Health Equity: 01/30/12

Monday, January 30, 2012

[EQ] Indicators as Interventions: pitfalls and prospects in supporting development initiatives

Indicators as Interventions:
pitfalls and prospects in supporting development initiatives

Rockefeller Foundation, December 2011

Kevin Davis and Benedict Kingsbury

Available online PDF [55p.] at: http://bit.ly/wnTGHo

“………..One of the most interesting findings presented in the report is that the process of creating and disseminating indicators can be an effective intervention that is particularly useful in addressing and marshaling a response to wicked problems—complex, interdependent, ever-changing global issues that require the application of iterative solutions in order to be managed successfully. As the authors point out, it is valuable to compare indicators with other potential interventions in the international development system and, in their most compelling and powerful form, use them to trigger actions that move us one step closer to addressing challenges affecting the lives of poor and vulnerable populations on a daily basis.

The ability of indicators to help reframe problems related to poverty and globalization is an excellent example of how new kinds of evidence can play an outsized role in shaping the responses undertaken by philanthropies, governments, and other organizations interested in ensuring social change. Moving forward, the growing emergence of user-generated information that actively involves beneficiaries in the collection, production, and assessment of data will likely significantly shape the next generation of indicators.

Similarly, a shift in the locus of indicator construction is also likely to take place in the coming years, moving away from the current situation in which institutions based in the global North produce indicators about challenges taking place in the global South and, instead, lead to a rise in South-South collaboration related to indicator construction. An example of this trend is the Ibrahim Index of African Governance created by the Mo Ibrahim Foundation, an instance where an African-based institution has developed an increasingly well-known indicator that tracks the quality of governance across the continent.

In conclusion, this important contribution to the field highlights how indicators create valuable, necessary, and quantifiable simplifications that both illuminate key dimensions of a complex problem while simultaneously allowing important comparisons to be made.

Readers will find the report useful whether they plan to create a new indicator, want to better understand tradeoffs between indicators and other intervention options, or evaluate in what ways indicators can be deployed most effectively. Finally, the report highlights pathways for needed future research about how indicators can lead to action and impact……….”

TABLE OF CONTENTS

Executive Summary

1. Introduction

1.1. Top-down problem-solving and the pathologies and pitfalls of indicators

2. Indicators and their alternatives

2.1. What is an indicator?

2.2. How indicators are produced

2.3. Alternatives to indicators

2.4. Case Studies

1. WHO/UNICEF Immunization Coverage Indicators

2. State Failure: The U.S. Fund for Peace Failed States Index

3. Impact Investment: The Global Impact Investing Rating System (GIIRS)

3. Roles for indicators in addressing social problems

` 3.1. The process of addressing social problems: framing, action, contestation, updating

4. Learning and Revision

4. Indicators and the framing of social problems

4.1. How indicators frame problems

4.2. Indicators: validity and measurement error

4.3. Discrepancies in framing between the indicator and the gold standard for the problem

4.4. Indicators that frame problems controversially

4.5. Do indicators promote common understandings?

5. How indicators influence action

5.1. Which indicators influence action?

5.2. What factors determine the influence of indicators?

5.3. Under what conditions can indicators promote optimally constructive action?

5.4. When do indicators promote coordinated action?

5.5. Does use of indicators enhance accountability for actions?

6. Contestation around indicators

7. Learning and revision

8. Conclusion

Appendix

This report draws extensively on background papers authored for this project by Nehal Bhuta, Sarah Dadush, and Angelina Fisher. Their papers appear, with substantial modifications, in K. Davis, A. Fisher, B. Kingsbury, and S. Merry eds., Governance by Indicators: Global Power Through Quantification and Rankings (Oxford University Press, forthcoming 2012).

