Friday, December 21, 2007

Performance Metrics

Dear Colleagues

The international relief and development sector is very weak on performance metrics, and so also is the medical profession.

WHO and others in the health and international relief and development community have worked for a long time to develop useful performance metrics about the malaria situation and the activities being funded.

The outcome shows, however, that there has been a serious absence of accounting input and the basics of cost accounting are missing.

Instead of measuring how much it has cost to do various things, and what has been achieved by doing these things in terms of the reduction of the burden of malaria in the community, there is instead a set of measures that simple show how much "coverage" has been achieved for the subject intervention.

Coverage versus cost shows something about the efficiency of the operation ... but nothing about the efficacy of the activity. Does the activity actually reduce the burden of malaria or not ... and how much does that cost?

Top leadership has made bold statements about the need for good performance metrics. Whenever President Bush has spoken about the President's Malaria Initiative (PMI), a very large US international commitment for health, he always adds in something about performance metrics. Unfortunately the examples he gives are usually simply about quantities delivered rather than the reduced burden impact to be achieved.

Even though I have tried to find quality information about cost effectiveness of mosquito and malaria control interventions, there is very little that is available. I am sure there is information in some archive, but it is not easy to find, and less easy to access and use.

Even though there is increased funding for malaria control, it is not enough to eradicate malaria unless it is used in the very best way possible. That requires data and decision making that is focused on cost effectiveness and multi-year results.

The Tr-Ac-Net Organization in cooperation with the Integrated Malaria Management Consortium (IMMC) has set out to provide a way for these data to be collected and stored in an easily accessible form for operational and analytical use. The goal is a low cost way to do this, and have it in a useful form for decision making.

Sincerely

Peter B in New York
The Tr-Ac-Net Organization

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