Why seven out of ten Caribbean infrastructure projects face delays: how Implementation Science offers a systematic solution

The Pattern We Keep Repeating

A road rehabilitation project in Jamaica takes three years longer than planned. A water infrastructure initiative in Saint Lucia stalls during procurement. A climate resilience project in Dominica struggles with scope changes and budget revisions. Different islands, different sectors, same story: Caribbean development projects consistently take far longer to deliver than originally planned.

The Caribbean Development Bank confronted this reality directly at their June 2025 Annual Meeting in Brasília. Their baseline assessment of 35 projects across ten Caribbean countries revealed what practitioners already knew from experience: persistent procurement delays, institutional capacity constraints, procedural inefficiencies, and oversight issues hamper project implementation across the region. But the assessment went further, identifying fragmented stakeholder coordination, disjointed communication, limited engagement during implementation, and insufficient on-the-ground readiness as factors negatively affecting project outcomes.

This is not a Caribbean-specific problem. A global analysis by the CoST Infrastructure Transparency Initiative examined 480 projects across three continents and found that 70% faced delays, with projects taking on average 73% longer than originally planned. The critical finding: 60% of delay drivers could be traced back to shortcomings in the preparation phase rather than issues arising during tendering or contract execution.

When delays are downstream symptoms of upstream planning failures, fixing procurement processes or improving construction management will not solve the fundamental problem. The solution requires looking upstream to where projects are designed, scoped, and prepared.

Why Implementation Science Matters

Implementation Science provides systematic frameworks for understanding why interventions succeed or fail when translated from design into practice. The discipline distinguishes between the intervention itself (the infrastructure project, the policy reform, the capacity building programme) and implementation strategies (the methods used to enhance adoption, integration, and sustainability of that intervention).

For Caribbean development projects, this distinction proves essential. Most project delays do not stem from poor technical design. Engineers know how to design roads, water systems, and climate resilience infrastructure. The failures occur in the implementation process: how projects move from concept through feasibility assessment, stakeholder engagement, resource mobilisation, execution, and sustainment.

The EPIS Framework (Exploration, Preparation, Implementation, Sustainment) offers a particularly useful lens for understanding project delays. EPIS frames implementation as four sequential phases, each with distinct tasks and common failure points:

Exploration Phase: Organisations recognise a need, seek interventions that fit their context, and make decisions about adoption. In Caribbean development projects, this phase often gets compressed. Donors identify needs, governments respond to funding windows, and projects get designed to match available financing rather than genuine implementation readiness.

Preparation Phase: Teams plan, secure resources, train staff, and restructure systems to support implementation. The CoST analysis found this is where 60% of delays originate. Poor feasibility studies, unclear scope, and inadequate financial planning set off a domino effect that carries through to execution. In Caribbean contexts, preparation failures often reflect capacity constraints. Small technical teams managing multiple priority projects simultaneously, limited access to specialised expertise for complex assessments, and pressure to move quickly to secure time-bound funding.

Implementation Phase: Organisations execute, learn, and adapt in real time. Even well-prepared projects encounter unexpected challenges. The difference lies in whether systems exist to detect problems early and adapt effectively. The CDB assessment highlighted disjointed communication and limited engagement as implementation barriers. Organisations struggle to maintain coordination across government ministries, contractors, consultants, and communities when projects encounter inevitable challenges.

Sustainment Phase: Organisations monitor, improve, and institutionalise practices to ensure long-term effectiveness. For infrastructure projects, this means ongoing maintenance, institutional knowledge retention, and adaptive management as contexts evolve. Caribbean projects often lack clear sustainment planning from the outset, treating completion of construction as the endpoint rather than recognising that infrastructure requires decades of active management.

The Preparation Phase Gap: What the Evidence Shows

The CoST research identified three primary preparation failures that cascade into delays:

Poor feasibility studies that fail to adequately assess technical, financial, environmental, or social dimensions. In Caribbean SIDS contexts, feasibility studies often apply templates designed for larger economies without adjusting for limited domestic contractor capacity, small markets for specialised materials, or vulnerability to external shocks from hurricanes and supply chain disruptions.

Unclear scope that leaves critical project elements undefined or subject to later negotiation. Scope ambiguity particularly affects projects requiring cross-ministry coordination or community engagement, common in climate adaptation and social infrastructure projects where technical interventions intersect with complex governance and social systems.

