Global Health Initiatives (GHIs) : institutional innovation and the challenge to development evaluation

This paper explores how GHIs as a form of institutional innovation are challenging the practice of development evaluation. It begins with a discussion of GHIs and criticisms or questions they have faced on accountability, sustainability and systems impact. It then outlines the short history of development evaluation and discusses how GHIs are pushing its practice towards a broader application of evaluation, performance evaluation. The paper discusses some of the strategic and political applications of evaluation and looks at systems impact, particularly vertical interventions and health systems strengthening, to illustrate the conceptual challenges that GHIs’ interventions can raise with respect to evaluation and how evaluation practice lags behind GHIs’ innovation. Finally, the paper looks at the Global Fund’s Five-Year Evaluation as an example of performance evaluation and how this evaluation addressed or failed to address external commentaries on its accountability,sustainability and systems impact. The paper concludes with some observations about the relationship between institutional innovation and performance evaluation