all the president’s men

…Museveni has increasingly become a drag on the ability of the country to move to the next state of consolidation. He has stabilised the political dispensation, sustained growth, tamed the army, facilitated the growth of a large and diversified private sector, a large and educated middle class and thereby laid the structural foundations for transformation. Yet his politics has remained unchanged in the face of this structural change, largely pandering to old social forces and unable to bring the new ones to the centre of his politics.

The political crisis in Uganda is therefore a product of the tension between an emerging new society and the prevailing political institutions and practices. If Museveni has successfully modernised Uganda, his biggest failure has been inability to modernise his politics.

That is Andrew Mwenda writing in the East African this week on how Museveni’s success is bringing him down. I largely agree with his analysis, but I think the role of those surrounding the president has been somewhat underplayed.

There has been a lot of hoohahing about the spilling of beans by the likes of John Nagenda, among many others, courtesy of Wikileaks. I personally enjoyed the final paragraph of Nagenda’s Saturday column (I can’t seem to find it on the New Vision website, which could use a redesign):

When I recall the whiskey-fuelled nights with various Ambassadors, Good God I shudder to imagine when and how I will be leaked!

All of this should tell us that many would-be advisors of the President are for whatever reason unwilling or unable to be frank with Museveni. Management of information to and from government, and the presidency in particular, is riddled with the same corruption and incompetence as is pervasive elsewhere. Who is the winner in this situation?

Perhaps Museveni’s success, as Andrew notes, is in many ways a major contributor to his demise. But many of those who surround him haven’t helped him “modernize his politics” either.

Impact evaluation and RCTs in health

I am currently working on a proposal for a pilot of performance-based contracts (PBC) in Uganda’s health sector, and have been busy navigating the literature out there. Fortunately for me, there is also a lot of discussion on randomized controlled trials (RCTs) and impact evaluation in the development blogosphere of late.

Today I’ve been reading “Performance Incentives for Global Health,” published by the Center for Global Development, and available for purchase or downloadable chapter-by-chapter here. It has proven very useful so far in helping me think through the various ways in which PBC pilots could be designed. In Chapter 5, A Learning Agenda, the authors write:

Impact evaluation is more than a tool for gauging impacts at the end of a program and providing the inputs into a cost-effective analysis. It can also help a program to evolve. For example, in the initial phase of a pay-for-performance program, three contracts with different risk levels can be piloted. Based on the results from an early evaluation, the most effective contract can be scaled up. Several parameters lend themselves to this kind of experimentation, including the relative effects of supply versus demand interventions, the level of rewards offered for performance, and the balance of trade-offs between access and use.

Rwanda is often noted as a pay-for-performance (P4P) success story, and Chapter 10 is devoted to this case study. The original study by Basinga et al. (2010) is available here (and co-authored by Rwanda’s current Minister of Health, Agnes Binagwaho, also available at @agnesbinagwaho). The authors find that P4P has a significant effect on the number of deliveries in health facilities, quality of prenatal care, and number of preventive care visits for children, but they find no effect on the number of prenatal care visits or immunizations.

In Uganda, a similar pilot, this time of private-not-for-profit (PNFP) facilities, found no effect of bonuses on health facilities’ performance in achieving self-selected health targets. They did find that financial autonomy improved health facilities’ performance, however. The study, “Contracting for Primary Health Care in Uganda”, remains an unpublished World Bank manuscript, as far as I can tell (publication bias at work), but the slides from the 2007 CGD presentation are available here.

I’d like to examine the effect of PBC on health outcomes in the public rather than PNFP sector (hopefully using a few variations of the contract “treatment”), as well as better understand why performance-based pay (in the form of bonuses) did not seem to have an effect on health outcomes in the Uganda pilot. Finally, I am interested in understanding the relative efficacy of supply-side (such as PBC) vs. demand-side (such as conditional cash transfers) efforts in improving various health outcomes. More updates on this to come.

new global development site

New global development website over at the Guardian. According to the press release:

“The Guardian today has launched a new website in partnership with the Bill & Melinda Gates Foundation to help focus the world’s attention on global development. The site will provide a new space for discussion and interaction on the biggest challenges affecting the lives of billions of people across the developing world, including poverty, hunger, infant mortality, adaptation to climate change and economic development.”

The site itself can be found here. I haven’t explored much yet, but so far the datastore looks particularly interesting…

What do people care about?