Inadequate financial planning that underestimates true costs or fails to secure realistic financing pathways. Caribbean governments often face constraints in counterpart funding, creating mismatches between donor expectations and government capacity. Projects get designed based on optimistic cost estimates without adequate contingency planning for currency fluctuations, import delays, or disaster recovery needs.

The CDB study added institutional and organisational factors specific to Caribbean implementation contexts:

Institutional capacity constraints where public sector entities lack sufficient staff with relevant technical competence, appropriate training, adequate numerical capacity, necessary digital infrastructure, or financial support to manage complex projects effectively. As one expert noted at the CDB seminar, "You can have someone brilliant at project execution, but if they're one of two people managing a $50 million project, it won't work."

Procurement delays that extend timelines and erode stakeholder confidence. Small island markets mean limited competition for major contracts, while international procurement processes designed for transparency can become bureaucratically burdensome without proportionate benefit in thin markets.

Oversight gaps where monitoring systems fail to detect problems early or lack authority to mandate corrective action. Fragmented accountability across funding agencies, implementing ministries, and executing contractors creates confusion about who holds responsibility for addressing emerging issues.

Applying Implementation Science Frameworks to Caribbean Projects

The Consolidated Framework for Implementation Research (CFIR) provides a systematic approach to diagnosing where projects go wrong and designing targeted solutions. CFIR organises factors associated with effective implementation across five domains:

1. Intervention Characteristics: The Project Itself

CFIR asks: What are the core components? What evidence supports it? How complex is it? How adaptable? What are the costs?

For Caribbean infrastructure projects, complexity often exceeds local implementation capacity. A climate-resilient water system involves civil engineering, environmental assessment, community engagement, financial management, procurement, and ongoing operations and depending on the specific context there might be other contextual factors involved. Each component requires specialised expertise that may not exist within a single government ministry. Projects succeed when design recognises this complexity and builds in technical assistance, phased approaches, or partnerships that provide missing capabilities.

Adaptability matters particularly in Caribbean contexts where hurricanes, volcanic eruptions, and other shocks can fundamentally alter project conditions mid-implementation. Rigid project designs that cannot accommodate necessary adaptations create delays when inevitably required scope changes trigger lengthy approval processes with donors or financing institutions.

2. Outer Setting: The External Environment

CFIR examines external policies, incentives, beneficiary needs, and inter-organisational networks.

Caribbean development projects operate in a distinct outer setting: small economies heavily dependent on tourism and external markets, high public debt limiting fiscal space, vulnerability to climate shocks, significant brain drain affecting technical capacity, and complex regional coordination through CARICOM and sub-regional mechanisms. Successful projects account for these realities rather than assuming conditions that exist in larger, more stable economies.

The policy environment particularly affects climate finance and regional infrastructure. Projects that navigate multiple national regulatory frameworks (for transboundary water resources or regional energy interconnection) or align with rapidly evolving global climate financing mechanisms require sophisticated understanding of the outer setting. Preparation failures often stem from inadequate assessment of these external factors.

3. Inner Setting: The Implementing Organisation

CFIR assesses organisational culture, implementation climate, and readiness for change.

The CDB study emphasised the need for "a result-driven culture" rather than cultures focused solely on planning or compliance. Caribbean public sector organisations often face conflicting pressures: demands for transparency and accountability that slow decision-making, political cycles that create uncertainty about project continuity, and limited authority to offer competitive compensation that drives talent retention challenges.

Implementation climate includes the tangible resources available (adequate staffing, appropriate technology, sufficient budget) and the intangible aspects (leadership support, clear priorities, tolerance for learning from failure). Projects that proceed without assessing implementation readiness (whether the implementing organisation actually has the climate to support successful execution), predictably encounter delays when these gaps manifest during implementation.

4. Characteristics of Individuals: The People Involved

CFIR considers the knowledge, beliefs, and self-efficacy of implementers.

Small Caribbean states face particular challenges with individual capacity. Technical expertise concentrates in limited numbers of professionals who simultaneously manage multiple priority initiatives. One person might lead disaster risk reduction while also serving on climate finance proposal teams and managing bilateral donor relationships. When key individuals leave for opportunities abroad or move to private sector roles, institutional knowledge departs with them.

Projects that depend entirely on external consultants for technical functions create vulnerabilities when those consultants depart. Successful approaches invest in capacity building for local teams, pair international expertise with national counterparts for knowledge transfer, and document systems clearly enough that transitions do not stall progress.

