Improving health aid for a better planet: The planning, monitoring and evaluation tool (PLANET)

Abstract

BackgroundInternational development assistance for health (DAH) quadrupled between 1990 and 2012, from US$ 5.6 billion to US$ 28.1 billion. This generates an increasing need for transparent and replicable tools that could be used to set investment priorities, monitor the distribution of funding in real time, and evaluate the impact of those investments.MethodsIn this paper we present a methodology that addresses these three challenges. We call this approach PLANET, which stands for planning, monitoring and evaluation tool. Fundamentally, PLANET is based on crowdsourcing approach to obtaining information relevant to deployment of large–scale programs. Information is contributed in real time by a diverse group of participants involved in the program delivery.FindingsPLANET relies on real–time information from three levels of participants in large–scale programs: funders, managers and recipients. At each level, information is solicited to assess five key risks that are most relevant to each level of operations. The risks at the level of funders involve systematic neglect of certain areas, focus on donor’s interests over that of program recipients, ineffective co–ordination between donors, questionable mechanisms of delivery and excessive loss of funding to “middle men”. At the level of managers, the risks are corruption, lack of capacity and/or competence, lack of information and /or communication, undue avoidance of governmental structures / preference to non–governmental organizations and exclusion of local expertise. At the level of primary recipients, the risks are corruption, parallel operations / “verticalization”, misalignment with local priorities and lack of community involvement, issues with ethics, equity and/or acceptability, and low likelihood of sustainability beyond the end of the program’s implementation.InterpretationPLANET is intended as an additional tool available to policy–makers to prioritize, monitor and evaluate large–scale development programs. In this, it should complement tools such as LiST (for health care/interventions), EQUIST (for health care/interventions) and CHNRI (for health research), which also rely on information from local experts and on local context to set priorities in a transparent, user–friendly, replicable, quantifiable and specific, algorithmic–like manner.

Using equitable impact sensitive tool (EQUIST) to promote implementation of evidence informed policymaking to improve maternal and child health outcomes: a focus on six West African Countries

“…Throughout the world and especially in LMICs, policy makers and other key stakeholders in the health sector have come to the realization that resources for scaling up cost–effective MNCH interventions in their populations are scarce. Consequently, they are faced with the complex task of identifying and implementing the most efficient and cost-effective interventions that will results to more deaths averted per fixed investment [ 53 , 54 ]. According to Sridhar and co-workers [ 51 ], health investors usually like to know how many deaths (or episodes of disease) could be averted for a fixed level of investment.…”

Tracking global development assistance for trauma care: A call for advocacy and action

“…However, the vast majority of the burden of injury occurs in LMICs with health systems more ready to effectively absorb DAH and rapidly commute aid into trauma care capacity improvements and benefit from the positive knock-on effects that might result from targeted health system strengthening initiatives (eg, pre-hospital emergency services, resuscitation capabilities, surgical capacity, rehabilitation education). Additionally, DAH-TC needs channels with expertise in trauma care to better identify potentially successful projects, direct strategic disbursement of funds, oversee accountability, improve the translation of objectives to action, and foster sustainability [ 39 ]. Channels with a focus on injury could also serve to advocate for DAH-TC and disburse monies over time to mitigate temporal economic trends and donor funding cycles.…”

Have geopolitics influenced decisions on American health foreign assistance efforts during the Obama presidency?

“…Given the magnitude of non-state health aid, potential complementarities and/or substitution effects (whether coordinated or not) could have affected our estimates [ 32 ]. Furthermore, our analysis does not distinguish between the provision of health aid vs the management of health aid [ 32 - 34 ]. For example, health aid provided by the US Government but managed through global health partnerships may have a more muted or powerful effect on health diplomacy than if the aid were managed directly by the US Government.…”