I love knowledge for the sake of knowledge, but as I embark on this five-year journey otherwise known as grad school, one thing I don’t want to do is get stuck inside, both literally and figuratively. Literally, I don’t want to see the sky for only 20 minutes a day on the walk to and from the car, and figuratively (and more importantly), I don’t want to get stuck in a world where only other academics or econ-y types find my work interesting/palatable/intelligible. This has been on my mind a lot recently as I have been trying to home in on a specific research question for my first major research project/paper (which I will hereafter refer to as a field paper). I can think of lots of research questions, but certainly not all of equal pertinence to the lives of ordinary people. Which got me thinking, what would be of most pertinence? I am not a doctor, I am not a teacher (yet, anyway), I am not a civil engineer…there are many things I can’t do to improve people’s lives. So what can I do? Well, hopefully (and this is the goal anyway, I think), I will be able to provide some small insight or suggestion to help solve problems people care about.  So what do people care about?

Since Uganda is mostly on my mind, I remembered a recent Afrobarometer survey asked exactly this question. Ok, not exactly. The exact question was, “What are the most important problems facing this country that the government should address?” The answers? (according to % of people who listed this concern first)

Poverty/Destitution: 43%

Unemployment: 28%

Health: 27%

Food shortage: 20%

Infrastructure/Roads: 20%

Seems pretty obvious in retrospect. But what wasn’t in the top 5? Democracy/Political Rights (3%), Orphans (2%), Political Instability/Ethnic Tensions (2%), International War (0%), AIDS (5%), and Inequality (2%), among others. Less obvious now, right? This is not to say that no one cares about these things, just that they are not the most important things for most people. Of course these things are also related to the above “most important problems”, and it could be that democracy (or something else) will solve all of these problems (I am skeptical though). Still, I think it’s always good to keep in mind what people are struggling with on a daily basis even while trying to figure out what’s up with democratic peace (for example).

Now, back to that field paper…

Afrobarometer Global Release

First of all, Happy Africa Day (yes, it is today, however underpublicised it may be). It was a good day for Afrobarometer to launch their Round 4 Results for surveys they have been conducting in 19 countries across the continent. I attended the Kampala release event today at the Serena Hotel, where Robert Sentamu of Wilksen Agencies delivered a presentation of the main findings, covering such topics as: democracy and regime consolidation, poverty reduction, globalization and cosmopolitanism, and the emergence of democratic citizens. Afrobarometer is a fantastic resource for scholars, journalists, civil society, political parties, and anyone else interested in public opinion, advocacy, policymaking, etc.

My one qualm with the findings of this release is that they paint a rather biased view of democracy and related issues in Africa. Why? Because Afrobarometer does not carry out surveys in countries where they have reason to suspect citizens will give “politically correct” answers for fear of repercussions by the state (i.e. Rwanda). This obviously leads to selection bias — the countries where citizens are/feel “more free” to say what they really think are also probably more likely to be more democratic. Excluding those countries where citizens are not free probably paints an overly optimistic picture of democracy in Africa as a whole. Nevertheless, the findings of the release are very useful (particularly for each individual country) and quite intriguing.

So what are the key findings?

On Democracy:

The 20 African countries included in the Afrobarometer include many of the most politically liberal countries on the continent, including 7 countries ranked by Freedom House in 2008 as “Free.” However, when we assess the quality of these regimes based on popular attitudes and perceptions, we do not find any consolidated democracies among them (although Botswana comes close). In fact, we find some consolidating as autocracies, but most countries are best understood as unconsolidated, hybrid regimes. They exhibit some key elements of democracy, such as regular elections and protection of core individual freedoms. But either the popular demand for democracy, or the perceived supply of democracy, or, in most cases, both, fall short of the standards of full democracy. But the trajectories of individual countries are extremely diverse, with some exhibiting sharp declines away from democratic consolidation, while others are steadily advancing.

On Poverty

Even with the significant growth that sub-Saharan Africa has experienced over the past decade, as of 2008 lived poverty (or the extent to which people regularly go without basic necessities) is still extensive. It has declined in nine of the Afrobarometer countries for which we have over-time data during this period, but it has increased in another six. Cross-national differences in economic growth help explain differing country trajectories in lived poverty. But a more complete picture must also take political freedom into consideration. Lived poverty is strongly related to country-level measures of political freedom, and changes in poverty are related to changes in freedom. This finding supports Sen’s (1999) argument about the crucial importance of freedom for development. Using our alternative measures of both development and democracy, we corroborate the findings of others that there is a “democracy advantage” for well being and prosperity.

See more findings and related articles/papers from the Afrobarometer website here.

