Anthony S. Chan PhdSeptember 2009

* The views expressed in this presentation are strictly my personal opinions and should not in any way be interpreted as reflecting the views of USAID

Aid Agency effectiveness Long Debate – Rostow (1960) to Easterly (2006) Blogs “ there is a surprising degree of unanimity that the aid system

today is deeply flawed and could be much improved” (Easterly 2006)

Lack of Coordination among agencies Development Finance is of poor quality System for allocating aid is haphazard, uncoordinated,

unfocused

Even if we agree, will need to have an accurate understanding before we can proceed to fix

Very common to think that we share a common understanding of a problem; often not the case

A better appreciation of the difficulties in allocating, designing, and implementing aid

Do we have a common framework In the broadest terms: Political Economic Social At a reasonably broad level – yes, but… .. Static Dynamic

Everything is necessary , no sufficient conditions Need to do everything right Leaders Luck Long term vs Short term

Development Modernization Quality of Life

Preferences – stakeholders, administrators, implementers, counterparts

Political Economic Social Donors Personalities Individuals Implementers New ways Old ways Ethnic groups

Best practices adapted to local conditions On balance market oriented is generally more efficient Appropriate role for the state Rules established Dispute resolution mechanisms Impartial Enforcement Security – personal, transactions Reconciling the long term and the short term

Analysis Problems Causes Solutions Design Specific Interventions - Feasible Set Implementation Mechanisms: Contracting, Grants Fiduciary Responsibility Capacity Building Training – Long Term, Short Term

Alignment of the stars – political will Generally no time for analysis Foresight, luck , off -the-shelf Need for quick wins Policy Dialogue – knowing what you are asking Donor’s foreign agenda Technical assistance, Training Multilateral Conditionality Coordination

Difficult Costly Medical analogy Dynamics – Time Horizon - cant say with a great degree of

confidence – when and what can one expect to observe results Will the results continue – sustainability Stakeholders Time Horizon vs actual time for Impact

Adminstering Assistance is labor intensive Coordination Responsibility Manageable Interest

Putting money through the government What is the recourse How does one judge performance Stakeholder tolerance Quality of counterpart leadership

Proving the counterfactual Quality of data Agreeing on the question

Fertility and Child SurvivalFertility and Child Survival

• Supporting over 49,000 Female Community Health Volunteers

• Providing supplements to over 3,600,000 children a year

• Increasing voluntary, early planning for birth, and infant care

1985 – 2006 Results• Total fertility down from 5.1 to 3.1 children per woman• Modern contraceptive prevalence up from 15% to 44%• Under-five mortality down from 196 to 61 deaths per 1,000 live births

735,000 Nepalis now benefit from access to rural roads

6 million people are reached by radio programs on democracy, elections, health and peace building

275,000 rural farmers have increased their incomes by 50%

90% of all children reached by USAID’s Vitamin A campaign

50,000 Female Community Health Volunteers working in all districts of Nepal providing health services to rural Nepalis