Making Donor Dollars Work: Measuring Impact in Rural Ecuador

Are we sure we are making a difference? An estimated $390 billion was donated to charitable causes during 2016 [1]. Of this, international charities received $22 billion that year. When we think about international development, then, how could this not be enough money? These charitable organizations are probably doing what most of us would deem “good work.” Still half the world’s 7.3 billion population lives on less than $2.50/day, and more than 1.3 billion people live in extreme poverty (less than $1.25/day) [2]. Over half of the globe still does not have adequate health care access [3].

I work for an innovative health care NGO, Andean Health & Development, which seeks to maximize donor dollars to make meaningful and sustainable change for the world. Andean Health & Development has created a high quality, self-sustaining health system for Ecuador’s countryside and trains local doctors to be global health leaders. Our latest initiative is the opening of the Andean Health Institute, which measures the impact of our work and shares lessons learned and best practices with the greater global health community to be applied to other parts of the developing world. If we can measure the effectiveness of our clinical programs and our rural Family Medicine program for Ecuadorian physicians, we can positively influence other NGOs, other health care providers, universities, and even policy.

At Harvard, I took a course called Performance Measurement for Effective Management of Nonprofit Organizations. The course explores how non-profit leaders—the very people who are solving the world’s problems—can measure performance to really know if and how their work is making a difference. An NGO first needs to answer its “question zero” before all other questions: what is it we are trying to accomplish? One Harvard Business School case we studied in the course, called “Jumpstart,” highlighted that implementation of measurement systems requires buy-in from all: leadership, employees, and partners. Together, this team can identify its organization’s “theory of change” by establishing goals and intended outcomes, by assessing which outputs and outcomes the organization actually has control over, and by creating metrics for its outcomes.

With performance metrics, NGOs can stick to what works and share the lessons they learned so that others (other NGOs, business, and government), too, can leverage investments made in international development.  Measuring and monitoring impact might be the way we maximize the potential of the next $390 billion+ that charitable organizations will receive this year.