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Demonstrating Performance: A Primer for Expenditure Reviews (June 2008)

Condition #6: Reach and Influence the Groups that Interventions Must Affect

Maximum benefit occurs when interventions reach and change those most in need. Failure to deliver output on target flags a major performance problem. Even if output was delivered well in all other respects, impact will be reduced if coverage is poor.

Coverage really matters. Producing output does not improve outcomes. Output must reach the groups or area where needs exist (see #1). Eg, to protect victims, regulation must affect those who are not inclined to self-regulate. Literacy programmes must reach the illiterate, education must reach the uneducated, food reach the hungry, etc.

Coverage is crucial in assessing interventions designed to promote equity or access. Coverage is often critical in risk management (eg, road safety; preventative) outputs.

The good news is that coverage can be assessed easily, cheaply and very quickly, if:

  1. output specifications clearly identify who should receive what (‘conditions of entry’)
  2. records are kept of who did receive output, and how they met entry conditions.

When coverage is good, leaders know quickly that delivery is on target, and a major prerequisite to achieving results has been met. When coverage is variable or poor, analysis may help leaders identify where, and ways in which delivery can be improved.

Management objectives shape how coverage is reported. Common measures show:

  • how many receiving output met entry criteria (objective: allocative efficiency)
  • how many meeting entry criteria actually received output (rightsizing; access)[4]
  • numbers in queues exceeding different levels of need (rightsizing; rationing).
Efficient Targeting of Rehabilitative Programmes

Remember that improving output distribution can improve outcomes in critical areas:

  • Coverage of interventions should be clearly stated and explained in specifications.
  • Arguments for broader (and tighter) coverage depend on need and proven effectiveness.
  • Scope may exist to manage costs using tighter allocative principles and entry criteria.
  • Good coverage is a precondition for both effectiveness and cost-effectiveness.

Notes

  • [4]The literature details several simple ways of reporting on Type 1 and Type 2 coverage issues, e.g. for the UK’s Sure Start family assistance programmes (www.beacon-dodsworth.co.uk/allocative efficiency.pdf)
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