33088 Capacity Enhancement b r i e f s S H A R I N G B E S T P R A C T I C E S A N D L E S S O N S L E A R N E D WHY PROCESS IS IMPORTANT FOR CAPACITY ENHANCEMENT: THE CASE OF CEARA Connie Steward, ART Lead Consultant, The Crossland Group Attention to process is key to capacity enhancement. The Brazilian state of Ceará, with the assistance of the World Bank, applied the "accelerating results together" (ART) methodology to develop and imple- ment poverty reduction plans using cross-functional and cross-organizational teams. In this case, three teams jointly led by state secretaries and Bank leaders focused on reducing infant mortality rates, improving primary education, and maximizing income opportunities for the poor. Participants credited results to the focus on process, which merged learning with work. Other important elements were stakeholder involvement, government ownership, high-level leadership, and locally supported Bank participation. Development assistance requires a focus on substance ership and involvement of people throughout relevant --the content provided--as well as the process of government service departments. engagement--how groups work together to achieve Using ART in Ceará, Brazil results over time. Capacity enhancement has typically involved provision of loans, consultative advice, skills The state of Ceará is one of the poorest in Brazil (see training and sharing of expertise. Although important, Figure 1). For the past two decades, Ceará and the these aspects are usually not sufficient to produce World Bank have worked together to find ways to enduring improvements. reduce poverty and foster sustainable development. Design and selection of the right process tools should Cooperation began in the late 1970s with the Northeast ideally be considered at the outset of engagement. Rural Development Program (NRDP, see end note 1); Process tools enable stakeholders to explore areas of today it consists of an array of investment projects, need, agree on priorities, develop solutions, and collab- studies, technical assistance, and capacity-building orate on implementation. When applied successfully, activities. The Bank also supports Brazilian federal these tools build trust, "ownership" of solutions, learn- government projects with activities in Ceará, such as ing, and partnerships among diverse groups. They also the Federal Water Resources Management Project, help increase capacity building and results achieved School Improvement Project II, AIDS II, and National and establish the foundation for transferring capability Environment Program II. to others. In this time, Ceará has significantly improved the Many process tools exist for use in large and small quality of life of its population and made impressive group environments. This brief reviews an example of progress on its poverty indicators. Poverty, however, work the Bank conducted with the State of Ceará in remains deep and severe by any standard. Concerned Brazil, in which the process "accelerating results that public policies were not achieving better results together" (ART) was applied to a situation requiring and responding to the conclusions of the state eco- integration across government institutions. Success in nomic memorandum2 published by the Bank in 2000, the short and long term depended greatly on the lead- the Government of Ceará and the World Bank agreed to S E P T E M B E R 2 0 0 4 NUMBER 9 ART has three phases, each involving discrete actions: Figure 1 ˇ Scope and prepare. Assess client needs using ART criteria. Confirm sponsorship and conduct scoping meetings to organize the work. Select the right resources, gather the right data, and prepare for the next phase. ˇ The business meeting. Conduct a three- to four-day session in which three to five teams work on major components of the challenge. Present recommenda- tions to senior leaders for immediate decisions. Commit to take action and implement decisions promote a joint effort to answer two questions: "how within ninety days. can we better coordinate our work to improve strategic ˇ Implementation. Create an integrated project plan for indicators and accelerate results?" and "how can the deliverables, accountability, and scheduled actions. Government of Ceará implement a more effective strat- Track and measure implementation after twenty, egy to combat poverty?" thirty, and ninety days. Capture learning and knowl- The state and the Bank agreed to use the ART edge to sustain changes. methodology (see Figure 2) to answer these questions. This brief describes the process, which focused on inte- The Scoping Meeting gration of services to make improvements in three criti- The scoping meeting in Fortaleza convened a range of cal areas: infant mortality, education, and income gen- Ceará state officials and Bank staff, including two eration. The Bank sponsored two interventions--the executive sponsors--the Governor and the Bank's ART process, which began in January 2002, and WBI's Country Director in Brazil--and two ART coordina- rural poverty distance learning event in April 2003. tors--the Secretary of Planning and the Bank's How does ART work? Principal Country Officer for Brazil. Team leaders included heads of Ceará secretariats of education, The ART methodology is one of the World Bank's key health, and economic development and Bank staff. processes for helping cross-functional and cross-orga- Also participating were fourteen other