How Can Civil Society Measure Value for Money and Prove Its Worth? Amanda Glassman Center for Global Development July 26, 2012.

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Presentation transcript:

How Can Civil Society Measure Value for Money and Prove Its Worth? Amanda Glassman Center for Global Development July 26, 2012

Outline  Investment Framework  Current Spending Levels  Cost-Effectiveness: What Do We Know?  Going Forward

Community Mobilization Community Centered Design and Delivery Community Systems Source: Schwartlander et al. “Towards an improved investment approach for an effective response to HIV/AIDS” Lancet 2011: 377:

Conceptual Framework MANAGEMENT INFORMATION SYSTEMS Quality of care EFFICIENCY Cost/Output EFFICACY Cost/Outcome “in the lab” EFFECTIVENESS Cost/Outcome in practice IMPACT

Current Spending Levels Global Fund Round 10 Proposals, Requested Disbursements Source: Round 10 Call for Proposals: Community Systems Strengthening, 2011

What CSS Entails for the GF Source: Round 10 Call for Proposals: Community Systems Strengthening, 2011

Investment Framework Source: Schwartlander et al. “Towards an improved investment approach for an effective response to HIV/AIDS” Lancet 2011: 377:

…but is it cost-effective? Type of Intervention HIV Prevention Efficacy TOTAL Positive Effect Adverse Effect No Effect Behavioral Structural: Microfinance, CCT Diaphragm Topical Agents (microbicides) Non-ARV based ARV-based PrEP Systemic, oral PrEP Treatment for prevention Male circumcision STI Treatment Vaccines Total Source: Padian, McCoy, Karim, et al. Lancet 2011;378: and updated with latest trial results.

QualityPoorFairGood Impact Largest impact Some impact Potential impact No evidence of impact Counseling and Testing 24% Prevention with Positives 1% Tx as Prevention ? Male Circumcision 5% MSM – 1% Abstinence 8% Peer Ed. 7% STI TX 1% Inj. and non-Inj. Drug Use 0.3% Female Sex Workers 5% PMTCT 25% Mass Media 9% Small impact of CSS interventions Source: Padian, McCoy, Karim, et al. Lancet 2011;378: and updated with latest trial results.

Issues: Going Forward  No impact evaluation; not enough data