The high cost of talking down to policy practitioners

Poor understanding of how markets work is a big stumbling block in developing country health policy making. I have seen the stumbling block in action, and concluded that it is an urgent priority to provide accessible knowledge resources and learning opportunities in this area. There are few good resources and fewer learning opportunities for policy practitioners working in, and on, developing countries.

So, I was delighted when I discovered USAID’s Healthy Markets for Global Health: A Market Shaping Primer. The Primer aims to provide developing country policy practitioners with some essential, practical knowledge about markets and forming policies to influence markets. I stayed up way past my bedtime pouring over it. And….I got a headache. The authors decided to use a unique definition of a market. They implicitly defined a market as: the set of actors making decisions related to production, distribution, and delivery of “global health products”. Now, whatever this “thing” is, it is decidedly not a market. There are different ways of saying it, but a market consists of the interaction between all the buyers seeking something and all the sellers from whom they may get it. The Primer team opted for their simpler alternative, presumably, to make the Primer’s content more accessible to practitioners.

A brief aside: I believe the quality of health policy in developing countries is undermined, considerably, by what I think of as “the wall”. “The wall” is my shorthand for the observably low interaction between the developing country health policy and ops research community and the developed country health policy and ops research community. Let’s leave aside, for the moment, the size of “the wall” and its foundations. I believe most of us believe that more interaction between these two worlds or “tribes” is better; we need more interaction, more communication, and, more engagement across these tribal boundaries. I believe both tribes would benefit. Given the paucity of content on the topic of markets in the health sector in the developing country literature, in this domain, more communication would especially benefit the developing country policy practitioner tribe.

And, you know what doesn’t help? Making up, and disseminating, special definitions for core concepts, like, oh…say…markets.

Perhaps you think using different words for core concepts, and different concepts for oft-used words, is but a minor offense.

Having sat through many, long, frustrating, discussions on public-private partnerships in the health sector, I must disagree. In my experience, when members of the developing country policy practitioner tribe try to engage in, and learn about, these issues, their ability to do so is greatly diminished when the vast majority of the existing knowledge is made inaccessible, or even impenetrable, because of “translation” problems. Check out this ppt – my small contribution to a Rosetta Stone for PPP discussions across tribal boundaries.

My point is this: teaching developing country policy practitioners about markets is a worthy aim. Making the content accessible is important. However, teaching practitioners a unique-in-the-world definition for market is a bad call. All the learners reached will hence forth find the vast body of knowledge on the topic of markets even less accessible and useful than if they knew nothing at all.

Perhaps the primer-makers believe they have re-packaged (“translated”) all the knowledge about markets the target learners will ever need; in which case, increasing the height of “the wall” between them and the rest of the world does no harm.  If so, I disagree.

What do you think?


One thought on “The high cost of talking down to policy practitioners

  1. April, I’m with ya! I think the problem is not just dumbing down the concept of markets for developing country practitioners, it is the large number of development practitioners, in all countries, who ignore the concept of markets altogether. I am working on a blog with a similar argument but looking at how development practitioners define “theory”. It is amazing the definitions that pop up in the development world for “theory” when talking about theory of change. Social science is not hard science, but nonetheless, there is a difference between hypotheses and theories and both should be based on more than what makes sense to the person thinking about it at that point in time.

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