Indicators as a Technology of Global Governance

PDF file [60p.] http://bit.ly/y7hn5C

IILJ Working Paper 2010/2 Rev

“…..The use of indicators is a prominent feature of contemporary global governance. Indicators are produced by organizations ranging from public actors such as the World Bank or the US State Department, to NGOs such as Freedom House, to hybrid entities such as the Global Fund, to private sector political risk rating agencies. They are used to compare and rank states for purposes as varied as deciding how to allocate foreign aid or investment and whether states have complied with their treaty obligations.

This paper defines the concept of an “indicator”, analyzes distinctive features of indicators as technologies of governance, and identifies various ways in which the use of indicators has the potential to alter the topology and dynamics of global governance.

Particular attention is paid to how indicators can affect processes of standard setting, decision-making, and contestation in global governance. The World Bank Doing Business indicators and the United Nations Human Development Index are analyzed as case studies…..”

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[EQ] Strengthening Health Systems: Perspectives for economic evaluation

Strengthening Health Systems: Perspectives for economic evaluation

Till Bärnighausen, David E. Bloom, Salal Humair

Harvard School of Public Health, Department of Global Health and Population

Africa Centre for Health and Population Studies, University of KwaZulu-Natal, South Africa

School of Science and Engineering, Lahore University of Management Sciences, Pakistan

Harvard Initiative for Global Health - January 2012 - PGDA Working Paper No. 85

Available online at: http://bit.ly/zcTV3L

"……..The recent shift towards funding HSS as opposed to funding only stand-alone HIV interventions has the potential to increase the effectiveness, efficiency, and sustainability of HIV programs. But several issues arise when considering when and how to combine HSS interventions with HIV-focused programs, and how to evaluate their costs and benefits.
First, the combination needs to be designed taking into account each country's circumstances.
Second, HSS interventions can differ substantially in scope or scale, raising different challenges in the evaluation of costs and benefits.

Finally, a full evaluation of an intervention needs to take into account issues such as feedback resulting from the intervention itself; and unintended consequences that can have major implications, particularly for the cost-benefit analyses of interventions such as those proposed by McGreevey et al. . Dynamic models that incorporate both feedback and unintended consequences are essential for a proper cost‐benefit accounting of HSS interventions…"

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"Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members".
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[EQ] A Framework for Disseminating Evidence-Based Health Promotion Practices

A Framework for Disseminating Evidence-Based Health Promotion Practices

Jeffrey R. Harris, Allen Cheadle, Peggy A. Hannon, Patricia Lichiello, University of Washington, Health Promotion Research Center, Seattle, Washington;

Mark Forehand, Michael G. Foster School of Business, University of Washington, Seattle, Washington;
Eustacia Mahoney, American Cancer Society, Seattle, Washington; Susan Snyder, Senior Services, Seattle, Washington.

Prev Chronic Dis - January 2012 Volume 9:110081.

Available online at: http://1.usa.gov/ysYbwJ

“…….Wider adoption of evidence-based, health promotion practices depends on developing and testing effective dissemination approaches. To assist in developing these approaches, we created a practical framework drawn from the literature on dissemination and our experiences disseminating evidence-based practices.

The main elements of our framework are
1) a close partnership between researchers and a disseminating organization that takes ownership of the dissemination process and
2) use of social marketing principles to work closely with potential user organizations.

We present 2 examples illustrating the framework: Enhance Fitness, for physical activity among older adults, and American Cancer Society Workplace Solutions, for chronic disease prevention among workers.
We also discuss 7 practical roles that researchers play in dissemination and related research: sorting through the evidence, conducting formative research, assessing readiness of user organizations, balancing fidelity and reinvention, monitoring and evaluating, influencing the outer context, and testing dissemination approaches…………”

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[EQ] World Development Report 2012: Gender Equality and Development

World Development Report 2012:

The focus of the report is Gender Equality and Development

The World Bank, 2012

Website: http://bit.ly/xiQkAq

Swedish launch of World Bank report on gender equality as a pre-condition for reducing poverty and increasing growth.

