Seven Questions with Rachel Glennerster, J-PAL

Rebecca Firestone: J-PAL, has changed the conversation  in global  development by conducting randomized evaluations of development programs. What is a “randomized evaluation” and why is it important?

Rachel Glennerster: Randomized evaluation in development draws on the concept of a randomized clinical trial, but adapted to a development context. What we often do is work with people who are implementing programs, and encourage them to select more areas than they were planning to work with and randomize who receives the program. If they’re rolling it out over time, we randomize when communities get the program.

That allows you to compare those who have received the program with those who haven’t, or haven’t yet, received the program, to isolate the impact of the program from all the other things that are going on. And there are lots of things going on in developing countries – countries are growing, there are droughts, etc. This makes it hard to distinguish what is the effect of a program and what is the effect of all the other things happening at the same time. By creating a comparison group that is likely to be the same statistically as the group who gets the program, you can know that any difference that you find is due to the program.

RF:  What is the value of randomized evaluations for development policy and program design?

RG: I come from the position of having been a policymaker before I joined J-PAL, so I’m very conscious of the fact that policymakers constantly have to make choices. There are a lot of things that we want to do, but we only have the money and capacity to do a relatively small number of them. So it’s important that we put resources where they are most useful and where they can have the biggest impact. Certainly, as a policymaker myself, I always found that I was having to make decisions without enough evidence. Providing policymakers and NGOs with information on what’s the most cost-effective approach, what actually changes in people’s lives if you spend money this way versus that way is very important if we’re going to reduce poverty.

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The Daily Impact: Massive Typhoon Heads Towards Philippines

November 8, 2013

The most powerful typhoon of the year is making its way to the Philippines, reports AFP. The country has jumped into action before it makes landfall.

President Benigno Aquino called on his countrymen to make all possible preparations for Typhoon Haiyan, which was generating wind gusts exceeding 330 kilometres (200 miles) an hour and set to hit on Friday morning.

“To our local officials, your constituents are facing a serious peril. Let us do all we can while (Haiyan) has not yet hit land,” Aquino said in a nationally televised address.

“We can minimise the effects of this typhoon if we help each other. Let us remain calm, especially in buying our primary needs, and in moving to safer places.”

Aquino warned areas within the expected 600-kilometre typhoon front would be exposed to severe flooding as well as devastating winds, while coastal areas may see waves six metres (20 feet) high.

Haiyan was expected make landfall on Samar island, about 600 kilometres southeast of Manila, then cut across the central and southern Philippines before exiting into the South China Sea late on Saturday.

State weather forecaster Glaize Escullar said Haiyan was expected to hit areas still recovering from a devastating storm in 2011 and from a 7.1-magnitude quake last month.

They include the central island of Bohol, the epicentre of the earthquake that killed 222 people, where at least 5,000 survivors are still living in tents while waiting for new homes.

“The provincial governor has ordered local disaster officials to ensure that pre-emptive evacuations are done, both for those living in tents as well as those in flood-prone areas,” Bohol provincial administrator Alfonso Damalerio told AFP.

Other vulnerable areas are the port cities of Cagayan de Oro and Iligan on the southern island of Mindanao, where flash floods induced by Tropical Storm Washi killed more than 1,000 people in December 2011.

Authorities said evacuations were taking place in many other towns and villages in Haiyan’s path, while schools were closed, ferry services suspended and fishermen ordered to secure their vessels.

Philippine Airlines, Cebu Pacific and other carriers announced the suspension of hundreds of flights, mostly domestic but also some international.

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Dov Seidman: Disrupting the Business and Social Sectors

A recent article in Smart Planet profiles Dov Seidman, the CEO of LRN . His company is an advisory and solutions firm in corporate compliance, but also gets in the social sector game. He’s telling the story of LRN’s two-year work with PSI as a part of their commitment to the Clinton Global Initiative.

More recently, LRN has turned its attention toward ethical culture in the non-profit sector, through a $1.5 million, two-year-long CGI commitment focused on two organizations: Population Services International (PSI), a global health initiative, and Network for Teaching Entrepreneurship, a support network for young people from low-income communities. Both have benefitted from LRN’s leadership development guidance, workshops on culture and other services.

