Tuesday, January 23, 2018 12:09:32 PM
Gina Lagomarsino :
Worldwide investments in health have led to dramatic gains. The number of deaths of children under 5 has been cut in half since 1990 - which means 122 million children have been saved over the past 25 years.
Progress in global education, however, has been less clear. While we've made great strides in increasing access to education worldwide, new estimates reveal there are 264 million out-of-school youth. What's worse: 250 million children around the world can't read, write, or do basic math - including 130 million who have attended school.
As the CEO of an organization working to build strong, self-sustaining health and education systems, I've pondered whether the global education sector can draw and apply lessons from the global health sector.
Of course, there are many ways these two sectors are different. One of the biggest differences is that foreign aid spending on global health dwarfs spending on global education. This can be explained, in part, because of the urgency related to many global health issues such as malaria and HIV/AIDS - which are life and death matters - and the fact that there are one-time, cost-effective AND proven health interventions - such as vaccines - that save lives.
It's hard to create the same urgency with education, and there are no silver bullet solutions. Educating a child takes many years and many actors - and the results are harder to measure.
Global health and global education are inherently different, and the health sector still faces plenty of challenges - but there may be opportunities for learning, particularly when we examine systems strengthening in both sectors.
Here are four opportunities to move closer to achieving quality education for all:
1. Invest in a strong global ecosystem for education.
Ecosystems produce high-quality global public goods - knowledge, tools, and networks that others can draw upon and replicate. A strong global ecosystem can support local change agents to achieve better education outcomes.
However, just 3 percent of official development assistance - or $242 million - for education went to global public goods in 2013. This compares to $4.7 billion (or 21 percent) of ODA in health - an astonishing difference. These findings were published in a study on sources of domestic and international financing for global education, led by Nicholas Burnett of Results for Development and Marco Schäferhoff of SEEK Development for the International Commission on Financing Global Education Opportunity.
To leverage existing resources and institutions geared toward improving education outcomes, Burnett and Schäferhoff argued that donors should double their support for global public goods to 6 percent, which would increase spending to $500 million per year.
2. Bolster collaborative learning approaches.
Strong global ecosystems also require collaborative learning - sharing expertise, experience, and knowledge across local, regional, and global networks. Countries need evidence about interventions that work, mechanisms for measuring their results, and access to peer networks to learn promising practices and receive support.
A great example in the health sector is the Joint Learning Network for Universal Health Coverage - a collaborative learning network of 27 countries that are working together to overcome barriers to achieving UHC.
Through peer-to-peer learning and the co-creation of tools and resources, the JLN is helping government officials with issues ranging from how to effectively engage the private sector to how to mobilize more domestic resources for health and much more. For example, JLN members Ghana and Vietnam are in the process of changing the way they pay providers based on their learnings from others in JLN's provider payment collaborative. Both countries are developing more deliberate incentives for providers to be more responsive to consumers, efficient in the use of resources, conscious of clinical quality and customer service and oriented to outcomes versus only providing services.
Collaborative learning networks for knowledge exchange need to be a key pillar of successful education ecosystems. If we apply the principles and lessons we've acquired through the JLN and similar health networks, strong education networks have the potential to advance us toward the overarching goal of education for all.
3. Rally around a single goal or outcome to galvanize support and create urgency.
In health, this is universal health coverage. Put simply - the goal is to achieve high-quality health care for all. But beneath this simple concept is a complex idea. It involves improving health systems - and that's not easy. Health systems face different challenges from place to place based on the local context, the history and the players involved. Progress is often slow and hard to measure. And there are many important sub-components to UHC, from improving primary care to increasing access to useful data.
If the global health community had tried to communicate all of those nuances, our effort to galvanize support and greater investment in health for all would have failed. With a simple call to action, we've seen growing political momentum. In December 2016, a coalition of 864 organizations and 117 countries - including the G7 - has reaffirmed health as a human right and made commitments to advancing UHC, one of the targets included under Sustainable Development Goal 3.
4. Invest in clear measurement frameworks that focus attention and action at the country level.
Donors typically do not want to invest if they can't measure the impact of that investment. Although there is room for improvements, the health sector has developed a number of clear results frameworks and indicators. And these frameworks are evolving to take into account the complexity of comprehensive health systems, which are similar to education systems. For example, this framework by the World Bank and World Health Organization measures health service coverage and financial protection to assess countries' progress in advancing UHC. And this conceptual framework by the Primary Health Care Performance Initiative details components and goals of a strong primary health care system.
One challenge in education that is less of an issue in health is that different countries may define success in education and goals of the education system differently. Still, a global measurement framework may be crucial to generating more donor willingness to fund the sector. A common measurement framework can also help to identify which countries are actually achieving results so that other countries can learn from them (supporting collaborative learning).
Thanks to global investments in maternal and child health, more children are living past their fifth birthdays and well beyond. This is a global health win we should be proud of, and a reminder of the work we have ahead. We can build on these hard-won gains by ensuring children have the education and skills they need to thrive. Better education outcomes, particularly for women and girls, lead to better health outcomes for families and entire communities. It's a virtuous cycle. Getting there, however, requires targeted investments in the broad constellation of public and private actors and institutions focused on advocating for - and delivering - inclusive, high-quality education across geographies.
(Gina Lagomarsino is the president and CEO at Results for Development (R4D), which works with change agents around the globe to create self-sustaining systems that support healthy, educated people).
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