Why is it that McDonald’s can produce a Big Mac that tastes the same across the world, but the global public health care field is making it up as it goes along?
That’s a question running through the mind of John Sargent, co-founder of the Switzerland-based analytics company BroadReach, which creates platforms for tracking disease incidence and other health indicators.
“There should be a standard,” Sargent said. “The most important thing is predictions. If you can see a massive resource restriction, or you know certain clinics are understaffed or are not performing well, you know where you should start targeting your efforts and how to get ahead of the problem.”
Programs such as BroadReach’s cloud-based analytics platform, which allow governments, organizations and individuals to aggregate and more accurately track their progress in funding or others areas in international development have become more commonplace in the Sustainable Development Goals era. It also offers a growing number of in-person “data labs” in Cape Town and Johannesburg, South Africa, where clients can work with experts to monitor performance and resources, among other indicators.
‘Data revolution’ taking form
The data trend, sometimes referred to as a “data revolution,” comes as part of a “phenomenal sea change,” that has flowed within the past seven years or so, suggested Eric Reading, executive vice president of the Washington, D.C.-based employee-owned international development company Chemonics. This was onset in part by Rajiv Shah’s tenure as United States Agency for International Development administrator starting in 2010 and the “healthy introduction of a scientist’s empirical and evidence-based approach to development.”
Shah’s background as a medical doctor was reflected through the “expectation of greater empirical rigor [at the agency],” Reading explained. “This translated into more resources for monitoring and evaluation, more questioning of whether or not programs were having the intended impact, more investment in scaling and interventions with demonstrated impact.”
Widespread growth of smartphone use and the internet has also aided in more effective and accessible data-capturing techniques, such as the popularization of online surveys. The International Household Surveys Network shows a direct correlation between global data availability and registered surveys and the number of mobile-cellular subscriptions from 1990 through 2013.
The nature of the results-based data that organizations such as Chemonics — operating in 80 countries across the globe — capture has especially enhanced over the last five years, Reading said, adding that there’s an understanding that competitively procured proposals for projects or programs will not be secured without “a solid plan of how you are going to do it.”
“The ability to [track results] in a reasonable, economical way has increased because of these factors related to data availability,” he said. “It is much more feasible to collect meaningful data and there is an expectation that you must be doing it now to implement a program successfully.”
The need for better data collection, however, remains. Last year, about half of 155 countries surveyed by the World Bank reportedly lacked adequate data to monitor poverty. Poor local data collection, data quality and lack of timely data were also recognized by the United Nations as problematic areas. This has ripple effects.
When numbers matter most
Lack of data can limit a government’s effectiveness in responding to ongoing social issues or individual crises, such as the Ebola outbreak in West Africa in 2014. Spotty demographics made it challenging to track the number of deaths and to control the virus’ spread in urban centers.
A partial understanding surrounding the exact number of community health workers operating in the field also means it becomes harder to identify and resolve health care shortages. Conversely, richer data lets governments rethink how they are training and dispatching health workers, said Michael Bzdak, executive director of corporate contributions for international pharmaceutical company Johnson & Johnson.
“We realized there were a lot of gaps in our knowledge, not just the quantity of health workers, but where they are dispersed,” Bzdak said. “We haven’t solved the problem. We are discovering the problem [along] with a lot of other NGOs.”
The organization supports upwards of 400 nonprofits globally, offers routine training of health care workers and is a partner of the Frontline Health Workers Coalition.
Data also routinely fails to accurately represent populations, rendering indigenous people and inhabitants of slums nearly invisible and excluded from data sets.
Women and girls are also considered marginalized from national and global data. There are 28 “gender data gaps” across five domains of development — the largest centered in economic opportunity. That’s according to the United Nations Foundation initiative Data2X, which tracks how women’s roles in development are not accurately measured.
Typical household surveys that collect population data tend to bypass women, explained Emily Courey Pryor, senior director at Data2X, reaching the listed male head of household. A woman may not also recognize her role in the informal economy, even if she works outside of the home supporting her family, Courey Pryor continued. The International Labor Organization has found that the percentage of women in informal nonagricultural employment is higher than that of men in 30 of 41 low- and middle-income countries that had data available by sex.
“When we started it was like, ‘OK, I get it,’ but when we really started digging in we began to see how important this [gap] is,” Courey Pryor said. “If you don’t know the extent to which women are participating, you can’t ensure women are getting the inputs that they need ... A woman wears multiple hats so a lot of that nuance can get lost in the data collection.”
This could impact the construction and implementation of development programs intended to reach women working in agriculture or informal sector jobs.
Courey Pryor cited two studies conducted in Uganda in the early 1990s — the second of which expanded by more than 700,000 workers, the majority of them women, upon including work as a secondary activity.
Work in real time, with a new system in mind
Filing data holes helps development work transform in real-time, outside of the traditional several yearlong cycles that tend to drive projects.
“If you look at the USAID system with four-year grants, one program would not change, but in a commercial environment any company would be data driven and constantly evolving,” said Carter Powers, chief operations officer at Dimagi, a social enterprise based out of the Massachusetts Institute of Technology’s MediaLab. The organization offers a free, customizable mobile platform, CommCare, that can be downloaded onto phones or computers to create health surveys or log data.
“If you don’t constantly evolve then you revert back to the mean,” he added. “You need to keep innovating to make your platform better and better.”
CommCare is currently present in 50 countries, primarily serving as a tool for frontline health care workers to digitize their paper records and create cohesive reports. In the 10 years since it was founded, the startup has expanded its reach and has scaled up to connect with health ministries.
Research shows the benefits of the program extend from a boost in facility-based births in Tanzania to a reduction maternal and infant mortality rates in Guatemala.
Powers spoke of how one local partner organization in Guatemala was able to leverage its digital system to get ahead of the curve on the government regarding an outbreak of diarrhea. This program now has committed resources and ministry support to scale the digital system to 3,000 users, or 25 percent of the national health care workforce.
“We are now entering a new phase where the whole system starts reacting to the data and starts changing the way the system is looking, and we start looking at the outcomes,” he said. “We are evolving, and excited about taking a system that tends to be static and making it more of a dynamic system.”
As an indicator framework for the Global Goals continues to develop, Chemonics’ Reading said he expects increased donor investment in marketing and evaluation, and a general sync-up in national data collection methods and the goals measuring development priorities.
Success in this area will require breaking down the goals into “smaller, actionable pieces,” said Powers.
“The [Global Goals] are a really important framework and people are committed to them. When we start looking at them, it turns from how we are going to break these down from the top-level goals to, ‘OK, does this district need coverage? How will we bring this to the workers on the frontline?’”
Following through on these types of questions — delivering broad, global targets to local actors — and then circling back with local data to national and international levels will provide a template for countries as they continue to work towards healthier, more prosperous societies with an eye on 2030.
To what extent has this “phenomenal sea change” of data activity transformed the way you conduct your work? What are the most evident changes at play? Tell us your story by leaving a comment below.
With potential to change the trajectory of crises, such as famines or the spread of diseases, the innovative use of data will drive a new era for global development. Throughout this monthlong Data Driven discussion, Devex and partners will explore how the data revolution is changing our approach to achieving development outcomes and reshaping the future of our industry. Help us drive the conversation forward by tagging #DataDriven and @devex.