5. Implementation Process: How Execution Unfolds

CFIR examines planning, engaging stakeholders, executing interventions, and reflecting on progress.

The CDB assessment found that fragmented stakeholder coordination and disjointed communication hamper Caribbean projects. Infrastructure projects typically involve multiple ministries (finance, planning, line ministries, environment), statutory authorities, contractors, consultants, affected communities, and financing partners. Without clear processes for coordination, decision-making becomes paralysed by unclear authority or conflicts between stakeholders.

Reflection mechanisms (structured processes for monitoring progress, detecting problems early, and adjusting course) often get neglected under pressure to execute. Yet these processes distinguish projects that adapt successfully from those that continue implementing poorly designed approaches until failures become catastrophic.

Practical Solutions: Implementing Implementation Science

Caribbean governments, development finance institutions, and implementing organisations can apply Implementation Science principles to reduce project delays through targeted interventions at each EPIS phase:

Exploration: Improve Project Selection

Strategy: Assess implementation readiness before commitment

Use rapid assessment tools that evaluate whether the implementing organisation possesses the necessary capacity (technical skills, adequate staffing, appropriate systems), whether the political and policy environment supports the intervention, whether financing aligns with realistic cost projections, and whether key stakeholders demonstrate genuine commitment rather than compliance-driven approval.

Uwamito Consulting's Project Triage Diagnostic tool provides systematic assessment of these readiness factors, identifying gaps that require remediation before proceeding. This upstream investment prevents downstream delays far more effectively than attempting to fix capacity gaps during active implementation.

Strategy: Match project complexity to implementation capacity

Not every infrastructure need requires a $50 million intervention. In contexts with limited implementation capacity, smaller phased approaches may deliver better outcomes than attempting comprehensive transformation. Implementation Science evidence suggests starting with minimum viable interventions that demonstrate success, build capacity and confidence, and create foundations for subsequent phases.

Preparation: Strengthen Project Design

Strategy: Invest proportionately in preparation

The CoST evidence suggests that inadequate preparation accounts for 60% of delay drivers. Yet preparation phases often get compressed under pressure to commit funds within donor timelines or political cycles. A systematic principle emerges: preparation investment should scale with project complexity, risk, and cost. A $50 million climate infrastructure project justifies six to twelve months of thorough feasibility assessment, stakeholder engagement, capacity assessment, and detailed planning. Attempting to prepare such projects in 30-60 days creates the conditions for subsequent delays.

Strategy: Conduct Caribbean-contextualised feasibility assessments

Standard feasibility templates often overlook factors critical to Caribbean implementation: limited contractor markets requiring phased procurement to maintain competition, import dependencies requiring contingency planning for supply chain disruptions, hurricane seasons that define practical construction windows, institutional capacity for operations and maintenance beyond construction, and social dynamics in small communities where infrastructure projects create disproportionate local impacts.

Strategy: Build in adaptive management from design

Projects designed with rigid specifications and change-averse contracts create delays when inevitable adaptations become necessary. Incorporate structured flexibility: phased designs that allow course correction between phases, pre-approved adaptation protocols for defined scenario categories, contingency budgets for justified scope adjustments, and clear decision-making authority for field-level adaptations within defined parameters.

Implementation: Improve Execution Systems

Strategy: Establish coordination mechanisms

The CDB study identified fragmented stakeholder coordination as a key barrier. Successful projects establish clear coordination structures: a project implementation unit with dedicated staff rather than additional responsibilities for already-stretched ministry teams, defined escalation pathways for resolving issues, regular coordination meetings with decision-making authority, and communication protocols that keep all stakeholders informed without creating information overload.

Strategy: Use adaptive learning systems

Implementation Science emphasises learning during execution. Establish regular reflection points (monthly or quarterly depending on project duration) where teams assess what is working, what is not working, why, and what adjustments would improve outcomes. Document lessons for institutional memory. Create psychological safety for raising problems early rather than concealing difficulties until crises emerge.

Strategy: Deploy appropriate technical assistance

The CDB assessment noted that beneficiary institutions must participate meaningfully in design, particularly for capacity building and technology transfer. Embed technical assistance within implementing teams rather than parallel consultancy structures. Pair international expertise with national counterparts for explicit knowledge transfer. Define clear graduation criteria for reducing external support as local capacity develops.