Following the main presentation, Managing Editor of the Daily Monitor, Daniel Kalinaki, made a thoughtful and eloquent presentation on the Ugandan context (excerpt follows):

As we head towards the next election in 2011, we find ourselves at a crossroads. We can choose to continue the personality-driven winner-takes-it-all political model where we have an election and petition every five years and then let our MPs and other politicians sleep on the job as long as they wake up and vote for their parties. Alternatively, we can choose a bi-partisan approach that puts Uganda first, that allows free and open debate about our burning priorities and how to achieve them, and which puts power back in the hands of the people.

Asking the politicians to decide which model to adopt is, like an African saying goes, asking the monkey to decide whether the forest should be cut down. It is up to the people to demand this right to be heard and served. The Afrobarometer survey and others like it help provide a reality check for our countries and provide useful information that can be used by the media, civil society, and progressive political groups to empower the public.

At the end of the day, however, the responsibility falls on every individual to inform themselves and others, in order to build political awareness and a critical mass of interested and involved publics who can mobilise, organise, demand and receive what is fairly due to them.

You can read the complete version on Kalinaki’s own blog.

Look out in the daily papers for more articles on the Afrobarometer surveys in the coming days…

No one cares about our nations more than we do

We appreciate support from the outside, but it should be support for what we intend to achieve ourselves. No one should pretend that they care about our nations more than we do; or assume that they know what is good for us better than we do ourselves. They should, in fact, respect us for wanting to decide our own fate.

Says Kagame in his op-ed last week in the Financial Times.

While I am concerned that certain individuals high up in the echelons of power actually care about themselves far more than their nations, I agree wholeheartedly with Kagame’s sentiment. Especially the bit about supporting a country’s own priorities, whether they be in health, education, infrastructure, etc., and not simply making up your own.

I wrote about donor distortions to Uganda’s health sector in this week’s Independent. I don’t think many U.S. taxpayers, for example, realise that they are contributing more to fighting HIV/AIDS in Uganda than the Ugandan government is contributing to Uganda’s health sector in its entirety. This is unacceptable on a number of levels. The current state of affairs is not the fault of only one party, but the donor/recipient relationship will never be equal and those involved should act/think accordingly, political correctness of “partnership” notwithstanding.

Debating Rwanda

Starting a conversation about Rwanda is like a box of chocolates, you never know what you’re gonna get. Observers of the small East African nation are often polarized in their views of the country’s governance — either President Paul Kagame is an inspirational genius getting things done in a country that was hacking itself to death just 15 years ago, or he is a brutal dictator, quashing the opposition, press and anyone else who threatens his power or so much as mentions the words “Hutu” or “Tutsi”. Whichever side you take, it is nearly impossible to talk about Rwanda without talking about Kagame. Because for many, Kagame = Rwanda (which is not to suggest that this is the way he would want to be perceived).

During the 15 year commemoration/remembrance of the 1994 Rwanda genocide last week, there were a flurry of articles and blog posts written on the subject, some applauding and others criticizing Rwanda’s current government. You could almost wonder if you were reading about the same country while reading two articles like VOA’s “Rwanda Gacaca Criticized as Unfair for Genocide Trials“, and then “Rwanda 15 Years On” by Josh Ruxin, director of Rwanda Works and Columbia University public health expert.

Meanwhile, human rights organizations have also been hard at work to publicize their own assessments. Human Rights Watched published a news story last week titled, “The Power of Horror in Rwanda” in the Los Angeles Times and lists many more country reports here. In their 2008 Annual Report on Rwanda, Reporters Without Borders wrote: “Appalling relations persisted between the government and a section of the independent press, especially the more highly critical publications…”

If you talk to journalists and some members of the diplomatic community in Uganda, you will hear stories of journalists being deported from Rwanda, picked up at their offices and driven to the airport without time to even collect their belongings, you will hear of the arrest of those who speak critically of the government, you will hear of those who have fled the country to escape imprisonment…you will even hear of those who have been disappeared. I cannot speak the truth or accuracy of any of this. What I have heard are second, third or fourth hand accounts.

What I have experienced first-hand is Rwanda (and specifically Kigali) today. I have visited government officials in their brand new office buildings, I have driven (been driven) on smooth roads, I have run on clean sidewalks and walked alone at night without fear, I have seen how patients are treated with care (and medicine…and new machines) in Kigali’s main referral hospital, I have met with investors and seen plans and blueprints for beautiful hotels and resorts around Rwanda. And I was impressed by it all.

