1. Leaving no one behind: The value for money of disability-inclusive development
Glasgow, 1st February 2017

2. Achieving the best possible impact with the resources available.
Value for Money
Achieving the best possible impact with the resources available.
Value for Money (VfM) often narrowly interpreted – equating good value with low cost: i.e. cost per beneficiary.
Value for money defined at achieving the best possible impact with available resources
But the definition of best impact is subjective
Value for Money is often interpreted narrowly – as essentially being about reducing cost

3. Leaving no one behind
People with disabilities – 15 % of the global population.
Disability rising on development agenda: SDGs, UNCRPD, major donors.
Disability inclusion as a social and human rights issue: benefits of inclusion to individuals, families, communities and wider society.
Often increased costs for comprehensive inclusion.
SDGs and pledge to lnob means shift from the MDGs and a new starting point of reducing poverty for everyone
Means we have to rethink what we mean by value
No intervention that leaves behind sections of the population behind can be considered good value for money
In fact – leaving no-one behind should be seen as contributing to good value for money, not detracting from it

4. VfM and disability inclusion: a conflict?
Increased scrutiny/focus on value for money, alongside SDG’s commitment to Leave No One Behind
If define VfM as cost per beneficiary, then there appears to be a conflict with disability inclusion.
But
It doesn’t have to be that way, it’s a question of the interpretation of value for money
Inclusive development often costs less than people think, but it does often cost more. Not just the case for reaching people with disabilies, but also other marginalised groups.
Frequently told that people would like to do more on disability – but it is too expensive.
doesn’t mean that there is a need to push back on value for money agenda – but to shape it in inclusive way

5. VfM and Leaving no one behind
New starting point: reducing poverty for everyone
Turn the concept of VfM around: interventions that exclude people with disabilities or other sections of the population are not good VfM. Not just about reaching the most people for the lowest cost.
Seeking VfM should not force people to chose between securing funding and targeting the hardest to reach.
What's more, Leaving no one behind can contribute to good Value for Money
SDGs and pledge to lnob means shift from the MDGs and a new starting point of reducing poverty for everyone
Means we have to rethink what we mean by value
No intervention that leaves behind sections of the population behind can be considered good value for money
In fact – leaving no-one behind should be seen as contributing to good value for money, not detracting from it

6. Bring equity up the agenda
Vfm frameworks often have 3 or 4 Es. Equity is always last, and often missed out all together.
We have framed equity as cutting across the other three Es
Also redefined – from ‘fairness’ in ICAI etc. framework to reaching the poorest and most marginalised.
Equity is often seen as an apology for a programme costing more. But Equity should not be seen as undermining the other areas of VfM, even if it results in higher costs per beneficiary, or fewer beneficiaries for a given cost. These additional costs are not wasted if they are necessary to reach those who are most marginalised; in fact the opposite is true – they are necessary to maximise the effectiveness of an intervention

7. General recommendations on assessing VfM of disability-inclusive development
Recognise (and articulate) the Value of disability- inclusive programming
Go beyond quantified comparisons – and ensure like for like comparisons and a range of quantitative and qualitative measures.
Include voices of people with disabilities in VfM - participatory planning and feedback mechanisms.
Follow best practice in project management and cost control
Value of disability-inclusion is rarely articulated – articulate the immediate benefits as well as the long term economic and social benefits
A common way of approaching VfM assessments is to make comparisons. While comparisons can drive improvement and inform decision–making, they are only effective if comparing like with like. This is particularly relevant in the case of disability because: limited data to make comparisons from, long history of marginalisation, diversity of people with disabilities. But also relevant more widely. Need to emphasise the importance of qualitative data. Lack of data on disability shouldn’t be used as an excuse for inaction – enough exists and more can be developed by testing different approaches.
Voices of people with disabilies and what they value is rarely considered – meaningful participation of people with disabilies in decision making/vfm assesements can be hugely powerful
No point in comparing unit costs of non-inclusive/inclusive programming. It doesn’t tell you anything. Instead, consider, explain and justify what might be driving higher costs in inclusive programmes
Still need to follow best practice in project management and cost control. Make robust case as possible.

8. Practical guidance on assessing disability-inclusive programmes
Do the benefits outweigh the costs? 1. Benefits Is the programme designed, implemented and monitored in a way that recognises the benefits of programming which includes people with disabilities? 2. Costs Are the costs of programming which includes people with disabilities explained and justified?

9. Equity in Effectiveness
BENEFITS
COSTS
Have all the outcomes of disability-inclusive programming been fully captured (including the intrinsic benefits of not discriminating and leaving no one behind)?
Does the programme have a credible theory of change that explains how inputs, processes and outputs contribute to these disability-inclusive outcomes, while being realistic about the level of external contribution and uncertainty associated with some of the longer-term benefits?

10. Equity in Efficiency BENEFITS COSTS
Is there reliable data on the number of people with disabilities who benefit from the programme and does this data show that people with disabilities are benefiting equally?
If the programme includes specific processes or outputs associated with disability inclusion, is there a clear justification for why these activities add value and contribute to the equity of the programme, compared with alternative less costly approaches?
Is there evidence on the diversity of people with disabilities reached by the programme (for example, representation of groups facing intersecting exclusion16, and of highly marginalised impairment groups17)?
Are there quality controls to ensure the programme is delivered in a way that is inclusive of people with disabilities (for example, do people with disabilities play a meaningful role in implementing and evaluating the programme)?

11. Equity in Economy BENEFITS COSTS
Do recruitment and procurement processes include policies to ensure equity (for example, equal opportunities policies for recruitment, accessibility policies for procurement, consideration of whether contractors’ and grantees’ activities have adverse effects on equity)?
Are the cost drivers of disability inclusion identified and justified, so that it is clear why unit costs might be higher than for a programme that does not include people with disabilities?
Are there processes to manage the cost drivers and eliminate costs that do not add value?

12. Equity – cross-cutting
BENEFITS
COSTS
Are processes in place to enable and evaluate the inclusion of people with disabilities, in inputs, processes, outputs and outcomes?
Are the cost drivers of disability inclusion
understood, justified, and linked to a credible theory of change?

13. Moving forward
Still very little out there on what works so test, research, document and share:
VfM metrics used in an inclusive way
Evidence on cost drivers in relation to VfM
The benefits of inclusion
Help to shape the Value for Money agenda in a way in which supports leaving no one behind – not hinders it