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How can development cooperation respond to the corona crisis? Food for thought from evaluation results

by Jochen Kluve


In view of the corona crisis, many donors are taking immediate action, expanding their activities and planning new programmes. At KfW Development Bank, we have asked ourselves which evaluation findings from Financial Cooperation (FC) and other institutions can sharpen the focus during conceptualisation. In addition to overarching findings from past crises and disasters, we would also like to provide sector-specific food for thought.

 

Worldmap that represents the health risk index of countries in the world.
Health risk index of countries in the world, from very high (red) to very low (green). Source: KfW 14th Evaluation Report, based on WHO data (2015)

i. Food for thought from past crises and disasters

Early response is the guiding principle for containing epidemics and crises. This is shown by analyses of Ebola projects: "The costs of late responses are hard to quantify, but studies have suggested that half the caseload could have been avoided - equivalent to thousands of lives saved - if the Ebola response had arrived one month earlier" (Clarke/Dercon, 2017, p. 32). FC evaluation experience shows that early response does not always succeed, measures may come too late or the crisis develops unexpectedly, as the Asian Development Bank also points out: "Design rapidly, but be mindful of quality at entry" (Vijayaraghavan, 2020, S. 3). KfW Development Bank stated in 2016: "Even with more predictable crises – such as food crises in the Horn of Africa – the international response tends to be slow and thus inefficient and expensive" (KfW, 2016).

When designing additional development cooperation (DC) approaches, lead times and the stage of the pandemic to be expected during implementation should therefore be taken into account. Where rapid solutions are required, the effective interaction of humanitarian aid and DC is important and cooperation with established (UN) institutions should be considered.

Flexible and harmonised financing is useful when circumstances are dynamic and unpredictable. Often, co-financing of multilateral organisations, as far as possible untied to a specific purpose, is an effective and efficient instrument to ensure that measures are tailored to needs in dynamic intervention contexts. In Yemen, when the civil war escalated in 2015, unpurposed FC funds for the United Nations World Food Programme (WFP) made it possible to distribute food at short notice – to all Yemenis without exclusionary character. Accordingly, the FC evaluations generally confirm the positive effects of co-financing.

Ownership is central to success and sustainability, but the question of who bears the risk often remains unclear. In the response to the Ebola crisis, overburdened national governments have shown a lack of clarity about who takes responsibility: national governments, the World Health Organization (WHO) or donors (Clarke/Dercon, 2016, p. 17/18)? Broad institutional support is desirable to raise awareness among national actors that pandemic control measures are a contribution to a global public good (Vijayaraghavan, 2020, p. 3).

Community-based approaches have been identified as relevant for success by numerous evaluation studies. Close cooperation with local actors helps to identify the urgency for immediate support and to act accordingly. Communication adapted to the cultural context and the involvement of local leaders are important for the success of the project. This was also a success factor in combating the Ebola crisis (Vijayaraghavan, 2020, p. 3).

Do no harm is an important guiding principle in the planning of measures in conflict and disaster situations. It is based on vulnerability analyses that take into account not only health care, but also the economic situation and existing lines of conflict.

DC implementation partners such as the United Nations or international non-governmental organisations can be exposed to increased risks, inter alia through increased access restrictions, but also by becoming the target of hostility, propaganda or attacks. Here too, it is possible to build on Ebola experience: Humanitarian aid and development cooperation should avoid strengthening the position of conflict parties or leading to changes in power structures. For a conflict-sensitive response to natural disasters, see our evaluation reports on tsunami projects in South East Asia.

Cost increases in a crisis situation should be anticipated at an early stage in order to be able to offer efficient and needs-based services for crisis management. Since national and global infrastructure often functions only to a limited extent, supply chain bottlenecks result in higher prices for food and consumer goods and in increased suffering for those affected by the crisis. In 2015, for example, the cost of implementing the World Food Programme's interventions for successful food aid in Yemen increased significantly compared to previous projects.

ii. Food for thought from relevant sectors

In the health sector, prevention is an established approach: (i) through education and (ii) through vaccination campaigns. For Covid-19, only education and symptomatic treatment are currently possible, but hopefully a vaccine will be available in the medium term.

