You’ve probably heard that leaders from around the world have just completed a three day high-level summit on the Millennium Development Goals in New York. It’s been a decade since the international community signed up to the MDGs, and two thirds of the way to the 2015 deadline.
In a blog update posted from NY a couple of days ago, World Bank Managing Director Ngozi Okonjo-Iweala cites statistics suggesting progress on various MDG priorities, such as gender parity in primary education, reducing maternal mortality, and access to safe drinking water. But Ngozi calls for more action, less talk, and points out that behind the statistics are people who continue to suffer from lack of the most basic needs. Among the various examples she provides, one in particular caught my attention: “Action is about saving lives – (e.g.) a Tanzanian woman who hears on the radio about bed nets at the local clinic. ”
This example highlights a necessary, albeit insufficient, condition for attaining development outcomes:
information that can help reduce poverty and save lives must be accessible to intended beneficiaries and, for this to make a difference, they must engage with the content of development messages. Any kind of behavior change in support of advancing toward the MDGs requires that these occur. If and only if the Tanzanian woman knows about the availability of bed nets at the local clinic (by listening to the radio, talking to a neighbor, etc.) can she then decide whether she would like to go and get one. If she doesn’t possess this basic piece of information, then the likelihood that she’ll go with the specific purpose of getting a net would obviously range from zero to nil.
That access to information and engagement with content are necessary (but insufficient) for attaining development impact is surely obvious, and often neglected. This point was made by Dr. Gerry Power, managing director of InterMedia (London), an international NGO that specializes in, among others things, “understanding the behaviors and views of people around the world, especially those in challenging environments.” Why is it, asked Dr. Power during a lunchtime seminar at the World Bank last week, that the MDGs mention the importance of citizen knowledge of vital information in only one of the eight goals (MDG 6.A.3)?
In his talk entitled “Access to Information, Mobile Telephony, and the MDGs”, Dr. Power presented a summary of public opinion data from Kenya, Ghana, and Zambia. In terms of health topics, percentages of populations that had never received information or received it more than 12 months ago ranged from a low of 5% on HIV/AIDS in Kenya (i.e., 95% received info, which is great) and a high of 42% on polio in Zambia (only 58% received info, which is dismal). Some of the worst findings include population percentages of those who did not receive any information at all or in the past year on diarrhea in Ghana (33%) and maternal and infant health in Kenya (25%).
The implications of these findings seem to be generalizable. Steve Burgess, a leading light on governance and anti-corruption at the World Bank and chair of the seminar, shared a persistent observation from years of experience working on public sector initiatives: without a well-functioning information system, development interventions tend to fail.
This lack of focus on what the MDGs’ intended beneficiaries know (and prefer) is, I think, symptomatic of the lack of accountability in development, more broadly. If we don’t care about what information people have, or if we systematically disregard this crucial link in the public goods value chain, then perhaps we don’t really care about results. People who are held accountable for what they do and suffer consequences for failure, such as marketers and those seeking elective office, care deeply about and religiously monitor the knowledge and opinions of their clients and constituents.
Leaf through a copy of last Sunday’s edition of The New York Times and you’ll find a story -- ironically buried on page 14 -- entitled “U.N. Poverty Goals Face Accountability Questions”. MIT development expert Esther Duflo, quoted in the piece, sums up fundamental criticisms of the MDGs: “If we miss the goals, who is going to punish us?” I don't think anyone will get fired or lose a reelection because of this -- which makes holding ourselves and each other accountable even more important.
On balance, I think the symbolic recommitment made by world leaders in New York earlier this week is a good thing. But it's certainly not enough to get us to where we say we ought to be in five years. For this, we need to start caring about and keeping track of whether the woman in Tanzania hears about the availability of bed nets, knows about the benefits of having one, and goes to get one from the local clinic. It would also be good to know whether anything we do actually contributes to this process.
Photo credit: Flickr user United Nations Development Programme