I am glad this subject has come up.
Work that I have been doing over the last five years to understand the progress
and performance of the global health malaria control sub-sector suggests that
way too much of the global health money is being consumed at the "top" of the
sector and far too little funding is getting to strengthen community level
healthcare. This is the same issue in many different parts of the health sector
... many different diseases ... and in both rich developed countries and poor
developing countries. Most decision making about resource allocation is driven
by the goals of management, whether it is a big NGO, pharmaceutical company, a
health ministry, a hospital or a network of doctors.
The needs of beneficiaries are poorly represented in part because the
prevailing systems of metrics do not include any metrics about the "value loss"
associated with poor health status of a single individual and in aggregate for
the community. This gets addressed in The Burgess Method of True Value Metrics.
The good news is that there are thousands of NGOs interested in health care
activities ... but they are not delivering their services very effectively
where they are most wanted. Bottom line, nobody knows where they are working
and what they are doing. Nobody seems to know where they would be most needed
and could be doing the most good. If there were metrics that showed at the
community level what the needs are, and what health care services including
government and NGOs are present ... and what they are doing ... and what still
is left needing to be done, we might make some meaningful progress.
This should not be an idealogical argument about public or private sector ...
free or paid ... but about needs, resources and how to get the best possible
As it is ... there will be a meeting in Amsterdam of this network of NGOs. I
hope that they enjoy themselves ... and look forward to learning of any steps
forward to better performance that they are able to make!
Meaningful Metrics for a Smart Society
www.tr-ac-net.org (being phased out!)
tel: 212 744 6469
Books: Search Peter Burgess at www.lulu.com