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In: Evaluation and development: proceedings of the 1994 World Bank conference, edited by Robert Picciotto and Ray C. Rist. Washington, D.C., World Bank, 1995. 211-8. (World Bank Operations Evaluation Study)This paper discusses some key findings and pros and cons in using beneficiary assessment (BA) as an eclectic learning tool to improve the quality of development operations. The four basic precepts of beneficiary assessment are: increasing the validity of information; being useful to decision-makers; being credible to the architects of development programs; and directing the learning so as to make development interventions more effective and sustainable. Since 1981, the World Bank has supported 47 BA in 27 countries covering the health, urban, energy, industry, education, and agriculture sectors. Some of the factors behind the positive response of management to this listening approach to evaluation are: usefulness of information derived from the assessment; applicability of using traditional questionnaire survey; less expenses and short time in conducting listening approach; and local knowledge. Meanwhile, the difficulties in applying BA fall into three categories: methodological, political, and cultural. This paper recommends that the BA approach should become the norm rather than the exception in development projects.
WORLD HEALTH. 1988 Jan-Feb; 10-11.In 1979 WHO invited its member states to participate in a global strategy for health and to monitor and evaluate its effectiveness using a minimum of 12 indicators. Members' 1982 implementation reports and 1985 evaluation reports form the basis for evaluating each measure. Indicators 1-6 have strong political and economic components in both developed and developing countries and are not complete. Indicator 7, for which rates of reply are satisfactory, asks whether at least 5 elements of primary health care are available to the whole population. The 8th gauge seeks information on the nutritional status of children, considering birth weight (a possible indicator of risk) and weight for age (a monitor of growth). Infant mortality rate and life expectancy at birth, indicators 9 and 10, are difficult to estimate in developing countries, and health services are not always kept informed of current estimates. Indicator 11 asks whether the literacy rate exceeds 70%; it can provide information on level of development and should emphasize literacy for women, for whom health information is critical. The last global measure yields information about the gross national product, which is not always the most recent, despite the trend of countries to publish their gross domestic product. Failure to make use of the best national sources, such as this, is one of several problems encountered by WHO's member states in collecting accurate data. Other problems include lack of universally acceptable definitions, different national accounting systems, disinterest of health authorities in economic matters, lack of staff, lack of financial resources in developing countries, and inadequately structured health system management. Each country must choose the most appropriate methods for collection of data. If an indicator cannot be calculated, the country is encouraged to seek and devise a substitute. WHO must produce more precise and reliable indicators. It must respond to requests for ways of improving or strengthening national systems.