I am not afraid of reform, innovation, or change, but many people worldwide are risk-averse.  In developing countries, some of this aversion is cultural, but usually, leaders are concerned that reforms will cost money, jobs, or their reputations.

Change becomes less frightening and more doable when donor funds are earmarked to test on a small scale or pilot a program.  It helps if earmarked funding is from outside sources so that there is minimal risk to the finances of an institution or organization.

Reputational risk can also be mitigated with donors, or outside advisors can take the blame when a pilot program runs into problems.  Leaders want to save face among their peers and public audiences when programs have problems.   As an outsider, I am prepared to take public responsibility for mistakes and apologize if needed.  Thankfully, it is rarely needed.