I want to propose what may seem to some a radical goal for the international development agenda: The most impactful way for knowledge to serve development is for every successful, local, intervention to “Pay it Forward” to another facility or region. For example a team of originators in a region that has reduced HIV, “Pays it Forward” by taking what it has learned to another region to help that region accomplish what the originating team has learned to do. A city that has successfully reduced E.coli in its water “Pays it Forward” by sending a team of originators to a sister city where the water is still causing disease.
The current way knowledge transfer (or spread as it is often called) is attempted is that the funder (e.g. the agency, foundation, NGO) of the intervention, builds into the contract, that those providing the technical assistance to the originators have the responsibility for spreading the intervention after it has shown to be successful.
But that practice is flawed for two reasons. First, technical assisters typically obtain the knowledge of what happened through interviews. Interviewers can obtain the explicit knowledge of the originators, but
much of what the originators will have learned while doing the implementation is tacit, which by definition, the originators are unable to articulate. Tacit knowledge is available when the person who holds that knowledge is embedded within a context where the knowledge is needed. Secondly, using the technical assisters to transfer the knowledge takes the success away from the originators and makes it the success of those that provided the technical assistance. “Paying it Forward,” as described above, acknowledges the success of the originators. The originators, being present in the new situation, can transfer both their explicit and their tacit knowledge to others. Calling on their tacit knowledge they can make adaptations to the new context. Moreover, the act of calling on their tacit knowledge, strengthens and sustains that knowledge within the originators. “We learn when we teach.”
Agencies, foundations and NGOs can support “Paying it Forward” by providing the funding to pay for the time and travel of the originators to work with another facility or region. And technical assisters can help by identify sites that need the knowledge the originators have gained.
There is a lot of talk a lot about South-to-South, but it is not South-to-South as long as the technical assisters take on the task of transfer. It is empowering when implementers put down the role of helpee and take up the helper role.
We actually already know a great deal about how to “Pay it Forward” from regions that have twinned or groups who have conducted peer assists and site visits across regions and countries. We have learned through the example of Positive Deviance, as well, that those embedded in the problem are best able to transfer the knowledge gained.
Technical Assisters are necessary to bring evidence based practice, to facilities and regions, but they have proven to be poor at transferring how that practice was implemented. Transfer remains the biggest challenge improvement projects face. The answer is to quit attempting to spread something that technical assisters can’t know enough about, rather to provide the financial support for those that accomplished the intervention to spread it.