DRAFT DRAFT DRAFT DRAFT

October 17, 2007

**[Please be advised that comments on this paper should be directed to
the working group via Jocelyn Rowe, ACVFA Executive Director at
jrowe@usaid.gov]{.underline}**

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############################################################################################################### ACVFA RECOMMENDATIONS {#acvfa-recommendations .Headings .unnumbered}

############################################################################################################### INVESTING IN PEOPLE {#investing-in-people .Headings .unnumbered}

############################################################################################################### Introduction {#introduction .Headings .unnumbered}

Investing in People (IIP), as defined by the F framework, aims to "help
nations achieve sustainable improvements in the well-being and
productivity of their people through effective and accountable
investments in education, health, and other social services." IIP is the
crucial foundation for advances in all other sectors of development;
without improvements in health and education, lasting gains in
democracy, economic growth and poverty reduction become all but
impossible. With twin focuses on organization and program implementation
and program depth and quality, we hope that our recommendations will
leverage the reform process to affirm the centrality of IIP to U.S.
foreign assistance and build on past achievements in education and
health for the future. The IIP ACVFA Working Group fully recognizes that
achievement and implementation of the recommendations herein require and
are dependent upon a shared understanding of and knowledge about the
definitions, needs for quality measurement, and commitment of new and
additional resources by all members of the development community,
including the Congress, foreign assistance agencies, businesses, and
non-governmental organizations at this critical time in which investing
in people is recognized as the foundation upon which development,
diplomacy, and international security rest and is essential for global
peace and progress.

## [RECOMMENDATION HIGHLIGHTS]{.underline}

## I. Organization and Program Implementation

-   **Revitalize the USAID workforce** in education, health and
    training, and deepen its technical expertise by expanding the number
    of staff, especially the addition of experienced, U.S. direct-hire
    personnel for field missions. The agency should also explore
    additional alternative personnel arrangements with NGOs,
    universities, and businesses.

-   **Demonstrate clear leadership in IIP development** by establishing
    specific long-term foreign assistance priorities in collaboration
    with host-country governments and development community partners and
    in alignment with Millennium Development Goals and the Paris
    Declaration processes for country-driven priority-setting, which
    address their IIP needs in the full range of education requirements,
    gender equity, and child and maternal health needs. This will
    require dedicating

> sufficient staff and resources to long-term strategic planning and
> policy formulation.

-   **Foster and support linkages within the framework** through
    incentives and high-level support for integrated, cross-sectoral
    programming such as between education, workforce development, peace
    and stability, and key health prevention programs, including HIV and
    AIDS. This is especially critical with regard to populations such as
    youth and women whose cross-sectoral needs require holistic
    responses. USAID must collaborate with the development community to
    promote, define, and highlight long-term, holistic IIP priorities so
    that funding and resource allocations can be applied to these
    cross-sectoral program needs and populations.

-   **Increase access to sustained resources** to support IIP programs
    with 10- to 15- year implementation horizons which will allow for
    effective programming focusing on strategic priorities for the
    long-term, solid partnerships with local organizations and greater
    focus on institutional capacity building.

-   **Strive for continuous improvement in programming** by developing
    quality indicators, mandating rigorous monitoring and evaluation of
    short-, medium- and long-term progress and using new knowledge
    management technologies to collect and disseminate information.

## II. Program Depth and Quality 

-   **Continue to meet the EFA (Education for All) commitment** for the
    U.S. share of the global needs to fully accomplish quality basic
    education for all by the year 2015 for the countries with the
    greatest needs, especially for girls in Africa. Recognize that EFA
    goals include commitment universal primary education and secondary
    education, early childhood development, adult literacy, and special
    needs including disabilities and HIV education.

-   **Design new programs and request new resources to address
    underfunded areas of critical need** including access and quality
    for secondary and tertiary education, malnutrition, impacts of
    climate change, reproductive health, maternal child health and youth
    employability. There should be increased emphasis on prevention,
    including behavior change, to keep pace with the expansion of
    treatment services within the health sector. This must be supported
    by new forums and expanded opportunities for dialogue with the
    development community to define common understandings and
    priority-setting for these and other critical areas of IIP
    investment.

-   **Build institutional capacity in health and education systems** by
    establishing long-term goals for IIP program design and
    implementation, recognizing that the accomplishment of IIP
    objectives must often span a generation. Increase long-term degree
    training for country personnel from ministries of health, education,
    and other sectors in the U.S. and third countries for senior public
    policy and technical positions. This should be coupled with
    increased help to national, in-country higher education
    institutional development and training as well as programmatic
    incentives to help countries retain good people in the public
    sector.

-   **Pursue public-private partnerships** to leverage the experience,
    skills and resources of the private sector in addressing pressing
    health and education concerns in mutually beneficial and innovative
    ways.

-   **Foster collaborative long-term partnerships with NGOs** which
    capture and retain knowledge, provide continuity in programming and
    strengthen the focus on transformative change.

