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Shanta and Quentin,

The questions that you both raise about quantity, quality, roles in capacity development, and reach are all vitally important questions as we work to improve health care in Africa (and of course beyond). At Georgetown and the World Faiths Development Dialogue (WFDD - the NGO born in 2000 in the World Bank) we continue to wrestle with the questions of what we know, why it matters, and what it means for policy and practice. We had the chance (in partnership with the Tony Blair Faith Foundation) to undertake a thorough stock-taking of the state of knowledge and understanding on faith and health; the results are summarized here http://berkleycenter.georgetown.edu/wfdd/publications/health-in-africa-and-faith-communities-what-do-we-need-to-know in a policy brief that summarizes the full report.

In an environment where knowledgeable actors use widely different figures and advance widely varying assertions, Quentin's work to separate fact from rough estimate or assumptions colored by belief more than fact represents a major advance. His mining of household survey data offers important new insights.

Looking towards a research and policy agenda, a few suggestions emerge from our own reflections. First, there are huge variations by country, colored by colonial history, post independence approaches to public service and private roles (including faith), outside resources available, and so forth. Knowing a country's history and the current roles in health (and in other sectors) of the variety of religious actors is critically important. Second, religious roles and institutions are ferociously complicated and they are dynamic. Appreciating differences among but also within religious traditions and denominations is vital. And we know too little about how roles are changing. Third, there are significant risks of missing both superb and negative experience because the evidence base on faith-inspired work is so patchy. Learning more can enhance efforts to improve service quality. And fourth, the tendency to isolation and separate paths that is a general characteristic of many faith-inspired health approaches and organizations goes against the goal of aid harmonization. Working for better knowledge, global and granular, and bringing voices and experience into strategy and policy debates makes eminent sense. It is not a simple matter to bring faith voices to the policy tables at different levels (global to local) but it is nonetheless important to do so.