“Ironically, mission-based organizations sometimes have greater challenges doing this,” Seidman says, adding, “In some ways, they are more relaxed about making the organization really operate optimally. In some ways, they are behind for-profits. In some ways, they take for granted that ‘We are so about the mission.’ [The truth is that] everybody is not ‘here’ because they love the mission … so that was an ironic lesson.”

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The Daily Impact: Global Fund Finds Savings in New Procurement Strategy

November 7, 2013

The Global Fund to fight AIDS, TB and Malaria unveiled a new procurement program that will save more than $100 million. Devex reports:

facebook-data-point-3The organization announced on Tuesday a new framework that allows it to pool orders from countries purchasing life-saving tools to combat AIDS, tuberculosis and malaria. This is a major shift from its current “spot tendering” approach, through which it submits separate, individual orders for each country, a practice that had huge effects on demand and prices as suppliers had “no visibility on procurement plans and cannot adequately plan production,” a spokesperson told Devex.

The latest approach, however, is expected to stabilize demand and prices, and give the fund opportunities to identify inefficiencies.

Under the new framework, supplier contracts will have a two-year framework, allowing the fund to monitor supplier performance in terms of pricing, delivery lead time, ownership of facilities, innovation, product quality and value proposition. Performance during that period will have an “impact on [the fund’s] future business with suppliers,” noted the spokesperson.

Savings

The Global Fund also announced on Tuesday a single tender for 90 million mosquito nets  the largest in its history  to kick off the new strategy. This is a pooled order for about 20 countries that have net requirements between 80,000 and 27 million in 2014, a move intended to save both organization and partners up to $140 million.

The initial savings, explained the spokesperson, “are linked to the countries using the pooled procurement mechanism, and as more countries use this mechanism, it is expected to get additional savings, as some of the discounts negotiated with suppliers are volume related.”

The choice of suppliers could also drive cost savings, as the fund aims to support production in the very countries where there’s high demand for lifesaving tools such as mosquito nets, thereby reducing costs such as shipment.

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Measuring Impact and Putting Data into Action

The latest edition of Impact magazine looks under the hood to see how NGOs, donors, charity watchdogs and corporations measure impact and what role measurement plays in decision-making.  Read the introduction from editor Marshall Stowell below and see all the articles here.

impactOct

In this issue of Impact we look under the hood to see how NGOs, donors, charity watchdogs and corporations measure impact and what role measurement plays in decision-making.

Answering 7 Questions, Abdul Latif Jameel Poverty Action Lab’s Rachel Glennester discusses the benefit of randomized evaluation and offers NGOs some sage advice, “Be willing to change things, mix things up a bit, not be too scared to try something different”.

Tom Murphy explores the debate on overhead vs. impact.  Art Taylor, President and CEO of BBB Wise Giving Alliance, Jacob Harold, President and CEO of Guidestar, and Ken Berger, President and CEO of Charity Navigator write, “The percent of charity expenses that go to administrative and fundraising costs – commonly referred to as “overhead” – is a poor measure of a charity’s performance.” A move in that direction would make heeding Rachel’s advice a lot more likely for many – giving NGOs greater latitude to spend funds on research and innovation.

The Center for Global Development’s Amanda Glassman discusses practical recommendations to help global health funders maximize their impact on health – or, in her words, “get more health for their money”.

Jodi Nelson, Director of Strategy Measurement and Evaluation at the Bill and Melinda Gates Foundation, makes a compelling case for putting data front and center in the post-2015 agenda.  She also shares the foundation’s new evaluation policy.

We also explore the range of ways some of the world’s leading NGOs measure impact. In her piece, PSI’s Kim Longfield sets context for NGO measurement as “stakeholders want to invest increasingly scarce resources where they will have the most impact.”

Four leading corporations have more in common than one might imagine when it comes to measuring corporate social responsibility efforts and their philanthropic investments.  The bottom line is that it’s becoming more closely linked to the bottom line. As John Lloyd of the LBG states, “community investment is becoming more strategic and more focused.”  For many, it’s now being integrated into broader business goals.