state secretaries, nizational teams tackle complex problems. ART is state government technical staff, the ART lead consul- based on the premise that careful definition of the chal- tant, and team consultants. lenges, bringing together the right people--in terms of At the meeting, three teams considered one of three knowledge, experience, and passion for change--and topics--quality of life, quality and quantity of educa- providing them with the right information will produce tion, and economic growth and employment--and optimal solutions to problems. defined specific challenges in each: ˇ Quality of life. How can we work Figure 2 together more to reduce the rate of Accelerating Results Together infant mortality further? ˇ Quality and quantity of education. How can we improve the quality of primary education in the state and the quantity (i.e. inclusion of rural children living in distant places; hours per day of education in selected rural areas)? ˇ Economic growth and employ- ment. How can we work together to maximize income opportunities for young people living in small and medium cities and rural areas? Institutional integration was an overarching issue that was identified *The Crossland Group in preliminary discussions and that S E P T E M B E R 2 0 0 4 NUMBER 9 arose in all group discussions and the plenary session. program for low-income rural populations, and The teams diagnosed poor coordination in implement- strengthening technical assistance on income and ing public policies among and within a range of institu- employment generation. tions: among different state secretariats; between the Implementation and Results state and municipalities; between the state and federal governments; between the state and the World Teams started implementing the action plans and Bank/Inter-American Development Bank; within the assessed progress at meetings 20, 30, 60, and 90 days Bank; within municipalities; and, in some cases, thereafter. Results also were measured at a 120 days between the state and civil society. check point and reconfirmed after one year. Infant mortality reduction. The infant mortality The Business Meeting reduction action plan was largely put into practice. The The teams reconvened three weeks later in Fortaleza at task force carried out several actions to boost cross- a business meeting. Each team had two team champi- sector and cross-institutional cooperation to enhance ons (one each from Ceará's government and the Bank), primary health care quality and increase access to qual- several sector experts, others strongly interested in the ity water supply. These included awareness raising of topics, and an ART team consultant to lead the process. key stakeholders in targeted municipalities, assistance The two executive sponsors provided overall leadership to municipalities with high IMRs in organizing primary for the workshop with support from the technical team and secondary health services, assistance to medical and ART lead consultant. caregivers on quality of pre-birth and mother care, hir- At the final session, the three teams presented their ing 118 health agents to work in high IMR areas, and recommendations, which the executive sponsors distance learning for doctors and nurses on reducing endorsed, and agreed on a time frame. Team findings child mortality and morbidity. According to the state of and proposals included the following: Ceará, results of ART included integration, faster and ˇ Infant mortality. Insufficient integration of policies greater coverage of services in priority infant health and programs was the general problem. The work- areas, and acceleration of new data gathering. group recommended creating a task force. With par- Quality of education. The recommendations of this ticipation of local health agencies, it would intensify working group were fully implemented, boosting the and integrate programs and actions, giving priority primary-level literacy program. Meetings with munici- to 34 municipalities with an infant mortality rate pal education secretaries led to 173 municipalities (IMR) above 35 deaths per 1,000 births, focusing on adopting the "Pact for Literacy," increasing the number the poorest families. of full-time primary schools from 38 to 48. ˇ Primary education. Unsatisfactory learning levels Municipalities agreed to make mothers a priority in lit- among children, inadequate education management, eracy efforts. An incentive scheme to improve educa- and little community involvement in schools hamper tion awarded prizes to schools and students for top improvement in the quality and quantity of basic scores in Portuguese and math examinations. education. Solutions include, respectively, (a) a pri- Economic growth and employment. The recom- mary-level literacy program emphasizing training of mended task force on cross-sector integration among teachers as literacy agents, (b) universalized train- secretariats was created. Discussion by key stakehold- ing of education managers in the public school net- ers on facilitating creation of small businesses resulted work, (c) a broad education campaign for communi- in a new, simplified, tax law which the government ties on the importance of their following up on approved for sending to the State Assembly. school processes and results, and (d) an increased Secretariats cooperated in that work and in promotion number of full-time primary schools. of fairs and conferences. Small-scale