Interministerial Collaboration Crucial to Human Development Impact and Outcomes: by Kesetebirhan Admasu and Osmar Terra

Human development priorities are generally multidimensional and intersectoral; yet government is traditionally organized in silos and thus ill-equipped to address cross-sectoral challenges. Ministers implement their sector specific policies and programs and compete fiercely for a larger share of the available budget.  Even within ministries, program directorates ring-fence their authority and battle over resources. The traditional lack of interministerial collaboration around common human development objectives undermines the potential impact and efficiency of government efforts and investments.  To facilitate this kind of collaborative approach to human capital development, the Harvard Ministerial Leadership Program increasingly engages clusters of human develop sectors ministers, as well finance and economic planning ministers from the same countries. The benefits of interministerial collaboration in the implementation of government programs is becoming clearer from a growing body of country experience. The Seqota Declaration to address malnutrition in Ethiopia and Criança Feliz Program to improve early childhood development (ECD) in Brazil are two standout examples.

Seqota Declaration 

In 2012, when Kesete Admasu became Minister of Health of Ethiopia, 44% of children were stunted and malnutrition persisted as one of the underlying causes of child mortality. Although Ethiopia registered one of the fastest rates of reduction in undernutrition, stunting remained high in the most vulnerable parts of the country. Dr. Kesete decided that transformative and collaborative change was needed.  In 2015 he led the Ethiopian government to announce the Seqota Declaration, an interministerial commitment to end stunting in children under two by 2030.

The Seqota Declaration has ten multisectoral strategic objectives which include transforming smallholder productivity and income; improving the health and nutrition status of children, adolescents, and women; and improving gender equity. These objectives are implemented by six federal sectors (Ministry of Health; Ministry of Agriculture; Ministry of Water, Irrigation and Energy; Minister of Labor and Social Affairs; Ministry of Education; Ministry of Women, Youth, and Children); with involvement from development partners and community organizations.

While the Declaration is still in its early stages, the intentionality behind its collaborative approach is relatively groundbreaking. Though previous efforts had been made to address malnutrition in a collaborative manner, actually operationalizing the collaboration across government proved challenging because interventions were still implemented independently and not properly contextualized. To more clearly define collaboration, Minister Kesete applied the “Three Ones” framework which clarified “one goal, one plan, and one monitoring and evaluation system” across sectors.

The Minister took some key steps to redefine interministerial collaboration in Ethiopia and bring other government actors on board. These include exhibiting strong political leadership, including garnering the public support of the Deputy Prime Minister; extensive consultation with relevant stakeholders to map existing roles and generate buy in; clearly defined implementation roles and communication routines across sectors and levels of government; and care to build on existing government structures such as the National Nutrition Coordinating Body and nutrition-related initiatives such as National Nutrition Programs.

Criança Feliz

 In 2015, Brazil had 15 million children under five but only 22% of children under three enrolled in early childhood education (ECD). Global research had long demonstrated that a comprehensive approach to ECD is fundamental to a child’s cognitive development, academic performance, and future life prospects. In 2016, Osmar Terra, then Minister of Social and Agrarian Development (currently Minister of Citizenship) launched an ambitious national ECD program known as Criança Feliz (Happy Child, PCF). PCF aims to promote the integral development of children considering their family and their life context through mandated home visitations as a primary diagnostic point that leads to referrals to social services available from various ministries. PCF mobilized an unprecedented level of interministerial collaboration at the federal level. The underlying idea was that government would not act in siloes but rather in a deeply coordinated way since every child in deprived circumstances needs the concerted efforts of different parts of government to achieve full potential.

PCF is led by the Ministry of Citizenship and managed by a National Management Committee with representatives from the Ministries of Education; Health; Women, Family and Human Rights; and Citizenship The committee was created by presidential decree, giving it the formality and gravitas to ensure that each ministry would take it seriously. Similar coordination committees must exist at the state and municipal levels.  A key to coordination across multiple municipalities, state secretariats, and ministries is a single, integrated information system which allows all involved parties to work from the same data for PCF operations and monitoring and evaluation.

In order to effectively and collaboratively implement PCF, Terra was strategic and deliberate over many years in sharing ECD research through public platforms and executive courses to build political support; bringing together diverse to stakeholders in new alliances; and implementing legal frameworks on which he would later build his comprehensive program. The result is that PCF has been sustained through a new presidential administration and currently makes it possible for more than 500,000 children and 100,000 pregnant women in Brazil to receive home visits every week.

Key takeaways for policymakers

 The lesson from Ethiopia and Brazil is that to be optimally impactful and effective,  government human capital development policies and programs need to be as multidimensional and intersectoral as the challenges themselves. This can involve comprehensive policy or programmatic interventions that harness the authority and resources of multiple ministries across government, in partnership with development partners, NGOs, and other stakeholders.  Effective interministerial collaboration requires strong, visionary leadership; centralized information systems; consistent monitoring and evaluation; and ongoing consultation and communication at all levels of implementation.

It would be much easier for ministries to just continue with business as usual.  But if we want to make headway on the pressing human development challenges of our time, cross-government collaboration is critical and it requires initiative and innovative thinking about how to extend available resources to catalyze progress. Interministerial collaboration should become the motivating mantra of every government.

Author Biographies

Dr. Kesete Admasu served as State Minister of Health from 2010 to 2012 and Minister of Health of the Federal Democratic Republic of Ethiopia from 2012 to 2016. Dr Kesete is a distinguished alumnus of the Harvard Ministerial Leadership Program.  He has received numerous national and international awards for his work in public health. A medical doctor by training with a Master’s degree in public health, Dr. Kesete is currently CEO of Big Win Philanthropy.

Dr.  Osmar Terra is the current Minister of Citizenship of Brazil and formerly Minister of Social and Agrarian Development.  He has served at the municipal, state, and federal levels in Brazilian Government. He was Mayor of Santa Rosa from 1993 to 1996, Federal Deputy and Secretary of Health for Rio Grande do Sul state between 2001 and 2015. Minister Terra serves as a special expert resource to Ministers participating in the Harvard Ministerial Leadership Program.