Sustainment: Plan for Long-term Success

Strategy: Design for maintenance from the outset

Infrastructure requires decades of active management. Projects that treat completion of construction as the endpoint predictably fail when maintenance lapses or operational expertise departs. Include in project preparation: realistic operating cost projections and revenue mechanisms, maintenance protocols with required skills clearly specified, training programmes for operations teams, and institutional arrangements for continued oversight.

Strategy: Build institutional knowledge systems

Small Caribbean states cannot afford to lose critical project knowledge when key individuals depart. Systematically document decisions, rationale, lessons learned, and operational procedures. Create accessible knowledge repositories. Build redundancy in critical skills rather than depending on single individuals.

Strategy: Establish feedback loops

Sustainment succeeds when systems exist to detect deteriorating performance and trigger remedial action. Include provisions for ongoing monitoring, clear performance indicators that signal when intervention is needed, and institutional authority to act on early warning signals.

What Success Looks Like

These approaches may sound burdensome: more assessment, more planning, more systems. The Implementation Science evidence suggests otherwise. Systematic preparation and structured implementation processes accelerate delivery by preventing delays rather than reacting to crises.

Consider what happens when projects follow Implementation Science principles:

A water infrastructure project conducts thorough implementation readiness assessment during exploration and discovers the executing authority lacks adequate procurement expertise. Rather than proceeding and encountering procurement delays during implementation, the project preparation phase includes embedding a procurement specialist who simultaneously manages immediate needs and builds internal capacity. The project executes on schedule, and the authority retains enhanced procurement capability for future initiatives.

A climate adaptation project designs with hurricane season constraints explicitly incorporated. Rather than experiencing construction delays when contractors shut down during hurricane threats, the project timeline accounts for these realities from the outset. Stakeholders maintain confidence because the project meets realistic expectations rather than repeatedly revising overly optimistic schedules.

A road rehabilitation initiative establishes clear coordination protocols during preparation, defining how the implementing ministry, contractor, utility companies, and affected communities will communicate and make decisions. When underground utilities are discovered that require scope changes, the established process allows rapid resolution rather than weeks of unclear responsibility and delayed decisions.

Moving Forward

The 73% problem is not inevitable. Caribbean development projects take far longer than planned because we consistently underinvest in preparation, fail to assess implementation readiness, and proceed without the coordination systems and adaptive capacity that execution requires.

Implementation Science offers tested frameworks and strategies for addressing these challenges systematically. The solutions do not require massive additional investment. They require redirecting effort from reactive crisis management to proactive preparation and structured implementation.

For Caribbean governments: Assess implementation readiness before committing to complex projects. Invest preparation time proportionate to project scale and complexity. Establish coordination mechanisms and adaptive learning systems as standard practice.

For development finance institutions: Adjust approval processes to reward thorough preparation rather than penalising time spent on proper feasibility assessment and stakeholder engagement. Provide technical assistance that builds implementing organisation capacity rather than creating parallel systems. Allow structured flexibility for justified adaptations rather than requiring rigid adherence to initial designs that prove inadequate.

For implementing organisations: Develop internal competencies in Implementation Science frameworks. Use systematic approaches to assess barriers and select appropriate strategies. Build feedback loops and learning systems that improve performance across all projects.

The evidence is clear. The frameworks exist. The question is whether we will continue repeating the pattern of delays, or whether we will apply what Implementation Science teaches about preparing thoroughly, implementing systematically, and adapting thoughtfully.

Uwàmìto Consulting specialises in applying Implementation Science frameworks to strengthen Caribbean development projects. Our Project Triage Diagnostic tool provides rapid assessment of implementation readiness and identifies targeted strategies to prevent delays before they occur. Contact us to discuss how systematic preparation can accelerate your project delivery.

References

Caribbean Development Bank. (2025). Accelerating Project Implementation to Reduce Poverty [Seminar proceedings]. 55th Annual Meeting, June 11, 2025, Brasília, Brazil. https://www.caribank.org/newsroom/news-and-events/seminar-1-accelerating-project-implementation-reduce-poverty

Caribbean News Global. (2025, June 27). CDB study reveals procurement delays, oversight gaps, and weak capacity undermining Caribbean development projects. https://caribbeannewsglobal.com/cdb-study-reveals-procurement-delays-oversight-gaps-and-weak-capacity-undermining-caribbean-development-projects/

CoST Infrastructure Transparency Initiative. (2025, May 20). Drivers of infrastructure delays: What can 480 projects across three continents teach us? [Research report]. https://infrastructuretransparency.org/2025/05/20/drivers-of-infrastructure-delays/

Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4-23.