> **[BACKGROUND SUPPORT AND DISCUSSION]{.underline}**

############################################################################################################### i. Organization and Program Implementation {#i.-organization-and-program-implementation-1 .Headings .unnumbered}

**Staffing**: We strongly advocate for the deepening of technical
expertise within the agency to position USAID as a thought-leader in
development for IIP. U.S. direct hire staffing levels must be
significantly increased to support internal capacity in strategic
planning, effective management and active field level support. To
support staff, the OE budget should be sufficiently robust to enable the
long-term planning and policy formation essential to effective,
coordinated investments in lasting IIP improvements. Personnel additions
should address both specific sectoral and discipline requirements as
well as include key personnel who can operate across and among sectors.
We also propose reviewing other government agency approaches to meeting
personnel needs which take advantage of personnel exchanges with
universities, businesses, and NGOs, and have demonstrated proven
opportunities for mutual advantage through these partnerships.

**Long-term policy goals and priorities**: For IIP to be truly
effective, there must be a vision for broad, long-term commitment. The
U.S. has always been a leader in foreign assistance reflecting the
American people's top priority to help people to build their own
capacity. USAID must be a leader in establishing long-term, holistic
U.S. foreign assistance priorities within the globally embraced
Millennium Development Goals (MDGs) framework through strategic planning
and visionary policy formulation. By aligning its contributions with the
MDGs, USAID will be able to better coordinate its investments in IIP
with other donor countries, leverage the impact of its funds by building
on the efforts of nations with MDG plans, partner effectively with
developing countries efforts, and play a leading role in the first truly
global effort to improve the well-being of the world's poorest and most
vulnerable people. Aligning IIP with the MDGs would further advance the
F framework top-line goal to reduce poverty and it would make addressing
the causes and consequences of poverty the core objective of IIP
efforts. Increased dialogue with the development community is critical
to collaborative agreement on priority areas for long-term IIP
investment.

**Integrated programming**: With the framework's vertical divisions by
sector, we are concerned that integrated (cross-sectoral) programming is
inhibited. It seems that the system of accounting which requires funding
to neatly fit into budget boxes has resulted in a decreased ability or
commitment to design, implement and monitor integrated programs. In IIP,
for example, synergies between basic education and nutrition programs
should be integrated to address hunger in the classroom, improve basic
nutrition and contribute to better attendance rates and learning
outcomes. Education also plays a crucial role in any effective response
to HIV and AIDS. We support creating linkages between objective areas to
facilitate cross-sectoral work that is not naturally fostered by the
framework or USAID's organizational units. In addition to high-level
support, overcoming fund authorization barriers will require the
creation of incentive mechanisms

to reward initiatives which undertake challenging cross-sectoral work. A
commitment to

these cross-cutting themes and programs should be reflected in foreign
assistance strategic planning and for future budget support requests. It
is important to remember, however, that not all programming needs to be
cross-sectoral. There is a need to establish criteria to determine when
single sector approaches may be more valuable, such as when attempting
to measure change over the medium and short term.

**Sustained Resources**: We believe that achieving effective programming
in IIP which is responsive to the increasing complexity of development
concerns will require innovative approaches and sustained funding. USAID
can benefit from the lessons learned with PEPFAR and the many successful
examples of multi-year funding in addressing the HIV and AIDS pandemic.
Sustained funding allows for the development of solid partnerships with
local NGOs and national governments, strategic and coordinated planning
and a greater emphasis on institutional strengthening and capacity
building. Many IIP programs require a 10- to 15-year implementation
horizon with clear-cut, 3- to 5-year benchmarks to ensure opportunity
for course correction, modification, and measurement on progress. Such
long-term horizons also enable private sector and NGO partners to be
more effective in their planning program design and implementation. We
also believe that USAID should remain the lead agency of U.S. government
foreign assistance for IIP programs with development resources managed
by civilian organizations.

**Monitoring and Evaluation**: To design and implement effective
programs, it is critical to know what works. USAID must engage in the
development of quality outcome indicators, especially for the education
sector, to enable useful and regular performance monitoring at all
stages of implementation. Indicators of progress need to recognize and
reflect the complexity and variety of IIP programs, rather than single,
simplistic indicators. Quality indicators should be coupled with a
commitment to devote 3 to 5 percent of program funds to support
monitoring and evaluation. Resources for monitoring and evaluation
should take advantage of host-country expertise. Often in-country
evaluators are able to deliver quality assessment that is grounded in an
understanding of the local situation as well as cost-effective.
Objective monitoring and evaluation provides relevant, accurate and
timely information essential to improving effectiveness and impact.

**Knowledge Management**: USAID and the F Bureau should establish strong
knowledge management resource bases that capture and maintain current
development experiences in IIP for easy analysis and dissemination
within its organizational structure. This should also allow USAID to
easily access and integrate experiences and share best practices from
other agencies and its partner institutions including universities,
NGOs, and businesses. Utilization of easy access portals, new data
distribution, and management systems should be acquired or contracted to
take advantage of the existing state-of-the-art knowledge management
programs.

