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

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

Health Policy Plan

Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, Oxford OX1 2ER, United Kingdom.

Published: February 2024

AI Article Synopsis

  • The Sustainable Development Goals (SDGs) create complex challenges for governments, especially in resource-limited settings where a sector-by-sector financing approach dominates.
  • A promising solution is to implement "development accelerators," which can simultaneously benefit multiple sectors, though their evaluation and adoption face difficulties.
  • A cost-effectiveness analysis reveals that sector-by-sector evaluation can misjudge the efficiency of interventions, and overcoming these challenges requires innovative financing mechanisms that align political incentives with evidence-based prioritization of accelerators.

Article Abstract

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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11020293PMC
http://dx.doi.org/10.1093/heapol/czad112DOI Listing

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