On 31 January, Minister for Finance Anders Borg and Minister for International Development Cooperation Gunilla Carlsson are to present the World Development Report 2012 in Stockholm, together with the report' principle author, Dr Ana Revenga (World Bank)

Overview PDF [4p.] at: http://bit.ly/zv6e4D

"……………The lives of girls and women have changed dramatically over the past quarter century. The pace of change has been astonishing in some areas, but in others, progress toward gender equality has been limited—even in developed countries.

This year's World Development Report: Gender Equality and Development argues that gender equality is a core development objective in its own right. It is also smart economics. Greater gender equality can enhance productivity, improve development outcomes for the next generation, and make institutions more representative.

The Report also focuses on four priority areas for policy going forward:
(i) reducing excess female mortality and closing education gaps where they remain,
(ii) improving access to economic opportunities for women
(iii) increasing women's voice and agency in the household and in society and
(iv) limiting the reproduction of gender inequality across generations.

Complete Report

World Development Report 2012: Gender Equality and Development (19MB, pdf) I Issuu

Main Messages (multilingual)

Overview (multilingual)

Introduction A guide to the Report (1.0MB, pdf)

Download by Chapter:

The Report has nine chapters in three parts.

Part I Taking stock of gender equality

Part 1:Taking stock of gender equality—presents the facts that will then provide the foundation for the rest of the Report. It combines existing and new data to document changes in key dimensions of gender equality over the past quarter century and across regions and countries. Its main message is that very rapid and, in some cases, unprecedented progress has been made in some dimensions of gender equality (chapter 1), but that it has not reached all women or been uniform across all dimensions of gender equality (chapter 2).

Download:
Chapter 1: A Wave of progress (913KB, pdf)
Chapter 2: The persistence of gender inequality (1.2MB, pdf)
Spread 1: Women's pathways to empowerment: Do all roads lead to Rome? (219KB, pdf)

Part II What has driven progress? What impedes it?

The contrast between the patterns and trends described in the first two chapters of the Report prompts one to ask what explains the progress or lack of it. Part 2—What has driven progress? What impedes it?—constitutes the analytical core of the Report. It presents the conceptual framework and uses it to examine the factors that have fostered change and the constraints that have slowed progress. The analysis focuses on gender differences in education and health (chapter 3), agency (chapter 4), and access to economic opportunities (chapter 5)—discussing the roles of economic growth, households, markets, and institutions in determining outcomes in these three spheres. Part 2 concludes with a discussion of the impact of globalization on gender inequality, paying attention to the opportunities and challenges created by new economic and social trends (chapter 6). The analysis in these four chapters leads to the identification of four priority areas for action: reducing gender gaps in human capital endowments, promoting higher access to economic opportunities among women, closing gender gaps in household and societal voice, and limiting the intergenerational reproduction of gender inequality.

Download:
Chapter 3: Education and health: Where do gender differences really matter? (4.7MB, pdf)
Chapter 4: Promoting women's agency (3.0MB, pdf)
Spread 2: The decline of the breadwinner: Men in the 21st century (175KB, pdf)
Chapter 5: Gender differences in employment and why they matter (4.9MB, pdf)
Chapter 6: Globalization's impact on gender equality: What's happened and what's needed (1.0MB, pdf)
Spread 3: Changing ages, changing bodies, changing times—Adolescent boys and girls (177KB.pdf)

Part III The role of and potential for public action

Part 3—The role and potential for public action—presents policy recommendations, examines the political economy of reforms for gender equality, and proposes a global agenda for action. The discussion starts with a detailed description of policy options addressing the four priority areas, complemented with concrete illustrations of successful interventions in different contexts (chapter 7). An examination of the political economy of gender reforms follows, with an emphasis on the issues that distinguish reform in this area from other types of redistributive or equality-enhancing reforms (chapter 8). Global action on gender equality should focus on complementing country efforts on the four priority areas identified in the Report (chapter 9).

Download:
Chapter 7: Public action for gender equality (1.0MB, pdf)
Chapter 8: The political economy of gender reform (1.1MB, pdf)
Chapter 9: A global agenda for greater gender equality (522KB, pdf)

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