The GiveWell Blog

The challenge of local ownership

(updated on: ) | by Holden

One of the consistent refrains we’ve seen in aid literature is the importance of local participation/enthusiasm/ownership for aid projects. Many programs have been criticized for being too “top-down” (i.e., imposing outsiders’ designs on local communities), with the implication that more “bottom-up” programs (i.e., getting local people to participate in the design of execution of programs) would be more likely toi create real and lasting change. For an example of this reasoning, see this USAID review of Integrated Rural Development programs (PDF).

The basic reasoning makes sense, but making a program “bottom-up” is easier said than done. For an illustration of why, see this World Bank review of “community-based development,” a term referring to “projects that actively include beneficiaries in their design and management.”

The frequent tendency for participatory projects to be dominated if not captured by local elites is highlighted by several case studies. Katz and Sara (1997), in a global review of water projects, find numerous cases of project benefits being appropriated by community leaders and little attempt to include households at any stage … even well trained staff are not always effective in overcoming entrenched norms of exclusion. In a study of community forestry projects in India and Nepal that worked reasonably well, Agarwal (2001) reports that women were systematically excluded from the participatory process because of their weak bargaining power. Rao and Ibanez (2003) find that in the participatory projects in their Jamaican case study, wealthier and better networked individuals dominated decision making. In a similar case-based evaluation of social funds in Jamaica, Malawi, Nicaragua, and Zambia, the World Bank (2002) Operations Evaluation Department concludes that the process was dominated by “prime movers.”

Abraham and Platteau (2004) present evidence on community participation processes in Sub-Saharan Africa based largely on anecdotal evidence from their work in community-based development and on secondary sources. They argue that rural African communities are often dominated by dictatorial leaders who can shape the participation process to benefit themselves because of the poor flow of information. (40-41)

These notes capture a concern of ours that applies to all aid projects: while the goal is to help those in the most need, those with the least need may be most likely to have the resources, connections and free time to get the inside track on any particularly generous aid project. This is also a major reason to be skeptical of simple evaluations comparing “project participants” to “non-participants,” as many microfinance evaluations do. Project participants may simply be better off to begin with (and some studies show that they are, such as the Coleman study referenced on the previous link).

We don’t believe that a simple and straightforward way to overcome this challenge is available. That’s why, although we agree with the basic concept that local ownership will improve a project, we don’t tend to judge projects by their formal commitment to local ownership – i.e., we don’t favor programs that work in formal community votes, meetings, etc. over programs that don’t. The former could be improving local participation or transferring more power to elites; the latter could be generating local enthusiasm simply through a good match between what people want and what they’re being offered.

It’s easy to claim that one is involving community members, but the ultimate test is in outcomes – whether the project ran well enough and generated enough local participation to accomplish its ultimate goals (improved health, incomes, etc.)

Embedded philanthropy

(updated on: ) | by Holden

This blog post is part of the Embedded Philanthropy Blog Series, sponsored by Telecom for Charity. The blog series was launched in May 2009 to highlight expert thinking and encourage discussions on the state of embedded philanthropy in today’s economy.

“Embedded philanthropy” (as defined by former GiveWell Board member Lucy Bernholz, via Tactical Philanthropy) is the practice of “building a philanthropic gift into another, unrelated, financial transaction.” The RED Campaign is probably the best-known example.

If you are thinking of participating as a consumer in embedded philanthropy, we urge you not to. Fundamentally, you are the one ultimately paying for the donation, as we discussed thoroughly here (if you don’t find the main post convincing, please see the comments as well).

Once you accept this claim, it appears that embedded philanthropy offers you, the consumer, no benefits, and has a couple of costs: (1) it narrows your options as a consumer (for example, you buy (RED) clothing instead of whatever clothing you want); (2) it narrows your options as a donor (i.e., the amount and recipient of your giving is determined by the company, not by you).

(2) is the more severe problem, and in some cases there may be ways around it. Telecom for Charity, the sponsor of this series, has informed me that its consumers can choose to donate to any charity of their choice (although I do not see this spelled out on its website). And with careful enough accounting, you can also make sure that your total giving for the year isn’t altered. But even in this best-case scenario, what’s the point? Why not just buy what you want and give what you want?

Much embedded philanthropy threatens to shift the choice of charity from individuals (giving for their individual reasons) to corporations (likely purely concerned with the PR aspects of the gift). All embedded philanthropy threatens to make donors feel they’ve “done their part” by signing up, instead of challenging themselves to give as much and as well as they can. No embedded philanthropy seems to offer genuine benefits to the consumer/donor. No embedded philanthropy can deliver on what I see as an implicit promise of “something for nothing” – the virtue of giving without the sacrifice.