Ehren Reed, Research and Evaluation Officer at the Skoll Foundation, shares three innovative examples outside of global health from a project measuring the success of a nation to a tool for companies to measure and disclose performance to the Ecological Footprint, which measures humanity’s demand on nature in comparison to available biocapacity. Ehren’s piece reminds us to look beyond our industry for innovative models.

What’s coming next for Impact? Our year-end issue will be released online and will once again look at the top moments in global health of the past year. We’re compiling our list but want to hear from Impact readers what you think the year’s most important moments were. You can email me directly at mstowell@psi.org or visit the Impact blog and share your thoughts.

Sincerely,

MARSHALL STOWELL
Editor-in-Chief, Impact

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“Life is priceless”: using mobile phone and SMS technology to reach most at-risk populations

Fabiola stands outside the door to the room that she rents on a weekly basis and uses to attend to her clients. She has been working in Guatemala City’s area of “La Línea”, a strip along the old train tracks where over 300 sex workers line the streets and receive up to 5 clients per day, each. “Sometimes clients will offer me more money to not use condoms, kind of what happened to ‘Patricia’ in her story”, she says.

Fabiola is one of the sex workers reached by the USAID Combination Prevention Program for HIV and invited to participate in an interactive behavior change communication methodology designed in the form of a “soap opera” and adapted to short message system (SMS) and mobile phone technologies. Users subscribe to the service and receive three messages per day, three times a week. They receive airtime and other prizes, by participating, responding to questions and completing their unique identifier code as a way to track their participation.

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The Daily Impact: Cancer Deaths Declining in the Americas

November 6, 2013

The mortality rate of cancer in nine countries in the Americas region is declining, says a new PAHO/WHO report. From the press release:

Overall, cancer is holding steady as the second-leading cause of death in the Americas, claiming an estimated 1.3 million lives each year, according to Cancer in the Americas: Country Profiles, 2013, released this week at the 5th International Cancer Control Congress (Nov. 3–6) in Lima, Peru.

The PAHO/WHO report shows that Latin America and the Caribbean account for approximately 50% of cancer deaths in the Americas, although they account for 63% of the hemisphere’s population. The highest cancer mortality rates in the region are found in Trinidad and Tobago, Cuba and Argentina, based on data provided to PAHO/WHO by its member countries. Mexico, Nicaragua and El Salvador have the lowest cancer mortality rates. Cancer deaths overall are declining in nine countries: Argentina, Brazil, Canada, Chile, Mexico, Nicaragua, Paraguay, Venezuela and the United States.

Cancer mortality rates vary for men and women as well as across countries. In Latin American and Caribbean men, the majority of cancer deaths are due to prostate cancer, followed by lung, stomach and colorectal cancers; and in women, breast cancer, followed by stomach, lung, cervical and colorectal cancers. In contrast, in Canada and the United States lung cancer is the leading cancer killer for both sexes.

Cancer morality is typically higher in men, driven by high rates of lung and prostate cancers. The exceptions are in El Salvador and Nicaragua, where female rates are higher owing to deaths from cervical and stomach cancers.

“The large number of deaths from breast and cervical cancer in Latin America and the Caribbean is very disconcerting, since cervical cancer is largely preventable, and breast cancer can be detected early and treated successfully,’’ said Silvana Luciani, PAHO/WHO advisor on cancer prevention and control. ‘’This points to the need to improve screening and treatment, especially for women in rural and remote areas, where access to health services is especially limited.”

The report is based on recent data compiled by PAHO/WHO about cancer mortality, risk factors, and cancer policies and services in the countries of North, South and Central America and the Caribbean. For each country, data are presented for leading cancer types (ranked by mortality); trends in cancer deaths from 2000 to 2010; main cancer risk factors (tobacco, alcohol, diet, physical inactivity, obesity); key socio-demographic factors; and health sector plans, policies and services for cancer.

