Examination of Witnesses (Question Numbers
60-67)
PROFESSOR ANTHONY
COSTELLO, MS
LINDA DOULL
AND MR
SIMON BROWN
12 JANUARY 2010
Q60 Mr Hendrick: On the quality issue,
like a lot of other countries it is slate and chalk for writing
with, which takes you back to my parents' generation in this country.
Professor Costello: Yes.
Q61 Mr Hendrick: In the English class
we saw the teacher had trouble conversing with us, never mind
teaching the kids English. I think there is a serious issue around
quality.
Mr Brown: Again, the School Sector
Reform Programme, so the Ministry of Education, is recognising
that. It is a programme that is funded through DFID and others
and is one that is very positive. They recognise that it is about
getting children into school and not only into class one, into
primary school, but also into pre-primary school, that is a very
important foundation, and we need to get into the quality of teaching,
that it is learning by rote. ECD facilitators, until recently,
only had 15 days' training. 15 days from nothing to then being
eligible to teach or facilitate 20-25 pre-primary children day
in and day out. They are recognising there is a lot of work to
be done on training, on qualification, on in-service training,
on infrastructure, both in terms of building new schools and new
classrooms but also within the classrooms in making them more
child-friendly. All of these things are in the School Sector Reform
Programme. That is a very stretching, hugely ambitious programme,
but at least there is the recognition that it is more than just
getting the kids through the door, it is getting the quality of
the institution, the teaching staff, the support staff and the
school governors increased to provide a quality education.
Q62 Mr Lancaster: Some of the evidence
we have received has suggested that DFID should be doing more
to support capacity building in civil society and, indeed, I think
VSO's evidence said just that. A simple question: what should
DFID be doing and in what areas? What specific programmes should
we be doing more to support?
Mr Brown: I think it is more about
finding a balance. In the submission, some of our civil society
partners—in fact a lot of our partners—felt that organisations
like DFID had moved away quite significantly from supporting civil
society to almost uniquely supporting the government. It is about
finding the balance, to go from there to there—it is something
quite aggressive. It is finding somewhere in the middle. All countries
need very strong governments, very capable governments, to provide
services, essential services. Equally, all countries, particularly
developing countries, need a very sovereign and strong civil society
movement to advocate for people's rights, to hold the government
to account and, where appropriate, to support the government in
the provision of some of the services, whether they be HIV services
or education services or whatever. I think it is more finding
the balance, and I think, particularly in the case of Nepal, there
is still money that is available that DFID contribute to but it
is not directly providing it; it is going into a basket of funds
that are coming from lots of different organisations. It is making
civil society aware that those funds exist and how to access them
that is probably the biggest thing that DFID could do right now.
Professor Costello: Our research
has been on looking at the impact of working with women's groups
in quite poor and remote populations, and some of this has been
DFID funded. We published a paper a few years ago showing that
if you just mobilise women's groups to help themselves on issues
around reproductive health and particularly new born care, we
showed a 30% reduction in new born mortality rates, just through
that process over a two-year period, and that most of those women's
groups have actually sustained themselves after we withdrew funding.
We have just repeated this in Jharkhand and Orissa in India with
even bigger impact—a 45% reduction in neo-natal mortality.
This is using a cluster of randomised control trials. One of the
interesting things there was how do you scale that up? It is not
something necessarily that really fits into a ministry of health
that is struggling to deal with supplies of drugs, vaccines, and
the like. Ideally, it would go through local government but local
government is a problem in Nepal until you get the constitutional
settlement. Do you work through major civil society organisations?
Yes, a bit, but ultimately you need some kind of public/private
solution whereby the local government does take it on, because
there is a local development office and, also, women's development
offices, but you also need the help of civil society organisations.
I think DFID could look at that because the benefits are not just
directly on health; they improve women's access to money, to credit
and probably they improve forestry. We showed in India, actually,
that post-natal depression rates were halved as a result of this
initiative because women felt the solidarity, and it brought a
lot of these family issues out into the open—the mothers-in-law
attended the groups and a lot of the power issues seemed to be
improved. So I think this is an area about mobilising women which
has multi-dimensional effects and could be invested in on a large
scale through both government and civil society.
Q63 John Battle: I would be interested
to look at the kind of wider question. You refer to the balance
of civil society and the institutions of the state, really. It
does not only apply, of course, in Nepal. I wonder, as someone
who does believe that you have got to have really strong advocacy
groups championing it and trying to get to the parts the state
never reaches—to lift up the poor and, as we said in the
first questions, building up from the base—whether we need
to question civil society groups, organisations and NGOs as well,
and ask whether they have got it right, whether they really are
reaching the parts that other groups are not and whether, in fact,
by providing services as well as championing they do not act as
a displacement of local government, for example, or even undermine
the possibilities of local government. One of our witnesses has
suggested that in Nepal, in particular, some of the groups could
be highly exclusionary of both the extreme poor and the socially
marginalised. I would be disappointed if that was the case, because
I look to NGOs, civil society groups and the community to be the
very groups that must be with the people building it up from the
base. Is there a tension there? How do you respond to that challenge
of not really reaching the parts that it should and that they
are undermining local government?
Professor Costello: One thing,
forming an NGO has been a route to corruption. When the Maoist
government came in they clamped down a lot on NGOs and certainly
a number of my friends said a lot of people were on the make here;
they would set up an NGO as a way of getting money and then cream
it off. What the extent of that problem was is difficult to quantify,
but certainly it is the case that people were using the format
of NGOs, and so when they had to be reregistered I think a lot
of them were put out of business. You could say, also, with the
international NGOs, that if they are going in and trying to set
up their own management systems it undoes some of the other, local
systems, and, also, you may have differential salaries. So the
huge UN problem is always there; that you are taking out the really
creative, talented people from the national systems and sticking
them into international organisations and producing lots of reports.