ART seminars ˇ Income opportunities for the poor. The main issues integrating state and municipal governments defined adversely affecting income and job generation are action plans, and implementation by several govern- (a) lack of cross-sector integration among state sec- ment agencies resulted in (a) a large local producers' retariats, civil society, and municipalities, (b) exces- fair, in which 120 businesses competed for opportuni- sive red tape for opening new businesses, and ties to supply school meals, (b) a large tourism fair and (c) low education levels associated with insufficient conference promoting tourism and information technical assistance for productive activities. The exchange among small and medium hotel owners, and team recommended establishing a task force for (c) small business "incubators" in each of three cross-sector integration among secretariats, facilitat- municipalities. ing small business creation, carrying out a literacy Lessons Learned High-level leadership. Senior-level sponsorship is In September 2002 the work groups met to assess out- essential in planning, decisionmaking, and checkpoints comes and develop presentations of results, which they throughout implementation. Many participants noted then gave to the executive sponsors. Participants con- how crucial the decisions made by high-level adminis- sidered the ART process overall to be a very positive tration (the executive sponsors) were to secretaries experience, citing the following factors as critical to working together in a concerted manner. The ART success: process also achieved better coordination and a cross- Focus on process. ART produced a deep reorganiza- sector approach among Ceará's state secretariats and tion of ongoing efforts in an accelerated, integrated, municipal governments. and efficient manner; thus, important steps were taken Bank as knowledge broker. Through the ART to increase integration among stakeholders in public process, the Bank fulfilled its role as "knowledge bro- policy planning and implementation. ker" for development impact: catalyzing funding and Merging learning with work. Although the Bank has convening the stakeholders. Processes such as ART are long provided technical expertise in learning environ- highly visible and tackle big problems; as such, they ments, it has less often invested in processes that demand careful planning and the involvement of the enable clients and the Bank to work together to solve Bank's country teams. complex issues using a consistent, reliable methodol- Local support for the Bank. The state government's ogy. Processes, such as ART, increase participation and trust in the Bank's country manager enabled the group keep the focus on tangible results to be achieved. It is to address big challenges with confidence. Future coop- not learning separated from problems to be solved, but eration of the Bank with Ceará in the ART process may rather learning and capacity building through work in a include local capacity building for mainstreaming the cross-organizational team environment. ART methodology into the state's administration. Stakeholder involvement. Implementation successes were largely due to local stakeholder involvement. Peer Reviewers: Antonio Rocha Magalhăes, Although the Bank participated in the process, govern- Principal Country Officer, Brasilia, Brazil, and ment officials held leadership and expert roles. Monica Clark Nunes Cavalcante, State of Ceará Secretaries led cross-functional teams during the entire Controller Secretary. process, including implementation. 1. The first project in Ceará, the Rural Development Project, Ownership by government. The state government was approved on September 13,1977. It consisted of a series of showed ownership over the ART process, from scoping coordinated actions to improve the living standards and incomes through implementation, and afterwards, as they of the low-income population of the Serra da Ibiapaba region in applied ART to other initiatives to reinforce the benefits Ceará. This approach, known at the time as " Integrated Rural Development Strategy", was named in Brazil as the of integration achieved, sustain the impetus of the Polonordeste Program. process, enhance the quality of public expenditures, 2. The World Bank. 2000. "Brazil Poverty Reduction: Growth and improve public management. and Stability in the State of Ceará. A State Economic Memorandum." Report No. 19217. Washington, D.C. About World Bank Institute (WBI): Unleashing the Power of Knowledge to Enable a World Free of Poverty WBI helps people, institutions, and countries to diagnose problems that keep communities poor, to make informed choices to solve those problems, and to share what they learn with others. Through traditional and distance learning methods, WBI and its partners in many countries deliver knowledge-based options to policymakers, technical experts, business and community leaders, and civil society stakeholders; fos- tering analytical and networking skills to help them make sound decisions, design effective socioeconomic policies and programs, and unleash the productive potential of their societies. WBI Contacts: David Potten, Lead Specialist, Country Programs Tel: 202-458-7873, Email: dpotten@worldbank.org Visit our website for more information and download the electronic copies of all Capacity Enhancement Briefs: http://www.worldbank.org/capacity S E P T E M B E R 2 0 0 4 NUMBER 9