Whole of government approaches to accelerate adolescent success: efficiency and financing considerations.

Journal: Health policy and planning

Volume: 39

Issue: 2

Year of Publication: 2024

Affiliated Institutions:  School of Economics and Finance, University of the Witwatersrand, Jan Smuts Avenue, Braamfontein, Johannesburg, Gauteng , South Africa. Centre for Rural Health, University of KwaZulu-Natal, Masizi Kunene Road, Durban, KwaZulu-Natal , South Africa. Department of Social Policy and Intervention, University of Oxford, Wellington Square, Oxford OX ER, United Kingdom. Health Psychology Unit, Institute of Global Health, University College London, Rowland Hill Street, London NW PF, United Kingdom.

Abstract summary 

The multiple domains of development covered by the Sustainable Development Goals (SDGs) present a practical challenge for governments. This is particularly acute in highly resource-constrained settings which use a sector-by-sector approach to structure financing and prioritization. One potentially under-prioritized solution is to implement interventions with the potential to simultaneously improve multiple outcomes across sectors, what United Nations Development Programme refer to as development 'accelerators'. An increasing number of accelerators are being identified in the literature. There are, however, challenges associated with the evaluation and implementation of accelerators. First, as accelerators have multiple benefits, possibly in different sectors, they will be undervalued if the priority setting is conducted sector-by-sector. Second, even if their value is recognized, accelerators may not be adopted if doing so clashes with any of the multiple competing interests policymakers consider, of which efficiency/social desirability is but one. To illustrate the first challenge, and outline a possible solution, we conduct a cost-effectiveness analysis comparing the implementation of three sector-specific interventions to an accelerator, first using a sector-by-sector planning perspective, then a whole of government approach. The case study demonstrates how evaluating the cost-effectiveness of interventions sector-by-sector can lead to suboptimal efficiency rankings and overlook interventions that are efficient from a whole of government perspective. We then examine why recommendations based on a whole of government approach to evaluation are unlikely to be heeded. To overcome this second challenge, we outline a menu of existing and novel financing mechanisms that aim to address the mismatch between political incentives and logistical constraints in the priority setting and the economic evaluation evidence for cost-effective accelerators. These approaches to financing accelerators have the potential to improve efficiency, and in doing so, progress towards the SDGs, by aligning political incentives more closely with recommendations based on efficiency rankings.

Authors & Co-authors:  Desmond Chris C Watt Kathryn K Rudgard William E WE Sherr Lorraine L Cluver Lucie L

Study Outcome 

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Statistics
Citations : 
Authors :  5
Identifiers
Doi : 10.1093/heapol/czad112
SSN : 1460-2237
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Development financing;accelerators;decision-making;economic evaluation;policy evaluation;research to policy;resource allocation
Study Design
Case Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
England