So I think these are important issues.
Ms Doull: I cannot really say
for Nepal, per se, but I think there are examples from other fragile
states—Afghanistan being quite an interesting one—where
the role of civil society and local NGOs has very much been promoted,
certainly within the health sector in terms of delivering and
partnering. One of the stipulations of an international NGO in
that country delivering services is that you do partner with national
NGOs and build capacity over a period of time with de facto then
handing over whatever service delivery or advocacy role within
an agreed time frame. That is agreed from the top down as part
of a kind of overall national strategy. We certainly had experience
of that in terms of delivering basic health services in Northern
Afghanistan where, over a period of three years, we have now completely
handed over to a national NGO, who is now delivering and is perfectly
capable of doing that. That required that all parties understood
what the joint objective or shared objective was, and that there
were also sufficient resources not just financial but, also, in
terms of technical assistance to capacity build as part of that
programme. So I think there is work to be done because inevitably
small groups will go off on self interests, and you see that everywhere.
If there is a greater shared understanding of what is being tried
to be achieved—
Q64 John Battle: I do not even think
we have got it right in Britain, because I am worried about the
trickle down theory. Sometimes, as NGOs, you get involved in the
mezzanine floor and really to reach the poorest of the poor in
difficult circumstances is just too hard; the spark, the ideas
and imagination come and you have to train people to even get
to there. Would you, in your NGO, for example, make it a policy
priority to regularly be checking and asking yourselves: "Are
we really reaching the poorest of the poor", and then, perhaps,
encouraging local NGOs to ask the same question, so they have
a responsibility to really try and reach those that government
systems do not reach, local authority systems do not reach and
even NGOs do not reach? Would you think that was one of your policy
priorities as an NGO?
Mr Brown: Absolutely, yes. We
are doing that right now in terms where we have been questioning
ourselves: are we reaching the people who are the most poor, the
most in poverty and the most unequal in society, and really questioning
ourselves. Do we encourage our partners to do the same? Absolutely,
through their own strategic planning processes, to really understand
who are the people who are wanting this help. As Linda said, and
I think it is a very important point, it has all to be joined
up; there has to be some plan there.
Q65 John Battle: Just to push the
logic a bit further, would you push that question at DFID, with
whom you have a partnering relationship, to make sure that they
are aware of and asking that same question?
Mr Brown: Are they working for
the most poor?
Q66 John Battle: Are they working
with NGOs that are working for the most poor? DFID can get caught
into the idea: "We have gone with some NGO" and then
they find out later that that NGO is corrupt—to use the
worst example—or are they find they are working with an
NGO that is in the mezzanine floor and not really reaching the
parts we need to. Maybe DFID needs to be focused as well as you
are so focused.
Professor Costello: I was just
going to state the importance of measurement here. For anything
you do now, measuring the impact across poverty quintiles is very,
very important. So the example of the incentive scheme, like so
many things that you try and supply from the top, is that the
better-off groups tend to benefit over the poorest—the inverse
care law. The thing we found with women's groups, because you
are setting them up across all communities, in India is that actually
the mortality effect was bigger in the poorest groups than in
the wealthiest groups. So it was not just a pro-poor, it was an
excessively pro-poor, intervention. I think you need to do the
measurement on of all of these things and really test them out.
Q67 John Battle: Following on then
(and I am grateful for that emphasis on measuring because we can
move away from that), is DFID doing enough to support measuring
and investing in it?
Professor Costello: I would say
one thing, and I have said it previously in relation to Bangladesh:
try and get DFID (and DFID are aware of this problem but somehow
organisationally it happens) to link up the research groups that
they fund with the country programmes. We do do it informally;
we have had some very good links with the DFID programmes in Nepal
(rather less so in Bangladesh) but I think if that could be structurally
done you would get much better bang for your buck. We in the research
community would love to do that, because looking at stuff at scale
is what you want; you do not want to do just all these pilot projects.
Ms Doull: Can I just add to that?
Again, you are not going to know whether you are reaching the
poor unless you have got some robust monitoring and evaluation
and that requires resources to do that, both financial, technical
and human. I think an example that we are experiencing now from
Congo not Nepal is where DFID has made gestures to support that
research but seems quite undecided whether that is something they
should or want to do or not. We have gone through a very difficult
negotiation with them; this is actually to be measuring the impact
of the abolition of user fees and it is not helpful when the goalposts
keep changing throughout the programme and process. I think, again,
it is understanding right at the beginning what is it you are
trying to achieve and that all partners are engaged in that process,
that resources are applied and that you stick with that for clear
outcomes. I think to change policy halfway through programming
does not help monitoring and evaluation.
Mr Brown: Also, patience; patience
and simplicity. Do not overburden with too many measures or a
collection of indicators; get it simple and be patient.
Chairman: Thank you for that. The Committee's
question always is: "What works?" and that is actually
what interests us. What we are finding out about Nepal is that,
on the face of it, nothing should work but, in reality, quite
a lot does. Obviously, it is a complicated situation post-conflict
but I think your contribution has been very helpful. We have one
more evidence session with the Minister after the second half
of this one, which will enable us to do a report. It is particularly
interesting—I think it is unique—there is no country
like it, I guess. Your evidence has been extremely helpful. Thank
you.
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