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Make MDGs about the HOW, not just the WHAT

Jody Zall Kusek's picture
As the old Japanese proverb goes: Vision without action is a daydream, while Action without vision is a nightmare. This could not be more prophetic as we turn our attention to what’s next for the Millennium Development Goals (MDGs). Now, after more than ten long years since the launch of the eight United Nations MDGs, we have real targets that move toward ending hunger and, for example, improving maternal health. We have reached agreement about “What” development success would look like if results were achieved on the ground and what targets should be used to measure this success.

Likewise over the last decade, another key development agenda has converged to support achievement of the MDGs. As we all know by now, the “Results Agenda” is focused on asking whether results have been achieved on the ground, and whether there is a known link to the money spent on development projects and programs and the results reported on. The results agenda has also supported countries improve their monitoring and evaluation (M&E) capacity to be able to measure and report on what has been achieved, and what continues to lag. Consequently, those countries did not just monitor the MDGs but also those indicators that showed that they were on their way to achieving them. 

Setting MDG goals and targets has clearly helped countries create the political will to mobilize new resources to meet the millennium challenges. This is exactly what the results agenda has been working toward. It also seems to have provided an important soapbox for economists to debate what would have happened in the country had these goals never been set in the first place. 

For example, the whole discussion around the Millennium Development Villages shows a clear disrespect about the need to think through not only results frameworks but also about proper methodologies to monitor and evaluate results (Read Feast and Famine). Another example of how poorly one had thought through the results framework of the MDGs is the fact that researchers are hardly able to discuss in a serious manner attribution of the adoption of the MDGs to the improvements in people’s lives as measured by the MDGs. An interesting paper on this topic by the Centre for Global Development (Read More Money or More Development: What Have the MDGs Achieved?) discusses not budget allocation increases to various programs that support MDG attainment, but actually discusses if the words ‘Millennium Development Goals’ showed up more frequently now than in the past when scanning with Google books. Certainly we need to do better going forward.

As we look to 2015 and beyond, it’s time to ask another set of questions: the HOW questions. How does a country implement development programs to deliver the results needed, on time, at the lowest cost, and to the maximum number of people who need them? How does a country identify and remove bottlenecks that keep the work from getting done?  How do we learn as we go to make sure that problems are identified, fixed, and the project stays on track to achieve the results the country cares about? Our colleague, Vijay Rao, has found that project implementation can consume up to 90 percent of project costs, and is often the weakest link in aid effectiveness.  As the MDGs move into the next phase we, more than ever, need to get the how question right.

India, for example, is well on its way to meeting its MDG target on HIV AIDS. Clearly the country answered important what questions, such as what was driving the epidemic in the country? They answered this through the use of rigorous problem diagnosis which led to the effective targeting of high risk groups. Every HIV program also came complete with a results framework to communicate what success looked like, as it placed a strong attention to measurement and reporting.  

However, moving the needle in favour of meeting this MDG came from the intelligent use of implementation tools such as performance dashboards and the use of standard operating procedures in delivering services. This ensured that no matter where a particular HIV-related service was delivered in India it would be delivered exactly the same way and with the same attention to quality and efficiency. As a result of their efforts, the Government of India’s AIDS program reduced HIV infections in India by over 60 percent, from over 5 million to 2.5 million new cases. A phenomenal achievement by any standard.

We believe that the continuing attention to using results frameworks, results chains and M&E capacity building are still important. But we would have to side with Peter Drucker, the overly quoted management guru who wrote that being able to do the right things shows leadership but paying attention to how programs are managed gets them right. As the experts consider the next direction to take the MDGs, we hope they will also take the lesson of India – make sure the work gets done right.

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