The Center on Democracy, Development and the Rule of Law is pleased to announce the release of the second module of mini-lectures in our Solving Public Policy Problems massive open online course (MOOC).

Evaluating Social Programs: The Case of World Health Partners-Sky

Using the Problem-Solving Framework discussed in the first module, Module 2 examines the case study of child health outcomes in Bihar, India (“The Case of World Health Partners-Sky”). In this set of videos taught by Francis Fukuyama, Olivier Nomellini Senior Fellow at the Freeman Spogli Institute for International Studies (FSI), he works through how to unpack an issue, by working backward from a problem to understand its drivers and potential points for intervention. Beware of leaping to a solution first, without properly understanding the root causes and making logical connections.

This case looks at the challenges of managing and evaluating new models of healthcare delivery in international development. It follows the story of a social franchising initiative funded by the Gates Foundation in Bihar, one of India's poorest states. The initiative sought to create primary healthcare centers at scale in remote rural parts of the state through a franchisee-based private sector intervention. These centers were intended to provide high-quality preventive care targeted at certain infectious diseases through technology and telemedicine-enabled infrastructure. It was expected that patients, some of the poorest in the world, would be willing to pay consulting fees in recognition of the higher quality compared to local alternatives. World Health Partners, an Indian NGO with experience in healthcare, received a grant of $23 million dollars from the Gates Foundation to execute this program. The Foundation also awarded a grant of $3 million to a group of academics to conduct a Randomized Control Trial to evaluate the effectiveness of the intervention. The case details the difficulties faced by WHP in implementing this ambitious program as well as the clash of incentives with the evaluators. There is also a discussion of how the Gates Foundation managed this grant and the challenges posed by its organizational structure. The case seeks to put readers in the shoes of an executive at the Gates Foundation who must make an important decision regarding the future of the program after the evaluation, with its limitations, finds no evidence for the effectiveness of the intervention.

The conclusion of this module includes an interview with Grant Miller, the Henry J. Kaiser, Jr. Professor of Health Policy at the Stanford School of Medicine, Senior Fellow at FSI and the Stanford Institute for Economic Policy Research (SIEPR), and a Research Associate at the National Bureau of Economic Research (NBER), who worked on impact evaluation for this program. Miller discusses the misaligned incentives for the implementation and evaluation teams, and offers advice for better processes.

Watch the introduction below, or access the full playlist of lectures on our YouTube channel.