Madeleine Clarke & John Healy at Stanford Social Innovation Review: “Philanthropy, especially in the United States and Europe, is increasingly espousing the idea that transformative shifts in social care, education, and health systems are needed. Yet successful examples of systems-level reform are rare. Concepts such as collective impact (funder-driven, cross-sector collaboration), implementation science (methods to promote the systematic uptake of research findings), and catalytic philanthropy (funders playing a powerful role in mobilizing fundamental reforms) have gained prominence as pathways to this kind of change. These approaches tend to characterize philanthropy—usually foundations—as the central, heroic actor. Meanwhile, research on change within social and health services continues to indicate that deeply ingrained beliefs and practices, such as overly medicalized models of care for people with intellectual disabilities, and existing resource distribution, which often maintains the pay and conditions of professional groups, inhibits the introduction of reform into complex systems. A recent report by RAND, for example, showed that a $1 billion, seven-year initiative to improve teacher performance failed, and cited the complexity of the system and practitioners’ resistance to change as possible explanations.
We believe the most effective way to promote systems-level social change is to place the voices of people who use social services—the people for whom change matters most—at the center of change processes. But while many philanthropic organizations tout the importance of listening to the “end beneficiaries” or “service users,” the practice nevertheless remains an underutilized methodology for countering systemic obstacles to change and, ultimately, reforming complex systems….(More)”.