“The idea is to provide key information that can help countries monitor progress in cancer control and assess areas of need, “said Luciani. “This report contributes significantly to the evidence base for cancer policymaking and health care.”

The report is part of PAHO/WHO’s efforts to support member countries as they address the growing epidemic of noncommunicable diseases (NCDs). PAHO/WHO is also working with countries and partner organizations to develop and implement comprehensive cancer control programs within the framework of the PAHO/WHO Strategy and Plan of Action on NCDs.

Read the report here.

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A Winning Strategy: Investing in Local Heroines

By Karl Hofmann, President & CEO, PSI

When you invest in local heroines, women win.

Despite all the systemic challenges women and children face around the world, we’ve learned that investing in local heroines who provide education and resources can help tear down barriers and save lives.

Here is an impact primer that shows how investing in local heroines helps PSI get results for women and children.

Local heroines trained in community health services save children’s lives.In many countries, mothers are unable to access health care for their children to treat preventable but deadly diseases like malaria, pneumonia, and diarrhea. We can shift that equation by deploying local health workers. In Cameroon, 48% of children received diarrhea treatment in areas served by community health workers vs. 7% of children in other areas with no community health workers.

Local heroines are effective champions for social change.There is often stigma associated with family planning activities. In Zimbabwe, where women are embarrassed to purchase female condoms, local heroines like hairdresser Tears Wenzira are distributing them in beauty salons. In fact, more than one million female condoms are distributed through this network of 2,500 hairdressers across the country.

Local heroines help keep mothers alive during childbirth.In the next 24 hours, 931 women will die worldwide from preventable pregnancy-related causes. In Pakistan, more than three-quarters of births take place at home, which is high-risk for maternal mortality. A pilot voucher program – where trained outreach workers recruit pregnant women from low-income households to receive subsidized reproductive health services from private health providers – increased prenatal clinic care by 16%, health care-facility based deliveries by 20% and postnatal care by 35%.

As you can see, PSI is committed to measuring our impact. And we’ve learned that investing in local heroines provides extraordinary returns on your investment.

Will you invest in a local heroine?

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The Daily Impact: UN and World Bank Heads to Visit the Sahel

November 4, 2013

World Bank President Jim Kim is joining UN SG Ban on a tour of the Sahel region of West Africa this week.

This is the second joint trip by Dr. Kim and Mr. Ban to Africa. They first traveled together to the Great Lakes region in May 2013 to support regional efforts to create lasting security and development in this vulnerable part of the continent.

Dr. Kim and Mr. Ban will be joined by Dr. Nkosazana Dlamini Zuma, Chairperson of the African Union Commission; Mr. Donald Kaberuka, President of the African Development Bank; and Mr. Andris Piebalgs, European Union Commissioner for Development.

The delegation will visit Mali on November 5th, Niger on November 6th and Burkina Faso and Chad on November 7th.

Africa’s Sahel Region is home to more than 80 million people. The region faces grave threats to its security and development, exacerbated by decades-long, regional economic, political, demographic and ecological stresses. Instability in the Sahel is caused by recurring pressures of rapid population growth, extreme climate, weak institutions and a lack of state presence in many remote areas.

“The people of the Sahel have lived for decades with threats to their survival, battered by conflicts, political instability and a harsh and unpredictable environment. Now is the time to help them build more stable lives, with better access to quality health care and education, as well as good jobs, especially for women and young people,” said Dr. Kim.

Mr. Ban said a United Nations Integrated Strategy for the Sahel puts a priority on governance, security and resilience.

“First, the crisis in Mali has underscored the need to do more than fight fires in the region – we need to clear away the problems that could ignite conflict and instability. Second, we must take a regional approach. The challenges in the Sahel respect no borders – neither should our solutions. More than eleven million people are food insecure. Five million children under five are at risk of acute malnutrition. The region is awash in weapons, and highly vulnerable to terrorist and criminal networks. The Sahel has suffered its third major drought in less than a decade, and the effects of global warming are being felt as never before. These challenges cannot be overcome by any government or organization alone. The issues are connected and we need an approach that connects our efforts,” said the UN’s Ban.

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