Project HOPE

A note on this page's publication date

The content on this page has not been recently updated. This content is likely to be no longer fully accurate, both with respect to the research it presents and with respect to what it implies about our views and positions.

In a nutshell

Project HOPE implements a diverse set of programs aimed at improving health and reducing poverty across 37 countries in the developed and developing world. We have documentation for several projects in the category of "Child Survival" (generally funded by USAID's Child Health and Survival Grants Program), and believe that these projects have largely been effective ways of saving lives. However, in looking at the organization as a whole, we are unable to gain the same confidence in a majority of its activities, and therefore cannot confidently recommend the organization.

The details

We first discuss the projects we have strong documentation on, and then discuss our relatively limited understanding of the rest of the organization.

Table of Contents

Child Survival programs

What do they do?

Attachments B-1 through B-7 describe Child Survival programs in Guatemala, Haiti, Malawi, Peru and Uzbekistan. Though these programs differ in their details, the major components are:

  • A focus on educating locals, particularly about safe practices for:
    • Giving birth.
    • Recognizing/addressing illness in infants.
    • Avoiding sexually transmitted diseases.
  • Vaccinations and vitamin supplements.
  • Training of local health staff.
  • Funding through the CSHGP program.

Does it work?

In all five of the Child Survival programs we have documentation on, Project HOPE conducted surveys several years apart, to track the change in local knowledge and attitudes. The following spreadsheet summarizes their findings:

Project HOPE: summary of survey data

Four of the five sets of survey data indicate large changes across many measured items, including mothers' knowledge of how to recognize and treat diarrhea; male and female knowledge of how to avoid sexually transmitted diseases; and mothers' attitudes toward seeking care in childbirth.

In addition, the Haiti report shows the proportion of children receiving vitamin A supplements going from 19% to 85% between 2001 and 2006 (Attachment B-2 Pg 6); the Malawi report has this proportion going from 13% to 46%, and the proportion of "completely vaccinated" children going from 66% to 81% between 1998 and 2003 (Attachment B-3 Pg 3).

Given what we know about the life-saving potential of vaccinations, vitamin A supplements, improved maternal care, and interventions to prevent and treat diarrhea (see our problems and solutions overview for details), we believe that the programs in this category have generally saved lives.

What do you get for your dollar?

Of the five reports discussed above, only the Haiti and Peru reports (Attachments B-2 and B-4) give information on how many people were served, and only the Haiti report provides the total cost of the project. Furthermore, although the survey data Project HOPE collected appears to be relatively strong evidence of the programs' effectiveness, it is difficult to quantify the effect on life outcomes, given that most of the program benefits are in the form of knowledge about handling various problems. For example, we know that seeking appropriate care during childbirth can save a mother's life, but we don't have information on the translation between recognizing the importance of this care and actually seeking it (and we also don't have information about the quality of care in the region).

From what we know about similar programs funded by CSHGP, we think a reasonable expectation might be in the range of around $1000 per life saved.

Other programs

We have very little information about the bulk of Project HOPE's activities. The following summarizes our understanding of its organizational budget, taken from its 2005 Form 990 (available on GuideStar):

  • $108 million: in-kind donations/expenditures. See Part III for expenses for the Humanitarian Assistance program, and Part I line 1d for the statement that $106 million of HOPE's $144 million in revenues was in-kind donations. We do not have information on whether these in-kind donations were used for the programs below, or shipped independently (as some organizations, such as AmeriCares, do); but despite the large size of this part of the budget, we do not find it highly relevant from our perspective, since it doesn't represent the use of cash donations.
  • $9.4 million: Women's and Children's Health. The programs discussed above fall into this category, but we have no sense for what else might be included under this heading.
  • $7.9 million: infectious diseases. Project HOPE sent two reports on programs under this heading. One (Attachment B-12) covers an HIV/AIDS program in Mozambique and Namibia, but does not show noticeable changes in condom use or sexual practices (see Pg 18 for Mozambique and Pg 40 for Namibia). Another report (Attachment B-10) covers a Malawi program, also aimed at HIV/AIDS, but the only information provided is on activities - condoms distributed, referrals, etc. - and does not give us the information we need to have any sense of the program's impact on people's lives.
  • $7.1 million: health training and facilities. Project HOPE sent one report on a program under this heading, a clinic in the Dominican Republic (Attachments B-8 and B-9).
  • $4.7 million: the Health Affairs Journal.

Ultimately, we do not have enough information on these programs to have a sense of their impact on life outcomes, with the exception of a limited set of CSHGP programs; we also have no sense of Project HOPE's overall strategy, and see no clear pattern in its activities.

Conclusion

We cannot confidently recommend Project HOPE because we have too little information about the organization as a whole. We have neither comprehensive evidence on outcomes nor an overall view of the organization's strategy. There are some programs we are confident in; there are others we are less confident in; and we have no sense of the likely impact of additional funding.

Attachments

A. Application and response