Despite all this, embedded philanthropy may be a net force for good if it mobilizes enough giving that wouldn’t have occurred otherwise. It’s hard to turn our nose up at (RED)’s claim to have directed over $130 million to the Global Fund to fight Aids, Tuberculosis and Malaria (which we view as an unusually strong charity). (RED) has had an amazing amount of corporate and celebrity support, and I haven’t seen any other embedded philanthropy campaigns that appear to have had anywhere near the same impact.

We don’t pretend to know much about mass fundraising; we target the specific donors who seek to accomplish as much good as possible. Embedded philanthropy may be effective for the former; we feel it has little to offer the latter.

Some thoughts on the yellow fever vaccine

(updated on: ) | by Elie

There’s news today that the Yellow Fever Initiative is facing a budget shortfall and may be unable to purchase needed vaccines in the near future (h/t Christine Gorman):

Emergency supplies of yellow fever vaccines are set to run out next year, and there is no funding to continue immunisation campaigns after that, World Health Organisation experts said on Tuesday.

The mosquito-borne yellow fever virus infects 206,000 people a year and kills 52,000, mainly in tropical regions of Africa and the Americas.

Recent outbreaks in Brazil, Central African Republic and elsewhere have drawn down the 6 million doses of yellow fever vaccine reserved for emergency response, and a $186 million shortfall has left the WHO unable to vaccinate high-risk people in Ghana and Nigeria as it had planned.
…
“For 2011, the Yellow Fever Initiative has no funding for either the emergency stockpile or the continued roll-out of preventive campaigns,” she told a news briefing in Geneva.
…
“As we look beyond 2009, we already see serious funding constraints,” Dr. William Perea, the WHO’s epidemic readiness and intervention coordinator, said in a statement after a two-day meeting of U.N. and aid groups.

Is there a real possibility of the program stopping because of lack of funds?

Is this the type of funding gap that will eventually be filled by donors (by governments or the Gates Foundation)? It seems like donors have a good deal of time before 2011 to give more money. Or, alternatively, can the WHO reallocate funds from a program that has adequate funds to the Yellow Fever Initiative which does not?

The history of Yellow Fever in Africa may shed some light on this:

Between the 1940s and 1960s, widespread mass vaccination campaigns in some African countries had resulted in the almost-complete disappearance of yellow fever. However, as immunization campaigns waned, a generation of people grew up with no immunity to the disease, and by the 1990s the number of annual cases had risen to an estimated 200 000 per year, with 30 000 deaths, and urban outbreaks were starting to occur.

Yellow fever had returned as a major scourge and, as urbanization progresses across Africa, the threat of a major epidemic looms ever larger. WHO estimates, for example, that this highly transmissible disease could infect around one third of the urban population, or up to 4.5 million people, in Lagos, Nigeria alone.

We’re interested in learning about programs that stopped because they just couldn’t raise enough money. Is that what happened with Yellow Fever? Are there other examples of this happening?

How can an individual donor support immunization programs?

I don’t know much about the Yellow Fever Initiative. How does it compare to GAVI or VillageReach (both on our list of top contenders to be a recommended charity in our upcoming report) as a means for donors to support expanded immunization programs, a proven, cost-effective method for improving health and saving lives in the developing world.

In 2007, GAVI supported the Yellow Fever Initiative with a grant of close to 60 million dollars. Is this grant subject to the same reporting and evaluation requirements of GAVI grants through its “regular” channels (which includes funding for Yellow Fever vaccines)?

There’s little information about the Yellow Fever Initiative online (its main page is here).

What can the developed world teach the developing world?

(updated on: ) | by Holden

When we aim for something more ambitious than transferring our wealth to those in need, we’re often implicitly assuming that we have superior knowledge, compared to the people we’re trying to help. This seems to me to be the sort of thinking underlying this comment: “how does handing out cash build community, solve macro problems, provide a base for effective activism?”

One thing I believe the developed world can teach the developing world is facts about medicine. For example, many people in developing-world communities do not know as much as we do about how HIV/AIDS is transmitted, how diarrhea is contracted, and what to do about it. We can share and promote facts about these diseases that do not depend on local politics, customs, etc. (for example, wearing a condom drastically reduces the risk of transmitting HIV). So far, so good.

What else do we feel confident that we can teach the developing world?

Do we have superior knowledge of how to run a business? Within their political, cultural and economic environment?

Do we have superior knowledge of how to build a healthy civil society? Of how to run their community?

Before we insist on “teaching” others about these things, we have to ask why we think we have things to teach. I’m not convinced.