Concerning prevention through education on transmission routes, protection options and risks, experience in the fields of HIV and family planning offers valuable insights: Social marketing agencies work context-based, can build on the trust of the population and complement state structures. Community-based approaches have proven their worth in promoting hygiene awareness activities (see Yates, 2017) (De Buck et al., 2017). Education and hygiene will remain essential, even once tests and treatment options are available for Covid-19, as they are not (usually) universally accessible. Despite treatment, prevention must not be neglected, as is unfortunately the case with HIV/AIDS.

As soon as the approval of a vaccine against the novel coronavirus becomes apparent, the focus will be on vaccination programmes in addition to prevention. Trust, close monitoring and, if necessary, adaptation to the security situation and the involvement of all major actors have proved to be crucial to the success of FC policy projects under the Global Polio Eradication Initiative in India and Nigeria.

The programmes, which were vertically and initially strongly driven by the international community, had hardly any spill-over effects on the national health care system. In large-scale immunisation campaigns, care must be taken to ensure that general vaccination and health programmes are not negatively affected, as was the case in India, where a major campaign led to a shortage of vaccination personnel. Such displacement effects also occurred in West Africa when the fight against malaria suffered from the prioritisation of Ebola (Walker et al., 2015).

Irrespective of the stage of pandemic control, maintaining basic electricity and water supply and sanitation play an important role. Not only because the structures required to combat a pandemic depend on this basic supply, but also because interruptions in the supply of water and sanitation can lead to further health problems for the population (in the worst case, epidemics such as cholera or dysentery).

Social security measures can also be a starting point for DC to mitigate the effects of the current crisis. Evaluations by KfW have, for example, looked at various transfer mechanisms in food security: cash and vouchers to purchase food (instead of food distribution) offer the target group greater freedom of choice, which has a positive impact on the diversity of food intake and strengthens self-efficacy in the purchasing decision. Examples of this can be found in the evaluations on basic nutrition in Yemen I + II and on UN financing in the Middle East.

Setting up microinsurance systems can reduce the financial burden on individuals in the event of illness. It is always important to keep the issues of cost coverage and sustainability of the supported systems in mind.
The effects of the corona crisis are multisectoral both in Germany and in the developing countries and therefore require efforts in all development-relevant sectors to increase the resilience of partner countries to future shocks.

 

Dr Jochen Kluve is Head of the Evaluation Department at KfW Development Bank and Professor of Economics at the Humboldt University of Berlin.

 

Literature

De Buck, Emmy et al. (2017), “Promoting handwashing and sanitation behaviour change in low- and middle-income countries: a mixed-method systematic review”, 3ie Systematic Review 36, International Initiative for Impact Evaluation (3ie), London.
Clarke, Daniel J. and Sefan Dercon), Dull Disasters? How Planning Ahead Will Make a Difference, Oxford University Press, Oxford.
Vijayaraghavan, Maya et al. (2020), “Responding to the Novel Coronavirus Crisis: 13 Lessons from Evaluation”, ADB Learning Lessons, Asian Development Bank.
Walker, P. G. et al. (2015), “Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity and the potential effect of mitigation strategies: A modelling analysis”, Lancet Infectious Diseases 15(7), pp. 825 - 832.
Yates, Travis et al. (2017), WASH Interventions in Disease Outbreak Response: an Evidence Synthesis. Humanitarian Evidence Programme, Oxfam GB, Oxford.

Evaluation reports of KfW Development Bank
14th Evaluation Report 2015 – 2016. Living in a threatened world – effectively countering dangers, Frankfurt.
India: Polio immunisation programme, ex-post evaluation, summary report, 2018.
Indonesia: (Health Insurance) HI reconstruction assistance for the district health system Aceh/North Sumatra, ex-post evaluation, summary report, 2013
Yemen: Basic nutrition/Mother and child health, ex-post evaluation, summary report, 2017 (in German).
Middle East: UN funding Syria crisis; ex-post evaluation, summary report, 2019.
Nigeria: Control of infectious diseases, ex-post evaluation, summary report, 2017.

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