This is not to say that everything in Rwanda is hunky dory everywhere all the time. Rwanda is a very poor country, with fewer resources and human capacity than Uganda, Kenya or Tanzania (in fact the country is soaking up talent from all over the world in its hospitals, universities, etc). Many people are concerned about what will happen in the next 5 or 10 years. They wonder whether Kagame will step down, or if he will become like so many African leaders before him, refusing to relinquish power. Being the optimistic person that I am, I of course am leaning towards the former. But these are critical years for Rwanda. These are the years in which systems, institutions, and capacity must be built if peace and development are to continue in an era post-Kagame or even post-RPF.

What I can say is that it is almost impossible (if not entirely impossible) to put oneself in Kagame’s shoes. He has and will make mistakes, as any leader will do. But I think as outside observers to Rwanda’s development we should ensure that in being critical, we are not unwittingly being hypocritical instead.

Rwanda Rising

Nobody likes to say “No, Mr. President.” So three years ago, when Costco CEO Jim Sinegal got a call from shareholder Dan Cooper, a partner in Chicago’s Fox River Financial Resources, asking if he’d have lunch with Rwandan president Paul Kagame, he agreed. That meeting in New York led to a presidential stop at Costco HQ near Seattle. Which led to Sinegal’s promise to visit Rwanda. “I made it in a moment of weakness,” he says, “before I realized how long it takes to get there.” He ended up taking his whole family, and today Costco is one of the two biggest buyers of Rwandan coffee beans — about 25% of the country’s premium crop, by Sinegal’s estimation. Without Cooper’s introduction, “no way would this have happened. I knew the Rwanda story, but I wasn’t intimately involved,” Sinegal says. “It took more elbow grease to get this started up, but it has been very profitable. Good for us and good for them.”

From the article in Fast Company magazine that CEO of Rwanda Development Board, Joe Ritchie, had mentioned in our interview last week in Kigali. Fortune magazine also addresses the issue of why CEOs love Rwanda.

Why Businessmen (and women) flock to Rwanda

When you think of Rwanda, if you think of genocide, you should think again. Not that we should forget the horrors of 1994, but Rwanda is moving on — and it wants your investment and tourism, not your sympathy.

Though it is difficult to rebrand the country (especially after movies like Hotel Rwanda), the government is certainly working hard to do so, and investors are listening. One way Rwanda has made business easier for investors is by creating the Rwanda Development Board (RDB). This is a new institution, essentially combining 8 previously independently existing organisations: the Rwanda Investment and Export Promotion Agency (RIEPA); the Rwanda Office of Tourism and National Parks (ORTPN); the Privatization Secretariat; the Rwanda Commercial Registration Services Agency; the Rwanda Information and Technology Authority (RITA); the Center for Support to Small and Medium Enterprises (CAPMER); the Human Resource and Institutional Capacity Development Agency (HIDA); and the Rwanda Environmental Management Authority (REMA).

While in Rwanda, I spoke to Clare Akamanzi, the Deputy CEO in charge of Business Operations and Services at RDB, as well as their new CEO, Joe Ritchie. Mr. Ritchie is the co-chairman (with President Kagame) of the Presidential Advisory Council (PAC), which hosts quite an impressive team of advisers, from Michael Porter to Rick Warren to John Rucyahana to Donald Kaberuka.

Through enhanced coordination at RDB one can now register a business in Rwanda in a record 2 days!

I will be posting the interviews with Joe and Clare after they have been published in the Independent.

This Week: Oil Roundtable

It’s official. Uganda has oil.

But how much and what kind? What does it mean for Uganda’s future? Who is calling the shots? Will it boost development, or will the oil curse strike again?

For answers to these questions and more, please attend a groundbreaking roundtable on Uganda’s oil sector, sponsored by Kampala-based think tank Fanaka Kwa Wote and the U.S. Embassy Kampala.

What: Oil Roundtable
When: Thursday, March 19th, 9:30am to 12:00pm
Where: Protea Hotel, Acacia Road, Kampala
Who: Panel of experts and interested parties, including:

Professor Jacqueline Lang Weaver, University of Houston
Mr. Stephen Birahwa, MP Buliisa and Member of the Committee on Natural Resources
Mr. Brian Glover, Managing Director of Tullow Oil
National Environmental Management Authority
Uganda Ministry of Energy and Mineral Development
Uganda Ministry of Finance, Planning and Economic Development

Moderated by Managing Editor of The Independent, Andrew Mwenda.