‘Fragmented’ maternal health aid data a step away from accountability

When it comes to the Muskoka Initiative  — Canada’s much-lauded effort to push global action on maternal and child health — the Conservative government has endeavoured to be more accountable and transparent than usual, according to a data analyst who's been keeping his eye on foreign aid spending. 

"The initiative was started in 2010, but since then Canada has become one of the leaders in transparency in many ways,” said Aniket Bhushan, a researcher with the North-South Institute in Ottawa.

At the 2010 G8 summit, Canada committed a total of $2.85 billion to fund more than 80 international projects related to maternal and child health — with $1.1 billion of new money to accompany the government's $1.75 billion in spending on programs over five years. 

About 80 per cent has, so far, been disbursed ahead of the 2015 deadline.

Following the G8 summit, Prime Minister Stephen Harper co-chaired a United Nations commission on accountability and transparency to monitor the progress. Among other things, the commission recommended finding new ways to gather health data and improve ways for civil society groups to provide feedback, as well as then sharing the information with the public.

Data is 'not accountability'

Non-profit organizations that receive funding are required to submit reports to the government on their progress.

"There’s a whole cycle of reporting that’s required on every program,” said Rosemary McCarney, president of Plan Canada, which has gotten more than $30 million of government funding.

A quick scroll through the Foreign Affairs, Trade and Development website shows a significant amount of data on the different Muskoka Initiative programs that are in place, as well as the amount of funding individual NGOs have received and quantifiable results of the programs.

But that may not be enough.

"The way I see the overall picture is that the data, to my mind, is not accountability," said Bhushan in an interview with CBC News, adding that it's merely "a prerequisite."

Bhushan, who has spent the past number of years mapping out Canadian aid data, acknowledges the government has done a lot to "put the data out there" (and added "there's a heck of a lot") but said that it's "fragmented" across different types and formats.

Indeed, the Foreign Affairs website has certain data sets on aid programs in less-than-common .CSV and .XML extensions. Bhushan said the information could use some work "so it doesn’t require a data expert to translate it every time a journalist has a question.”

He said the "dots are there," but the government needs to join them.

"I think it should be within their interest to do the most they can in providing a comprehensive picture to Canadians,” Bhushan said.

Muskoka Initiative 'not a straightforward commitment'

Of course, it doesn't help that the Muskoka Initiative is also "not a straightforward commitment," he said, referring to the separation of the $1.1 billion and the $1.75 billion in funds. He said that projects allocated under the $1.1 billion of new funding are being tracked, but it's "a little bit more complicated" to track the existing $1.75 billion in funding for programs allocated before Canada made its high-profile pledge.

Not to mention the sheer brevity of the time frame that makes it difficult to track information. 

For example, one of the biggest health indicators, Bhushan said, is the maternal mortality rate — the number of women who die as a result of pregnancy for every 100,000 births each year. He said the rate changes "quite slowly year on year."

"[The Muskoka Initiative has] only been three years," he said. "How do you know that that change of X per cent in [maternal mortality rate] relates to those thousands of dollars that have been spent and not others?”

Amref Health Africa (formerly the African Medical and Research Foundation) has received more than $15 million in federal government funding for two projects since 2011. One of its projects is to help rural communities in Tanzania access the formal health system by training nearly 4,000 volunteer health workers to go into communities to deliver services, along with creating a model to replicate those efforts in different regions. 

“We are on the right track to achieving a very significant impact,” said Festus Ilako, Amref's Tanzania country director.

However, Ilako said that having only three and a half years to carry out such a program is "a bit short."

He said for a development program that needs sustainability and strength, "three and a half years was not enough." 

Thank-yous 'not simply anecdotal'

"The results would not be impressive as it might have been if we had five years,” Ilako said. Amref's Tanzania project was shortened to three years out of the possible five because of delays in getting funding from the government.

Ilako said the project wraps up next year, but he's already started to work toward closing up shop. He raised the possibility that if the Muskoka Initiative was to renew and similar funding be obtained for the network of NGOs currently doing work in Tanzania, reducing the maternal mortality rate by three-quarters (as per Millennium Development Goal No. 5) could be achieved "shortly after 2015."

Plan Canada's McCarney said the government funding has done a lot of good. She said it's enabled the organization to have critical outcomes, such as increasing the number of women who obtain prenatal care — visiting a health provider at least four times during pregnancy — by 20 per cent in the countries of Ghana, Mali, Ethiopia, Bangladesh and Zimbabwe. She noted Plan achieved that increase in just a year, from September 2012 to 2013.

She said Plan was also able to gather data and have a level of reporting that goes "above and beyond what's mandated" and it's currently sharing the data with other groups as well.

That means the thank-yous and praises the organization gets are not empty.

"It’s not simply anecdotal," said McCarney. "It’s qualitative data that’s supported by quantitative data.”