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This page provides a brief account of the USAID Child Survival and Health Grants Program (CSHGP), a government program that funds international aid projects. Some of the charities that we've evaluated run this program, so we feel it is helpful to provide context on the program's overall design, as well as information about why projects funded by this program may be unusually well-documented and attractive to a donor with our priorities.
A more detailed account of the program is available in the 2005 USAID CSHGP Report. All page references on this page are to this report, unless specified otherwise.
CSHGP influence on program design
CSHGP is a funding program: charities apply to USAID with a project proposal, and receive grants to implement their program.
To our knowledge, CSHGP does not specify the required components of a program, beyond the broad goal of "contribut[ing] to improved child survival and health outcomes at the district/multidistrict level." (Pg 13). However, we believe that this funding program plays a major role in its grantees' priorities and program design. The process is competitive (Pg 15 shows that four of twelve new applications were approved in October 2005), and provides a central source of technical support (see Pg 13); it also requires detailed implementation plans, and uses a central set of indicators to measure results (Pg 53).
The programs it funds are far from identical, but as we describe below, they have some qualities in common, particularly in terms of measurement.
Activities common across CSHGP programs
As Pg 18 shows, all or nearly all of CSHGP grantees' activities fall into one of the following categories:
- Vitamin A
- Micro Nutrients
- Pneumonia Case Management
- Control of Diarrheal Disease
- Control of Malaria
- Maternal and Newborn Care
- CHD Spa (note: we took this label from the document, but are unclear on what it refers to)
- HIV/AIDS Control
Strengths of CSHGP programs
Monitoring and evaluation. CSHGP uses Knowledge, Practice, and Coverage (KPC) Surveys to monitor progress (Pg 8). Many of the applicants that we named finalists use data from KPC surveys, including Food for the Hungry and Project HOPE; yet when looking at these same organizations' projects outside of the CSHGP program, we generally see much less measurement, and therefore have much less idea of whether and how a project is changing people's lives. Consequently, we believe that USAID encourages meaningful measurement more than other funders do, and perhaps more than its grantees would on their own (although it is difficult to know where grantees' priorities lie, as their ability to conduct measurement may depend on what a funder will pay for).
Cost-effectiveness. Using data from 13 projects, USAID estimates that the average cost per life saved across CSHGP projects is $1,235 (see Pg 83). This syncs with the independent estimates we have done of particular projects, and is about as cost-effective as our strongest finalists' programs.
Consequences for a donor
Considered on its own, the CSHGP program may be on par with our strongest finalists. From what we've seen, CSHGP projects appear to consistently save lives in ways that are cost-effective, comprehensive (i.e., addressing many needs in a community rather than focusing narrowly on one), and well-measured and documented.
We aren't sure exactly what consequences this has for a donor. One could take the approach of donating to a particular organization, with the stipulation that funds be used for a program along these lines, but we don't recommend this (see our reasoning on this general topic). One might also consider a donation to USAID itself; we have not done a thorough examination of how USAID works, and have little sense for how such a donation would be received.
For our part, we prefer to give without strings attached, to an organization that we have thoroughly evaluated and that appears excellent across the board. This approach gives us more confidence that unexpected changes (in funding, or in knowledge of the world's problems) will be responded to well. Our strongest finalists - PSI, PIH, and Interplast - fit this description, and are generally competitive with CSHGP in terms of the apparent quality of their programs (both design and cost-effectiveness); as a result, we have opted to focus on them.