Recientemente, los gobiernos, organizaciones internacionales y ONGs han estado más interesadas en fortalecer los vínculos entre ayuda para desarrollo y desempeño. Por ejemplo, toda la ayuda que da la U.S. Millennium Challenge Corporation está explícitamente condicionada al cumplimiento de 17 indicadores de buena gobernanza, desde libertades civiles a tasas de vacunación y tasas de educación primaria de niñas. Aunque condicionar la ayuda con el desempeño puede crear incentivos para mejorar el esfuerzo ymovilizarrecursos adicionales, puede tener ciertos riesgos, como problemas de tareas múltiples o cuando el esfuerzo es puesto sólo en los indicadores clave, comprometiendo otras actividades. También existe el riesgo que la ayuda a base del desempeño haga que los presupuestos sean redireccionados a proyectos con más recursos o a zonas con mejor desempeño.
In 2007, the Government of Indonesia launched Generasi (the National Community Empowerment Program— Healthy and Smart Generation), a community block grant program to improve health and education in rural villages. Generasi provided communities with funds they could use for any purpose—from hiring extra midwives to opening new schools—that would improve health and education as measured by twelve performance indicators (see box below). Villages elected eleven-member management teams to conduct social-mapping exercises, participate in discussion groups, and consult with health workers and teachers to decide how to spend the funds.
Generasi targeted twelve indicators that donors chose as key markers of progress towards long-term improvements in health and education:
Health | Education |
Prenatal care visits | Primary school enrollment |
Distributing iron tablets to pregnant women | Primary school attendance |
Childbirths with trained midwives | Middle school enrollment |
Postnatal care visits | Middle school attendance |
Immunizations | |
Consistent infant weight gain | |
Monthly weight checks | |
Distributing vitamin A pills to children |
To measure the impact of community block grants and the additional effect of incorporating performance incentives, researchers randomly assigned 264 subdistricts, each with about twelve villages, to one of three groups:
Group | Number of subdistricts | Grant | Details |
Comparison group | 83 | No grants | |
Unconditional grants | 88 | Community block grants | Grant amounts were based on the number of potential beneficiaries—pregnant women and children—in each village. |
Incentivized grants | 93 | Community block grants | In the first year, grant amounts were based on the number of potential beneficiaries in each village. Subsequently, 80 percent of funds continued to be divided among villages according to the number of beneficiaries. The remaining 20 percent of funds allocated to each subdistrict formed a bonus pool, which was split among villages according to performance on the targeted indicators. Researchers surveyed households, village leaders, healthcare providers, and school officials 1.5 and 2.5 years after Generasi began. They collected information on the targeted indicators as well as long-term health and education outcomes, including childhood malnutrition and test scores. |
Researchers surveyed households, village leaders, healthcare providers, and school officials 1.5 and 2.5 years after Generasi began. They collected information on the targeted indicators as well as long-term health and education outcomes, including childhood malnutrition and test scores.
Análisis de Costo-Efectividad:El desafío en calcular la costo-efectividad del programa es que hay varios resultados posibles. Por esto, los investigadores calcularon los beneficios totales del programa como el número total de "puntos extra" que el programa creaba, utilizando la escala asignada a cada uno de los 12 indicadores para medir desempeño por comunidad. Los investigadores calcularon que el programa Generasi generó un punto extra adicional por cada US$8-US$11. Al traducir esto a resultados, esto quiere decir que el costo de prevenir que un niño sea desnutrido es de US$384-US$528 y el costo de matricular a un niño adicional en la escuela es de US$200-US$275. Cuando los costos adicionales del desempeño son aislados, el costo de los incentivos mismos viene a ser de US$0.60 por punto (US$29 por cada caso adicional de malnutrición prevenido). Esto sugiere que aunque el programa en sí no es particularmente costo-efectivo, proveer incentivos es una forma de hacer un programa de subvenciones normal más costo-efectivo. Agregar incentivos a programas de subvenciones ya existentes puede ser una forma costo-efectiva de mejorar la efectividad de la ayuda para el desarrollo.