Development information - accounting and accountability (4)
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Dear Colleagues,
Somehow I missed the post by James Michael Hayes, but I found the ex-
change on accountability in development very thoughtful and on point.
Thank you!
Dr John Kiwanuka Ssemakula (MD, MPH) is right. Efforts to improve ac-
countability will be most valuable if they focus on outcomes. Out-
comes indicators not only can tell us which projects are NOT effec-
tive, but also give us statistics that support public relations, mar-
keting and fundraising for those programs that DO effectively and ef-
ficiently produce desired results. To move beyond buzzwords, what do
we do? First, define desired outcomes for development. Every develop-
ment project should include outcomes indicators appropriate to its
objectives. In addition, macro-level outcomes indicators would be
useful, if feasible. The trick is to keep the focus on actual out-
comes (e.g., how many children returned to health), not process
(e.g., how many units of medicine delivered).
Here are three possible outcomes indicators that would have to be de-
fined more precisely:
* Short- and long-term reductions in morbidity/mortality directly at-
tributable to poverty (e.g., starvation, malnutrition, water-borne
diseases), in absolute and relative terms.
* Short- and long-term increases in family and community self-
sufficiency (i.e., meeting basic human needs, prioritized along
Maslow's hierarchy or something comparable), in absolute and relative
terms.
* Perception of effectiveness among intended beneficiaries. Most ef-
fective is for local communities (not governments, the people,
through neutrally facilitated fora) to define their own desired out-
comes indicators and monitor progress towards them.
Such a process facilitates true empowerment, a sense of ownership for
establishing and problem-solving community goals that can have value
far beyond the specific results of a single intervention. What do you
think? Dr. Burgess, could macro-level outcomes indicators be incorpo-
rated into your envisaged database? Who wants to refine and improve
these initial proposed indicators? Let's keep this exchange going.
Karen Hoehn
mailto:karen@healthstrat.com
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