implementation finally got going, in early to mid‐2017, there was evidence of adaptation and of innovation (see Annex 8.3 for comparison of innovation across the visited states). The workplans are clearly understood to be flexible documents by the TA states and this fact appears to have left room for some “muddling” and iteration in the states during implementation. But the basis on which micro‐ adjustments were encouraged by ADG was not always apparent. In the absence of well‐documented theories of change, it does not seem that adaptation involved methodical reassessment of initial assumptions or was always carried out in a way that required clear justifications. State implementers also reflected that they felt the need for better data analysis skills to help them adapt in accordance with the evidence.<sup>14</sup> Regarding the third ingredient – “supporting change that reflects local realities and is locally led” – ADG conveyed that they felt it was within the implementer’s capability to identify challenges and to come up with the most appropriate solutions to address these. While ADG did recommend the possible application of certain solutions based on their own knowledge of what had worked well in other contexts, they appear not to have seen their role primarily as experts offering solutions.<sup>15</sup> Rather, they envisaged their role as being to create space for a latent creativity and innovation to emerge. Accordingly, even though they gave training to assist with problem identification and asked questions that helped PMUs to refine their analysis, the onus was placed on program officers responsible for each of the interventions<sup>16</sup> to be the ones to actually identify the critical drivers relating to their theme. Decisions about strategy and prioritization seem to have been made by certain individuals (typically program officers responsible for the different thematic areas) largely on the basis of their intuitive (‘gut’) sense of what was achievable. (As one of ADG’s liaison officers put it, “The states actually know what to do and how to do it. But they need space and confidence...they need the leeway to do what they do. You have to clear the way. Our role was to create space.”) It is our impression that after the MICS 2016 survey results came out, highlighting the negative performance of the eight TA states against the six outcome indicators thus far (in our section on impact, below, we question whether this was an appropriate means of measuring the success of the TA), ADG began to operate somewhat more out of a pressure to achieve results than to ensure a locally‐driven process. Having begun with an emphasis on very state‐specific, tailor‐made solutions, it appears that towards the later part of their contract, ADG began to push for more standardized solutions, most likely reflecting their increasing desperation to improve results (and thus obtain a performance payment as well as a potential extension of their contract with the federal government). Apparently, Bank staff also gave explicit guidance that ADG should ‘do more’ to support expansion of two particular activities: Maternal and Neonatal Child Health (MNCH)<sup>17</sup> weeks and Quality Implementation Supervision Support (QISS).<sup>18</sup> ADG thereafter placed various “liaison officers” in the

> 14 Though public sector staff in the TA states did refine interventions based on data analysis, they admitted finding it difficult to drill down into what is driving failure of certain interventions and expressed concern that they were sometimes misinterpreting data.

> 15 One of ADG’s liaison officer notes that in two states there were proposals to do costly launches of the SOML program, which would have used about N 10 million of project funds. Rather than saying they should not do it, ADG’s approach was to ask the states: How far will this move any of your indicators and are there other places it could be put that would move them more? The response by the states was to revise the workplans and to incorporate the launch into an actual rolling out of activities.

16 In most states there is one program officer for each of the SOML thematic areas e.g. a malaria officer, nutrition officer, immunizations officer etc.

> 17 States are expected to conduct week‐long campaigns twice a year that are targeted to cover a range of immunizations, nutrition objectives and other interventions for mothers and children.

18 QISS refers to regularized visits conducted by state and local government staff to monitor the range of equipment, infrastructure and services in operation at health facilities across the state. Teams of government staff visit each facility with a checklist and submit their findings back to local government representatives and the SOML PMU.

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