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for implementation research. Implementation Science, 4(1), 50.

Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76.

Across the Caribbean, government services are rapidly moving online. Benefits applications, healthcare appointments, court filings, and payment systems now demand digital access as the default entry point. Ministries frame these changes as efficiency gains, but beneath the shiny platforms and streamlined interfaces, a quiet challenge unfolds: thousands of Caribbean citizens are being systematically locked out of essential public services because they cannot navigate the digital systems designed to serve them.

This is not a technology problem. It is an implementation problem. When governments digitise services without building the infrastructure, skills, and support systems that enable universal participation, they replace one form of exclusion with another.

Who Gets Left Behind?

The digital divide in the Caribbean cuts along predictable lines of vulnerability. Research from the Economic Commission for Latin America and the Caribbean shows that in Latin America and the Caribbean region, only 46.4% of low-income households have fixed internet connections compared to 84.6% of wealthier households. The urban-rural divide compounds this disparity further.

Trinidad and Tobago's National Digital Inclusion Survey 2021 confirms what frontline workers already know: digital development varies dramatically across geographic areas and demographic groups. The country's own digital transformation project acknowledges that "providing internet and mobile connections for vulnerable and underserved populations (i.e., rural, physically challenged, youth, and elderly) remains difficult."

Older adults face compounded barriers. They report low confidence using devices, require assistance setting up technology, and struggle with interfaces designed for digital natives. When health services moved online during COVID-19, older adults from minoritised ethnic backgrounds faced particular challenges navigating remote appointments, understanding digital platforms, and explaining symptoms without in-person interaction.

People with disabilities encounter accessibility barriers that designers often fail to anticipate. Screen readers break on poorly coded forms. Visual or motor impairments make complex navigation impossible. Cognitive differences clash with rigid, unforgiving interfaces.

Rural communities face infrastructure gaps that no amount of digital literacy training can overcome. Unreliable connectivity, expensive data packages, and limited device access create fundamental barriers before questions of skill even arise.

Migrants navigating government systems in their non-native language find digital platforms particularly unforgiving. Unlike human counter staff who can clarify misunderstandings, automated systems offer no flexibility for language barriers or cultural confusion about administrative processes.

The Hidden Costs of Online-Only Systems

When governments shift services online without maintaining alternative access points, the consequences extend far beyond inconvenience.

Benefits go unclaimed. When applying for social assistance requires online submission, those without reliable access or digital skills simply cannot apply. They miss deadlines, fail to navigate multi-step verification processes, or abandon applications when error messages provide no clear path forward. The system counts these failures as reduced demand rather than systemic exclusion.

Healthcare delays become dangerous. Online appointment booking seems efficient until you consider the person who cannot secure a slot because they lack internet access, the elderly patient who misses follow-up care because email notifications disappeared into spam folders, or the diabetic who cannot refill prescriptions through the new portal.

Informal fixers emerge. A shadow economy develops around digital access. People pay neighbours or relatives to complete online forms, creating dependencies that compromise privacy and agency. Some turn to storefront businesses charging fees to navigate government websites, introducing costs that defeat the purpose of free public services.

Dignity erodes. Being unable to independently access services your taxes support diminishes citizenship. The message received is clear: you do not count in this modernised system unless you can keep up.

The False Assumption: Phone Ownership Equals Digital Access

Policy makers often confuse device ownership with digital capability. Yes, high mobile phone penetration exists across Trinidad and Tobago, exceeding Latin American and Caribbean averages. But owning a smartphone and successfully navigating complex government portals are entirely different capabilities.

Digital literacy research consistently demonstrates that merely having access to devices does not translate to effective use. People need information navigation literacy to access the internet safely. They require culturally appropriate content in plain language. They need confidence overcoming fear of making mistakes. Research shows that digital skills shape people's digital experience, helping them overcome fear of using electronic devices and navigate digital spaces effectively.

When governments assume "everyone has a phone now" and design accordingly, they systematically exclude those whose phone skills extend to calls and WhatsApp but not to multi-factor authentication, PDF uploads, or government portal navigation.

What Inclusive Digital Government Actually Requires

Moving services online can genuinely improve access and efficiency, but only when implementation considers how citizens will actually use these systems. Caribbean governments pursuing digital transformation can learn from both successes and failures across the region and globally.

