mindset, unaccustomed to this notion of finding locally‐driven, hybrid solutions.<sup>21</sup> Our own analysis confirms some instances where the firm could have been stronger at offering a variety of technical solutions as options for implementers to consider – options that were in keeping with the existing conditions and problems as identified by local stakeholders. That said, the very novelty of adaptive implementation – in Nigeria and elsewhere – means that, by definition, every firm that takes on this challenge for the first time is bound to encounter serious difficulties. (This does not absolve ADG of reasonable criticism, but it also means that their genuine efforts in these challenging circumstances should be fully appreciated.) Aside from the capabilities of the firm conditioning the quality of the approach, there are elements of the World Bank’s organizational environment – its skillsets, incentives, instruments and resources – that either support or undermine a more flexible, problem‐driven model. For example, although state level officials testify to the fact that the PfR instrument made possible a far more innovative, locally‐empowered and responsive way of working, it is also true that the instrument itself is still extremely novel in Nigeria and required significant socialization. Field work confirms that various agents in the states have faced significant challenges, delays and unintended effects as they have tried to understand and navigate this new performance‐based system that they have hitherto never encountered. The initial state advances were themselves seriously delayed and there continue to be challenges passing PfR payments through the state system: at the end of a year of implementation, an average of only 33% of funds had been disbursed in total. Drivers of this slow disbursement include bureaucratic obstacles (such as imposition of and subsequent required training for the accounting system, REMITA), infighting between the state and primary health care providers (the SPHCDAs) and rank opportunism and interference, as exemplified by the Abia case (Annex 8.1). In this context, ADG’s TA was required to be not only an agent of socialization into the brave new world of adaptive implementation _but also_ into PfR. Delays in fund disbursement contributed to a misalignment of TA and state implementation,<sup>22</sup> a somewhat unbalanced emphasis on planning, and what was perceived by various actors as an abrupt (and unfortunate) exit of ADG’s support.

World Bank staff and federal level officials have also been learning and adjusting to the PfR instrument as they go, and they readily refer to aspects that, given a second chance, could be designed differently. For example, although the SMART survey, on whose results performance payments were to be made, was expected to take place every year, in practice it was used to form a 2015 baseline but then did not take place in 2016 or 2017 and has only recently been undertaken in 2018.<sup>23</sup> The use of an alternative survey tool in 2016 raised significant outcry and has affected perceptions of overall fairness.<sup>24</sup> The fact that this 2016 survey, against which performance was measured and payments 21 There is a possibility that what federal level officials saw as low technical capacity, ADG saw as a case of letting state implementers lead in the design of hybrid, state‐relevant solutions.

22 Initially it was planned that the TA would take place in a fairly linear model – an initial preparation, sensitization and planning phase that would include obtaining political buy‐in and would result in completion and acceptance (by government) of state‐level action plans in eight states; an immediate implementation phase with constant monitoring, adaptation and learning over a yearlong period; and a completion phase characterized by reflection on results and capturing of lessons learned. This was originally expected to be completed by June 2017. Due to funding delays, however, the firm adjusted its efforts, such that the initial planning phase spanned a year‐long period, certain activities had to be repeated due to loss of momentum, and implementation and lessons‐learning phases were collapsed into six months.

23 Results from the 2018 survey round – reportedly completed in June 2018 ‐ are still not available at the time of writing.

24 In 2016 an alternative household survey – the Multiple Indicator Cluster Survey (MICS) – was used to determine progress on the six coverage areas and performance payments were awarded on the basis of that survey’s results. While some federal level government officials and Bank staff argue that there is a strong correlation between the MICS and the SMART surveys, the outcry generated among state officials after revelation of MICS results demonstrated that complementarity of the surveys was not a matter of consensus. Given that the MICS does not in fact measure one of the six key indicators – Vitamin A coverage – the states that 10