At the start of UNGA week, I attended an event called “The Next Generation of Development: Integrated Investments for Youth.” There was basic agreement among the illustrious panel of experts, which included UN Women Executive Director Phumzile Mlambo-Ngcuka, Founder and Executive Director of the African Institute for Development Eliya Zul and U.S. State Department Special Coordinator for the Post-2015 Development Agenda Tony Pipa, that integrated development is the wave of the future we all need to see and support.
But a lot of questions were also left unanswered and require the serious input of everyone working in development to try to figure out some answers.
In general, “integrated development” refers to attempts to work across development sectors to bring more holistic programs to resource-limited settings. Integrated development programs could include components dealing with education, health, governance, policy, human rights and other areas, rather than work in just one sector.
Notably, there was a lot of talk at the event about “evidence.” At one point, the moderator, journalist Femi Oke, asked the panel what the evidence on the benefits of integrated development says. When panelists tried to answer mostly by discussing the difficulties of collecting evidence on the benefits of integrated development and various attempts to do so, Oke was not satisfied and replied, “But you didn’t answer my question–what is the evidence?”
It’s no wonder the panel didn’t have a straightforward response to this question; the evidence for integrated development approaches isn’t terribly extensive. This is not surprising given the fact that most development work currently takes place within well-structured siloes in health, education, human rights, etc. FHI 360 conducted a literature review earlier this year and identified 25 interventions in the published literature that met their definition of “integrated development” and their standards for sound study design. Of the 25 interventions, 13 produced positive findings, 9 produced mixed results, and 3 suggested a neutral or unknown effect.
The authors note that part of the lack of evidence has to do with the quality of existing evaluations. In fact, they observed that the vast majority of integrated development approaches occur informally without properly conducted evaluations. In many cases, for example, a health organisation may tack psychosocial support on to HIV treatment programs, but not adequately measure the specific effects of integrating psychosocial support into the more traditional healthcare-only program. A proper impact evaluation would require several comparison groups, including one that received HIV treatment but not psychosocial support. Very few organisations undertake such rigorous evaluations, even though this is the only way to answer questions about whether and when integrated development approaches are appropriate.
Making sure rigorous evaluations on integrated approaches are conducted is just the first step. How to measure outcomes with multiple approaches and sectors involved is an important topic for discussion. Even within specific sectors, such as global health, indicators and outcome measurements are not standardised. Across sectors, they are even less standardised. The wider development community needs to have an in-depth discussion about how to standardizssendicators, who develops these indicators,and how they can be utilised in widely differing settings.
These types of complex questions are what led Mlambo-Ngcuka to point out that that integrated development is not easy. Bringing stakeholders from different sectors together can be extremely difficult, and it requires time, careful planning and sustainable funding.
As she also noted, “Integrated development is not a panacea.”
This was certainly the most important take-away from the evening. There are situations in which specialists alone are needed. Smallpox eradication is an example of a single-sector intervention that was absolutely revolutionary.
Integrated development is going to become more and more prominent as the SDGs unfold because, at least in design, the goals in the SDGs are very interconnected and often call upon multiple sectors to work together to solve each problem, one of the key differences from the MDGs.
As we work within this new development framework, it will be important to push for the strongest possible evidence to guide us in our efforts to identify the best approaches and best interventions to advance human development.
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