Maintain assisted digital channels. Not everyone will successfully use digital services independently. Trinidad and Tobago's digital transformation project explicitly aims to "improve efficiency and reduce transaction costs to government and citizens, while expanding the inclusiveness of the provision of such services to the elderly, the poor, persons with disabilities, women and girls and residents of rural communities." This requires trained staff who can guide users through digital processes, help desks in community locations, and phone support that does not simply redirect to websites.

Design for offline alternatives. Essential services should never exist only online. Paper forms, in-person appointments, and telephone submission options must remain available, particularly for services affecting basic rights and entitlements. Research on European digital public services shows that barriers such as limited digital skills, access to technology, and inadequate service design disproportionately affect vulnerable groups including the elderly and low-income populations.

Build digital skills as social protection. Digital literacy cannot be treated as a personal responsibility separate from service delivery. When governments require digital access for benefits, healthcare, or civic participation, they must provide structured pathways to acquiring necessary skills. Community-engaged learning approaches that bring trained facilitators into communities show promise for reducing digital divides experienced by underserved populations.

Test with actual users before launch. Caribbean governments pursuing digital transformation initiatives can incorporate user testing with vulnerable populations before rolling out new systems. What works for a ministry official with reliable internet and university education may fail completely for a rural resident with intermittent connectivity and primary school completion. Implementation science frameworks like the Consolidated Framework for Implementation Research (CFIR) emphasise assessing characteristics of individuals including their knowledge, beliefs, and self-efficacy before expecting adoption.

Create feedback mechanisms that capture exclusion. When people cannot access services, they often disappear from official view. Systems should track abandonment rates, failed attempts, and requests for assistance as signals of exclusion rather than simply measuring successful completions. This data should drive iterative improvement rather than being dismissed as user error.

The Urgency of Now

Governments are moving quickly. The UN E-Government Survey shows Latin American and Caribbean countries are highly committed to pursuing digital government strategies. Multiple regional initiatives from UN DESA, ECLAC, the World Bank, and the IDB are actively supporting Caribbean digital transformation.

But speed without inclusion creates harm. Every month that services exist only online is a month that vulnerable citizens cannot access what they need. Every poorly designed portal is another barrier to healthcare, income support, or civic participation.

Progress should be measured not by platforms launched or services digitised, but by whether all citizens can actually access what they need. When a rural grandmother can apply for her pension, when a migrant can renew their work permit, when a person with disabilities can complete a form independently, when anyone needing government services can do so with dignity, then we will have achieved digital transformation worth celebrating.

Until then, what governments are building is not modernisation. It is another way to leave people behind.

Need support implementing inclusive digital government services? Uwàmìto Consulting works with Caribbean governments and development organisations to design and implement digital transformation initiatives that genuinely serve all citizens. Our implementation science expertise helps you navigate the complex human factors that determine whether technological investments create value or create new barriers. Get in touch to discuss how we can support your inclusive digital transformation journey.

Organizations across the Caribbean face a persistent challenge. They invest significant resources in crafting comprehensive strategic plans, secure stakeholder buy-in, and gain approval from boards and cabinets. Then the plans stall. Research shows that approximately 76% of well-informed strategies fail during execution (Carucci, 2017). This failure occurs not because the strategies are weak, but because organizations lack the systems, capacity, and coordination required to translate strategic documents into operational reality. The gap between strategy and implementation represents the single most expensive inefficiency in Caribbean development work today.

Systematic reviews of peer-reviewed literature identify consistent barriers to strategy implementation across public sector organizations (Vigfússon et al., 2021; Girma, 2022). These barriers include fragmented leadership structures, inadequate resource allocation systems, weak coordination mechanisms across organizational units, and insufficient performance monitoring frameworks. Caribbean Small Island Developing States face additional structural challenges. Limited human resource capacity, competing urgent priorities, and external shocks like hurricanes and economic volatility create an environment where even well-designed strategies struggle to gain traction. A study of public sector organizations found that those with strong organizational capabilities (including workforce skills and management systems) achieved significantly better implementation outcomes, yet many organizations rated their internal processes and incentive structures as merely adequate (Mwanza et al., 2025). The Caribbean development sector mirrors these global patterns. Organizations formulate ambitious climate resilience frameworks, food security strategies, and digital transformation roadmaps. Consultants deliver polished documents. Cabinets approve budgets. Then progress stalls because no one established the implementation architecture: the coordination mechanisms, monitoring systems, risk protocols, and capacity-building programs required to execute complex multi-year initiatives in resource-constrained environments.