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############################################################################################################### ii. Program Depth and Quality {#ii.-program-depth-and-quality-1 .Headings .unnumbered}

**Public-private partnerships**: Actively engaging private sector
institutions in development work has the power to create mutually
beneficial partnerships improving health outcomes and supporting quality
education. USAID should continue its current focus on partnering with
the private sector to leverage skills and technologies and pool
resources. The ability of private sector corporations to partner with
NGOs and government makes it possible to bring innovation, technology
know-how, and efficiency, and also to relate IIP to economic growth.

**Host-country input**: As USAID knows, the inclusion of host country
input in establishing priorities is essential. This becomes especially
important in IIP where program quality and results depend most visibly
on local perceptions. The process of determining priorities should be as
transparent as possible and involve mechanisms to solicit feedback and
input from country level stakeholders including mission staff, host
country government staff, international and local NGOs and the private
sector. Funding mechanisms must also be flexible to effectively respond
to changing host country priorities. The accomplishment of significant,
at-scale development for IIP requires collaboration and partnership by
the U.S. for assistance with other donor agencies, working in concert
with overall leadership from the country itself.

**Youth and secondary education**: Given the framework's organization by
sector, as opposed to population segments, we are concerned that
critical populations for development are not adequately addressed. This
is especially true with regard to youth. The youth cohort, currently the
largest in the world's history with 1.5 billion people ages 12-24, faces
tremendous challenges and will require sustained, strategic,
multi-sectoral investments if young people are to become healthy,
engaged, productive adults. We recommend that youth become an agency
priority within the framework in order to address critical concerns of
education, workforce development, health and civic engagement in a
comprehensive and cohesive way. As countries succeed in meeting their
universal basic education goal, USAID, together with other development
agencies, must also support new, innovative, and more effective means to
meet the growing secondary education and technical skills development
needs of youth. Youth development must also include employability skills
development which recognizes that many young people have not been
reached previously by the formal education system. These programs must
take advantage of the new learning technologies and private sector
training capacity and utilize technical trainers from all sectors. The
youth emphasis will require new and additional resources so that
investment is not at the expense of investment in children's education
and health priorities.

**Women**: Women constitute another population not sufficiently
highlighted within the framework. While we recognize that the
framework's people-level indicators require disaggregation by sex, we
would argue for a full integration of gender into the IIP objective. The
range of critical IIP investment in women and girls which results in
greater peace and stability, global citizenship, future generations'
health and education, and improved economic growth requires leadership
through a strong office within the U.S. foreign assistance program which
is given high priority. In recent years this attention has diminished
while the critical importance and need for such leadership continues to
increase and be a central accomplishment of development objectives.
Despite recent gains, education of women and girls must be clearly
presented as a strategic and operational priority. This could include
the formulation of indicators appropriate for gender analysis of
programs as well as an increase in the capacity for gender work at all
levels.

**Critical areas in health**: Within the health sector, important gains
made in HIV and AIDS, malaria, child immunization and family planning
require continued support and attention. Alongside initiatives targeted
at specific diseases, it is essential to focus also on gaps between
current investments as well as emerging critical needs. Malnutrition,
for example, receives less attention than more visible diseases even
though nutrition is a necessary condition for good health and impacts
learning outcomes. Reproductive and maternal child health also should be
more closely integrated into HIV and AIDS services. The health benefits
of improved housing, especially in urban areas, has not been given due
recognition. Along with clean water and sanitation, improved housing has
been linked to lower incidences of malaria, respiratory and
gastrointestinal diseases. Greater focus on the impact of climate
change, which disproportionately affects poor populations in developing
countries, is similarly needed. In all of its health, nutrition,
malaria, and HIV and AIDS programs, equivalent attention should be given
to prevention strategies, as well as treatment and care, in order to
ensure lasting impact of these investments. Finally, the important role
of NGOs in delivering these wide-ranging health interventions should be
strengthened; assistance through U.S. PVOs to community- and faith-based
organizations is essential to long-term advances in behavior change,
immunization and nutrition.

**Emerging concerns in education:** Impressive gains in access have been
made in primary education; however, there is still a need to carry
forward the commitment to Education for All in poor countries where the
need is great. With the expansion of access, we have also seen
overcrowding in classrooms, scarcity of resources and inadequate teacher
training demonstrating the need to focus on excellence in education. In
a rapidly globalizing world it is essential that education emphasize
values of tolerance and citizenship alongside literacy and numeracy
skills to develop engaged national and global citizens. Major emphasis
must be given to quality improvement of learning materials, teaching
methods, tests and measurement, as well as management systems, and
curriculum relevance to workforce needs. In addition to the continued
support of primary education, new investment in quality education should
be expanded to the full spectrum of educational needs and settings,
including critical needs in higher education, the growing demand for
secondary education, and revitalized international participant training.
International training is essential for host country professional
capacity building

and strengthening of local institutions. Training and capacity building
of local school boards and parent-teacher organizations and education
provision in emergency, conflict, post-conflict and high migration
settings are also areas of emerging importance.