The Center for Global Development (CGD) publishes studies about different aspects of development. A recent blog post about the need for performance based evaluation and the CGD report "Are Funding Decisions Based on Performance?" have attracted my attention. The blog post is to be found at http://blogs.cgdev.org/globalhealth/2010/04/do-pepfar-the-global-fund-and-the-world-bank-map-make-funding-decisions-against-performance-and-why-this-matters-now.php?utm_source=GHPRN&utm_medium=email&utm_campaign=nl_GHPRN_06252010.
The paper may be downloaded from http://www.cgdev.org/content/publications/detail/1424030/
The issues being talked about in the CGD report and the blog are important ... but I am disappointed at what emerges as a result. It is years and years and years that the main official relief and development assistance (ORDA) organizations have talked about improvement in the performance metrics systems ... going back 30 years and more ... and the outcome, the change in process that will get change in performance ... is miniscule.
This is the comment I have posted to the CGD blog:
My work with the official relief and development assistance (ORDA) industry goes back to 1978 ... my prior background was engineering, economics and corporate management accounting.
In some parts of the health industry there is great attention to cause and effect and science has moved ahead in an amazing way ... but in the operational activities of the ORDA community and global public health, the acquisition and use of data is dismal, and I would add ... perhaps fraudulent ... certainly not transparent.
When one "follows the money" all sorts of issues arise ... and this should be of great concern. It seems that there is a widespread mindset that the big job is to get the donors to deliver the money ... and after that getting results is not very important. It is an appalling state of affairs that this has become widespread ... almost universal!
I argue that we ought to know what things cost and be able to compare costs between times, between places and between organizations. This should show us something about cost efficiency. Only things that are cost efficient should get funded. One strike and you are out!
I argue that we ought to know a lot more about impact and cost effectiveness. How much was the expenditure and how much progress was achieved as a result of the expenditure. ORDA activities have been going on for 60 years, and yet there is relatively little data about cost effectiveness. In malaria there are many different interventions that in combination produce impact ... but what mix has worked best? ... at what cost? ... with what impact (improvement in the malaria situation)? ... and specifically in what communities?
With some knowledge not only about time but also place it becomes possible to get some validation of data and the stories being told. This can be invaluable ... many stories do not hold up when there is even simple validation!
When the Global Fund was proposed, I thought it a good idea. When it started out I changed my mind because it rapidly adopted the many bad practices of the ORDA world including a singular focus on analysis of proposals and data collection, analysis and reporting about actual performance that is meaningless. As a consequence, the world knows very little of how impactful the Global Fund has been.
I am not optimistic than any of the leaders in the ORDA community are going to take any significant initiatives to improve data acquisition and reporting about performance. In this situation, at some point society as a whole will have to do this. It will not be easy, but it can be done. Hopefully the major institutions will realize ahead of time the impact that this will have and reform themselves ahead of time.
It could get interesting!