The literature identifies several implementation enablers that distinguish successful organizations from those that struggle (Cândido & Santos, 2019). First, integrated leadership frameworks that align senior executives with middle management prove essential. Strategy cannot cascade through an organization when mid-level managers lack clarity on their role in execution. Second, organizations need real-time monitoring systems that surface implementation challenges early. Traditional annual reporting cycles allow problems to compound for months before becoming visible. Third, organizations require flexible structures that enable rapid decision-making when external conditions change. Caribbean SIDS cannot afford rigid bureaucratic processes when hurricanes, commodity price shocks, or pandemic disruptions demand immediate strategic adaptation. Fourth, successful implementation requires systematic attention to organizational culture and employee engagement. Research demonstrates that organizations with supportive cultures that clearly communicate strategy and explain the logic behind strategic choices achieve dramatically higher implementation success rates (Kaplan & Norton, 1996, as cited in multiple implementation studies). Finally, modern performance measurement frameworks that track leading indicators rather than only lagging financial metrics enable organizations to manage strategy execution proactively rather than reactively.

Uwàmìto Consulting specializes in building the bridge between strategy and implementation. Over the past six years, we have managed more than 20 development consultancies across the Caribbean, supporting national governments, multilateral donors, regional bodies, and civil society organizations. Our work demonstrates consistent patterns. When we design strategic plans, we simultaneously build the implementation architecture: project management systems, monitoring dashboards, risk registers, and stakeholder coordination protocols. When we support entities to refine the grant and financing applications, we do not stop at securing funding approval. We establish project management offices, train government counterparts in results-based management, and create knowledge management systems that capture lessons for future initiatives. When we developed a community-led monitoring system for HIV services, we delivered not just a framework document but a fully operational system with trained field officers, data collection tools, secure databases, and reporting templates that organizations continue to use today. This approach reflects our understanding that Caribbean development challenges demand integrated solutions. Strategy documents alone change nothing. Implementation without strategy creates chaos. Organizations need consultants who can design bankable strategies and simultaneously build the capacity and systems required to execute them.

The graphic we created illustrates this reality simply. Strategy without implementation becomes expensive shelf decoration. Implementation without strategy becomes expensive chaos. You need both, and you need the expertise to bridge them. Uwàmìto Consulting offers Caribbean governments and development organizations what they actually require: consultants who combine deep technical expertise with practical implementation capacity. We do not deliver reports and disappear. We embed systems, train teams, establish coordination mechanisms, and ensure that strategic investments generate measurable results. When you engage Uwàmìto, you partner with consultants who have managed HIV prevention programs reaching 5,000+ people, reviewed national suicide surveillance systems adopted by Ministries of Health, and built strategic frameworks that organizations use daily for fundraising and program development. Our track record demonstrates what becomes possible when strategy and implementation function as integrated disciplines rather than separate activities. This is how development consulting should work. This is how Caribbean organizations can finally close the strategy-implementation gap.

Ready to close your strategy-implementation gap? Contact Uwàmìto Consulting for a confidential consultation. We begin with a Resilience Audit to identify your organization's specific implementation barriers, then design integrated solutions that deliver measurable results. Visit www.uwamito.com or email melliot@uwamito.com to start the conversation. You can call or WhatsApp: 1.868.756.9981

Refrences:

Cândido, C. J. F., & Santos, S. P. (2019). Implementation obstacles and strategy implementation failure. Baltic Journal of Management, 14(1), 39-57. https://doi.org/10.1108/BJM-11-2017-0350

Carucci, R. (2017, November 13). Executives fail to execute strategy because they're too internally focused. Harvard Business Review. https://hbr.org/2017/11/executives-fail-to-execute-strategy-because-theyre-too-internally-focused

Girma, B. G. (2022). Pitfalls on strategy execution of an organization: A literature review. Financial Metrics in Business, 3(2), 227-237. https://doi.org/10.25082/FMB.2022.02.004

Mwanza, M., et al. (2025). The role of strategy implementation practices on performance of the public sector organisations. Africa's Public Service Delivery & Performance Review, 13(1). https://doi.org/10.4102/apsdpr.v13i1.891

Vigfússon, K., Jóhannsdóttir, L., & Ólafsson, S. (2021). Obstacles to strategy implementation and success factors: A review of empirical literature. Strategic Management, 26(2), 12-30. https://doi.org/10.5937/StraMan2102012V

The COVID-19 pandemic has exposed the vulnerabilities of healthcare systems worldwide, particularly in the Caribbean region. It has highlighted the need for a more resilient and responsive approach to public health, one that prioritizes primary healthcare and health prevention. As countries in the Caribbean seek to build back better, reinvesting in community health workers (CHWs) presents a vital strategy for strengthening healthcare systems and improving health outcomes.

