Final thoughts for 2010

I've spent the last few hours perusing global health and development websites. I wish that I had more time to do this on a regular basis.

A few comments and suggested readings from the web:

This is a blog that Bill Easterly just turned me onto: Good Intentions are not enough. I am all about people trying to start a dialog on how to improve aid and the mechanisms of how donor dollars reach the intended recipients. Great to find such a thoughtful author who is able to dedicate so much time to tackling these issues.
In particular, I wanted to highlight this series of posts:
I know a lot of students and recent graduates who are using the economic situation as an excuse to go abroad. While it's exciting that the climate may lead to a boom in interest in global health, it's important to seek responsible opportunities and think through what impact your travel and volunteering may have on organizations and their communities. Saundra does a great job of laying out some basics for the commitments you should be willing to make, the questions to think through, and common pitfalls. I'm learning a lot from this myself--I've wanted to go abroad for some time and have been wrestling with a lot of the issues that she mentions (most prominent in my internal dialog--what jobs exist that I can do better than a local? Where can I add value rather than be in the way?). These questions are not meant to be discouraging so much as a deep, honest look at what you're getting yourself into. It's okay to conclude that you're going for selfish reasons (to clear your mind, have fun before you're saddled with real-world commitments, etc.), but better to admit that up front and plan your trip accordingly.


Givewell.net
Somehow these guys get a lot of airtime. What I gathered from their site--I'm pretty familiar with a fair number of the organizations that they mention--is that really, no one can provide them with good data. Their intention is noble, finding some set of metrics that can be applied to NGOs and help "lay" donors figure out how to best allocate their money, but even for the highly ranked organizations, there are a lot of unanswered questions. Kudos for raising them; next step is organizations responding to the pressures for increased data collection and transparency.
I think that the metrics leave a fair amount to be desired, at least by my standards as a donor. I would want to know what percentage of staff is comprised of local people and if they make an effort to use locally sourced products. If a product is shipped in, why is that? For example, even if a Zambian NGO has slightly higher overhead than a US NGO, if they are employing Zambians both at the organization and to make the bednets, etc., the "wasted" money is still making it into the country and probably providing secondary benefits.
Additionally, there should be some indication of how well an organizations mission and approach matches with local priorities. If a community really wants to take on child malnutrition, I would rather support that than a polio eradication campaign in the some community. Points should be given to organizations that are trying to serve a community's priorities. I believe that community engagement is necessary to effective and long-lasting change, so starting with their priorities, and working with them to incorporate issues that they may not immediately identify (such as polio, if that is the case), is a better approach than parachuting in with predefined goals, and institutions with the former approach should be rewarded.
Who does an organization partner with? BIG question! If a non-profit is doing a great job fighting HIV, but pulling all doctors out of the public sector (so no one is around to deliver newborns, or provide emergency surgeries, etc.), would you really view that as a success at the macro-level? Some basic context would be very helpful in evaluating how responsible/disruptive an NGO's approach is to the local systems. This may seem contradictory to the previous comment about hiring locals, but it would be ideal to a.) retain local professionals that otherwise would have migrated to better jobs in other countries, b.) increase training opportunities and thus increase the supply, and c.) when necessary, bring in professionals that cannot be found locally.
I'm not sure if it's Givewell's job to provide all this data, but since they one of the leaders in the field of ranking NGO effectivess, I thought that I'd evaluate their current metrics and offer some thoughts on additional questions to ask.
Interestingly, Kristof recently offered his picks of good NGOs to recognize during the holiday, and several of his choices (Acumen, Fistula Foundation and BRAC) contradict Givewell's assessments. Givewell disqualifies them on the basis of lack of definitive data on their results--an idea that I will try to explore in more detail early next year.

Goal for 2010--be better about blogging regularly.