Dealing with complexity in a realist synthesis: community accountability and empowerment initiatives

Realist evaluation (Pawson and Tilley, 1997) and realist synthesis (Pawson, 2006) were developed to assist policy makers and program staff to find pathways through complexity - specifically, to develop and test usable theory about complex and varied interventions applied across multiple contexts. One of the central ideas is that understanding how and why something works, or does not, in particular contexts can assist with practical decision-making: whether to use a particular kind of program in a particular situation; how to adapt a program to a particular context; and so on. But if complication and complexity are the norm in social programs (Rogers, 2012, Westhorp, 2012, Westhorp, 2013), how exactly does realist synthesis address this? Can it in fact deal with the complication and complexity of real programs and real decisions? And how might practitioners and policy makers actually use the results? This chapter explores these questions through the lens of a recently completed realist review of community accountability and empowerment initiatives. It begins with an overview of the review in terms of its scope, processes and findings. It then analyses the review in terms of Pawson's VICTORE framework (discussed earlier in Cchapter 1) to demonstrate the complexity of the review topic, how complexity was reflected in the findings, and how the methodology of realist synthesis helped us to manage and deal with complexity. We then discuss how the findings from a realist synthesis can assist in dealing with the complexities of policy and program management in the real world.