “positive deviance” is an important method to improve performance and scale achievements. Sometimes, it’s better to learn from success than failure.
As it happens, The Economist wrote a fantastic article on Bangladesh – an extremely poor country on the eastern side of India that nevertheless has a “record on child and maternal mortality [that] has been comparable in scale” to 19th century Japan, the accepted winner of human health improvement. The article asks my question: why is Bangladesh doing better than its GDP growth would predict? It seems to me that the answer is instructive for other efforts at alleviating poverty and improving the lives of the worst off.
According to the article, four factors explain Bangladesh’s extraordinary performance:
1) Family Planning by Empowered Women. Bangladesh won independence from Pakistan in1971, and its nascent leadership realized two things: 1) population growth needed to slow; and 2) the government was too new and not legitimate enough to coerce its population to slow (a la India’s forced sterilization or China’s one-child policy). Instead, it used community health workers to distribute birth control and advice nationwide – leading to women feeling empowered to make decisions about their family, which in turn led to an increase in education rates
2) The Green Revolution and Emigration. Rice yields trebled and the country was able to move to twice-yearly harvests – leading to de facto crop insurance, which kept farmers from falling into poverty after a bad harvest. Additionally, villagers have emigrated to the Middle East in search of higher wages – and then send that money back to their families in Bangladesh
3) Semi-Competent Government. Despite what The Economist calls a “political circus,” focus has remained on alleviating poverty, with the government allocating 12% of public spending to safety nets programs regardless of who has been in charge
4) BRAC and Other NGOs Stepping In.The nascent Bangladeshi government allowed BRAC and other NGOs to help because it “realized it needed all the help it could get.” BRAC is known for inventing microcredit, and another organization — Grameen Bank – is known for popularizing it. The evidence shows that microcredit has been a net positive for Bangladesh, and shouldn’t go unremarked upon, but it’s BRAC’s ability to continually shift focus that has allowed it to be a success. As the article states, “…one of the biggest challenges of development [is] that solving one problem leads to another,” so in response BRAC has turned into a NGO conglomerate (like General Electric in the private sector) that does a lot of seemingly-disparate-but-connected things
It’s this final factor that interests me most, because it refutes one of the arguments I’ve consistently seen levied against aid/NGOs: they alleviate the symptoms of poverty, not the disease (allowing the government to remain inactive). In Bangladesh, BRAC stepped in and solved problems the government was unable to, leading to significant increases in human wellbeing – especially for women. It tried – and is trying – to cure the disease. In essence, it off-loaded some of what we typically assume to be the government’s responsibility (providing for the health of its people, say) until the government was able to take over.
Which naturally leads to the question of how to scale BRAC’s successes to other countries; or, put another way, what are the conditions necessary in another country to allow a BRAC-like organization to succeed? I think the list looks something like this: a small, dense country; a locally-run NGO with the resources and expertise to enact village-by-village change; a self-aware government that recognizes it needs help; established social programs to provide the base infrastructure on which to build.
To throw some cold water on the topic: it’s not clear there are many countries that fit the bill for this type of intervention. Bangladesh is a relatively small country with a high population density, so BRAC health workers could reasonably expect to visit nearly all of the women; that would be difficult in a country like India or the Democratic Republic of Congo. The government allowed BRAC to help in a significant way, something that may be unlikely in Uganda or Pakistan. And decades of government upheaval didn’t affect spending on social programs in Bangladesh – something that seems impossible in a country like South Sudan or Mali. And there’s the perennial question of whether NGO interventions allow bad or corrupt governments to not take responsibility for their people, too.
All of which is to say: Bangladesh may be a unique, unscalable case – but it’s worth trying to replicate success, especially when that success comes from a “positive deviant” that is expect to perform worse. The more we ask “Why is X succeeding, and what can we learn from it,” the better.