Office Discussions: Why We Dare to Reinvent

OPEN OFFICE DISCUSSIONS

Why We Dare to Reinvent

JOKE LE POOLE - FOUNDER & DIRECTOR

At Max Foundation, we are constantly thinking about our impact. If there’s one thing I’ve learned as director, it’s that there’s always room for improvement. For every question we answer, a new one comes along. The developments in the WASH sector keep us constantly on our toes, and we’re not afraid to try new things! Even as we continue to learn and grow, our overall mission remains the same: to combat child mortality by promoting a healthy start in life. And seems that our dynamic approach has caught the attention of our peers. We recently learned that Max Foundation is one of five finalists for the Impact Challenge Award! So, what have we been working on lately? Where to even begin?

Response to Edmond’s post and related questions

Thanks for your insightful blog post, Edmond. It gave me a lot to think about. Over the last few years, increased knowledge and the emergence of new project results have allowed us to scale up Max Foundation’s programmes. This has been a game changer for us in South Asia, Nepal and beyond. We’ve been able to carry out more interventions and expand the scope of our projects. Bigger projects mean more options—and that’s a good thing! But they also bring more factors to consider when figuring out the most effective way to fulfil our mission.

There is growing pressure from both the NGO and funding sectors to supply analytical proof that certain approaches are ‘better’ than others. And we get it. But we also believe that if we want to further the development of our WASH and nutrition projects, we need to understand what drives our beneficiaries to change their hygiene and nutrition habits and also work to promote the social conditions that will allow parents, families, schoolchildren and even governments to make better choices over the long term. All of this takes time.

Opportunities for Integrated Approaches

Rather than solely pursuing one-off interventions like chlorine tablets and latrine instalments, which are fairly easy to measure and might seem cost-effective at first, Max Foundation aims for long-term development cooperation. Not only are we interested in effectiveness, but also sustainability. This is why adhere to more complex approaches, such as Community Led Total Sanitation (CLTS), courtyard sessions and, most recently, child growth monitoring charts. These approaches use behavioural science to obtain sustainable results, making them an effective and economical means of achieving long-term change.

Behavioural science tells us that we, as humans, are inclined to follow familiar, long-nurtured patterns of behaviour. We are more likely to prioritize quick, efficient decisions over ‘better’, more conscious choices. Therefore, we believe that improved access to health, hygiene and water and sanitation facilities is only one part of the story. We also have to change human behaviour—something that is not going to happen overnight.

Unfortunately, much of the sector is still focused on solutions that may seem promising at first but end up being ineffective in the long run and a major waste of donor money. We’ve put a lot of thought into constructing, validating and reinventing our current Theory of Change. In doing so, our mission statement has evolved to reflect our ‘effectiveness’ mindset. By shifting attention to the latest research on the effects of WASH and nutrition integration, we’ve broadened our avenues to impact child health. For example, our Max Nutri-WASH approach encourages individuals and villages to improve their own living environments, while also stimulating local entrepreneurs and governments to support access to hardware and services. Max Nutri-WASH has been integrated into our flagship programme, Max Healthy Village, and we plan to reach more than 1.3 million people by 2021.

What’s wrong with a good cocktail?

In response to Kellie Liket’s remarks, my question is: what’s wrong with a good cocktail? We are convinced that our agile way of working makes us more suitable to move beyond pre-existing methods and structures. By offering a solid combination of balanced, effective interventions, we can tackle the root causes of child mortality from different angles and promote a long-lasting healthy start for children under five. Now, of course, the more interventions you have the harder it is to provide hard scientific evidence for each one, but so far, our results indicate that there is power in variety. Where one effort falls short, another one picks up the slack, and step by step, people are changing their habits and becoming healthier.

The Output-Outcome Effect

Integrated approaches can be hard to measure. The principles of effective altruism do not allow for a ‘golden standard’ research method for measuring causal relationships between our outputs and the number of childhood years improved. Moreover, the randomized controlled trials (RCTs), which many organizations use to measure the impact of single interventions, tend to offer a limited picture. “RCTs are not a one-size-fits-all answer to how to evaluate a nudge. And in fact, many interventions for long-term change may appear to fail not because their theoretical assumptions are wrong but because they are not being evaluated in the best way possible.”(source: link). When it comes to measuring our current impact, we believe that the effectiveness of our mission—to save any many children’s lives as possible in the most effective and sustainable way possible—is more important than claiming to be the most effective in everything that we do.

A Call for Action

Although our pilot projects on integrated approaches have shown successful results, we cannot expect our ‘effective’ methods to continue working on their own. Instead, we see these positive results as an opportunity to test new ways of working and adapt our projects accordingly. We agree that better measurement is needed, and we are working on this, but in the meantime, we would like to open up the discussion with our peers. Can we create a win-win situation for everyone? By sharing our expertise, resources and methods for improving child health, we can challenge the status quo.

So, what do you think?

Our main goal here is transparency. We want everyone in the Max Foundation to reflect and share their thoughts, doubts and lessons learned as we explore the why, how, and what. Stay tuned for our next blog posts with some more thoughts on the next steps.

In the meantime, chime in via Facebook and share your thoughts with us.

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