London, 12 December 2008 - Poor and inaccurate information is hampering global aid efforts to improve the lives of the world's poor but greater coordination, transparency and investment can significantly increase the impact of humanitarian aid, GAVI Alliance officials stated today.
"In order to direct aid where it is most needed, manage it properly and measure its results, good data are fundamental," said Nina Schwalbe, GAVI's head of policy. "But it's a significant challenge, no matter whether you work in health, food, clean water or refugee assistance."
Unstable social and economic conditions, migratory populations, and the lack of trained personnel, infrastructure and technology hinder the efficient counting of people living with HIV/AIDS, families who are hungry or the number of displaced persons. Aid agencies currently rely on administrative or self-reported data, household surveys or ad hoc audits. Experts agree that no process is infallible.
GAVI CEO Julian Lob-Levyt recommended that government agencies, donors, aid agencies and others coordinate better with each other and align their efforts with developing country programmes.
"Data collection initiatives are often redundant," said Dr. Lob-Levyt. "The aid community needs to work closer together so as not to duplicate efforts already undertaken by countries themselves. This would ease the burden of work and be more cost-effective."
In some countries, redundant collection processes produce data to meet an information need that could be met through a single data source, while other information needs go unmet due to a lack of systematic planning.
GAVI officials said the increased use of household surveys in monitoring aid effectiveness is needed, where appropriate, and that further investment should be made in new technologies for data collection and management. However, data collection needs to be tailored to the needs and objectives of each country.
The recommendations were presented following a two-day meeting of a GAVI data task team, a group of independent epidemiologists, statisticians, and global health experts that the alliance set up to examine ways to improve data collection and quality for development initiatives.
Task team members include experts from the World Health Organization, UNICEF, the World Bank, UNAIDS, the Norwegian government, health ministries from developing countries, the Harvard School of Public Health, the Institute for Health Metrics and Evaluation and The Lancet journal.
GAVI convened the task team in part to review its own Immunisation Services Support (ISS), an initiative that provides critical funding to child immunisation programmes in the world's poorest countries. Appropriate data is vital to ensure that over- and under- reporting does not occur.
An analysis of ISS undertaken by GAVI in 2007[i] prompted the alliance to undertake a large-scale review and seek advice from the Swiss Tropical Institute. Separately, the Institute for Health Metrics and Evaluation (IHME) published a study today on the topic, a meaningful and important contribution welcomed by GAVI.
Task team members raised questions at the meeting about the IHME report methodology, agreeing that it was only indicative and that its data would need to be confirmed on a country by country basis.
"All methodologies have strengths and weaknesses," said Ms. Schwalbe. "When ISS was conceived, alliance partners understood the inherent risks in weak reporting systems and data quality. Still, ISS has been a path-finder for country-driven development ownership, even if it represents just 11% of GAVI's business. Now is a good time to evaluate its benefits and learn lessons for GAVI and for the wider 'results-based financing' debate."
Since its inception in 2000, ISS has helped achieve high rates of basic DTP-3 coverage, thus establishing a solid foundation for basic immunisation in poor countries. A 2006 study[ii] by the Institute for Health Metrics and Evaluation concluded that performance-based systems had a positive impact on immunisation rates.
"It is important to distinguish between data quality challenges and the benefits of performance-based aid programmes," said Ms. Schwalbe. "By tackling the data challenge head on, GAVI can provide lessons to the greater aid community. We are a learning organisation and want to contribute to the development of the next generation of results-based financing programmes. The current work on data quality by us and others will help do just that."
The GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation) is a public-private partnership of major stakeholders in immunisation and health system support. It includes developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, civil society, the Bill & Melinda Gates Foundation and individuals. WHO projections show that GAVI support by the end of 2008 has prevented more than 3.4 million future deaths.
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[ii] Effect of the Global Alliance for Vaccines and Immunisation on diphtheria, tetanus, and pertussis vaccine coverage: an independent assessment; Chunling Lu, Catherine M Michaud, Emmanuela Gakidou, Kashif Khan, Christopher J L Murray Lancet 2006; 368: 1088-95; September 18, 2006; DOI:10.1016/S0140-6736(06)69337-9