Targets and indicators in World Bank population projects

In reviewing World Bank evaluations of the impact of population projects, the author explains the nature and uses of four families of performance indicators. Two measure inputs: Project implementation indicators, which are project-specific, are the principal measures used in Bank supervision. They measure success in creating sources capable of conducting certain desired activities. Process (or activity) indicators measure performance of a project's intended activities but tell nothing about the yield or output of those activities. Two measure output: Performance (or intermediate-output) indicators measure the yield or output-performance of a project or program. For family planning, the principal indicator in this category is acceptor figures, normally with details about methods used plus the age, parity, and geographical distribution of acceptors. Quality may or may not be good and coverage may or may not be comprehensive. These indicators do not directly measure ultimate demographic impacts - lower fertility and slower population growth. Demographic outcome (or impact) indicators do measure demographic impacts, usually the contraceptive prevalence rate and age-specific and total fertility rates. One can use a desired value of any comparator as a target, but a target is only one possible comparator. Two more widely used comparators for family planning are trends (comparing current with past performance) and international performance (an external comparison). The author recommends strengthening the Bank's use of world (successful developing country) standards and of trend analysis rather than increasing its use of target setting. The Bank's primary interest is normally the performance of the borrower's national program, so more attention should be given to program-level rather than to project-level performance - except for pilot projects. The author recommends: that the Bank standardize its terminology about these four families of indicators; that the Population and Human Resources Department periodically prepare comparator tables and graphs for use in Bank project and sector reports; that the Bank discontinue Project Performance Audit Reports on population projects, as they seldom add much to information and judgments contained in Project Completion Reports - the money saved could be applied to more effective evaluation research; that operational staff show more concern for a program's contraceptive mix; that more attention be paid to a program's service quality; and that the use of demographic and health surveys be the rule, not the exception, in Bank population and health projects.