Community health workers (CHWs) often live in the community they serve and may often receive lower levels of formal education and training than professional health care workers such as nurses and doctors. According to the World Health Organization (WHO, 2021), This human resource group has enormous potential to expand the reach of the public health system especially benefitting vulnerable populations such as rural, remote, or hard-to-reach communities and marginalized people. CHWs are often impacted by the said challenges themselves and know the language, culture, and dynamics of the communities they engage which improves the performance, efficacy, and efficiency of the health system. In the Caribbean, CHWs have played a crucial role in improving access to healthcare, particularly in rural and underserved areas (Jeet et al., 2017)

At Uwàmìto Consulting, we have witnessed firsthand the impact of investing in CHWs. Through our technical assistance and capacity-building efforts, we have supported clients in Trinidad and Tobago and Suriname to strengthen their CHW programs. In Trinidad and Tobago, we engaged stakeholders, conducted community pilots, and trained individuals to implement Risk Communication and Community Engagement (RCCE) methodologies, reaching over 2,000 people with health services. In Suriname, we provided technical assistance to develop and implement a Community-Led Monitoring (CLM) system to improve the quality and accessibility of HIV services.

The evidence supporting the effectiveness of CHWs in improving health outcomes is compelling. A systematic review by Scott et al. (2018) found that CHW interventions led to significant improvements in maternal and child health, infectious diseases, and non-communicable diseases in low- and middle-income countries. Another study by Kangovi et al. (2020) found that a CHW program in the United States reduced hospital readmissions and improved patient satisfaction.

Investing in CHWs also makes economic sense. A study by Seidman and Atun (2017) estimated that scaling up CHW programs in sub-Saharan Africa could yield a return on investment of up to 10:1, with significant savings in healthcare costs and increased economic productivity. In the Caribbean, where many countries face resource constraints and increasing healthcare costs, investing in CHWs can be a cost-effective strategy for improving health outcomes.

To fully realize the potential of CHWs in strengthening Caribbean healthcare systems, there is a need for increased investment and policy support. This includes:

1. Providing comprehensive training and certification programs for CHWs, covering a wide range of healthcare topics and skills.

2. Integrating CHWs into the formal healthcare system, with clear roles and responsibilities, adequate compensation, and opportunities for career advancement.

3. Allocating sufficient resources for CHW programs, including funding for salaries, training, and equipment.

4. Developing partnerships between CHWs, healthcare facilities, and community organizations to improve coordination and referral systems.

5. Investing in research and evaluation to better understand the impact and effectiveness of CHW programs in the Caribbean context.

Countries in the Caribbean that already have CHW programs can benefit from a boost in investment and policy support. For countries without CHW programs, there is an opportunity to learn from the experiences of other countries and invest in this vital workforce. The COVID-19 pandemic has underscored the importance of building resilient and responsive healthcare systems, and CHWs are a critical part of the solution.

At Uwàmìto Consulting, we are committed to social development, and having a strong health system is a critical element for development in the Caribbean. Through the technical assistance, we continue to see the importance of primary health care, and more importantly, the role CHWs can play in strengthening the overall health system. We therefore call on all governments, key stakeholders, and development partners to prioritize investments in this important strategy to improve the resilience and sustainability needed to secure the future of the Caribbean.

References:

• Kangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., and Long, J.A., 2020. Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: A randomized clinical trial. JAMA Internal Medicine, 180(10), pp.1315-1324.

• Kraef, C., Kallestrup, P., Olsen, M.H., and Bjerregaard, P., 2020. Community health workers in the era of COVID-19: A systematic review. Tropical Medicine & International Health, 25(11), pp.1327-1336.

• Scott, K., Beckham, S.W., Gross, M., Pariyo, G., Rao, K.D., Cometto, G., and Perry, H.B., 2018. What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Human Resources for Health, 16(1), pp.1-17.

• Seidman, G., and Atun, R., 2017. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Human Resources for Health, 15(1), pp.1-13.

• Jeet, G., Thakur, J.S., Prinja, S. and Singh, M., 2017. Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications. PLOS ONE, 12(7), p.e0180640. https://doi.org/10.1371/journal.pone.0180640