The value for money of leaving no one behind

At an event on disability inclusion a few weeks ago, one of the participants put up their hand and said: “this is all really interesting, and I understand why it is so important, but we are also being pushed more and more on value for money – how can we do both?”

This conflict is felt throughout the development community. On one hand, the Sustainable Development Goals pledge to leave no-one behind, but on the other the focus on value for money is growing. The apparent conflict between these two objectives puts the Sustainable Development Goals’ ambition to leave no-one behind at risk.

We frequently encounter this challenge in our work on disability. Suppose you’re designing an education programme and you want to, ‘ensure equal access…including [for] persons with disabilities’ (SDG 4.5). This takes dedicated resources, such as the costs of identifying children with disabilities who are out of school, of training teachers in inclusive practices and of providing practical adjustments like materials in Braille or assistants for learners with deaf-blindness.

Scoring this programme against a narrow definition of value for money – one that looked simply at the cost per beneficiary reached – would suggest it was poor value for money.

But this isn’t how value for money has to be.

Such a narrow view misses the bigger picture. Most importantly, the human rights benefits of ensuring quality education is accessible for everyone, but also the wider social and economic benefits of inclusive education for children with disabilities, their caregivers and their communities.

Published guidance, including from DFID and ICAI, recognises that value for money is much more than simplistic comparisons of unit costs. But this guidance has not always been translated into practice. There is little literature on what ‘leave no one behind’ means for the way that development actors approach value for money.

Without the knowledge of how to ensure that value for money leaves no-one behind, it is too easy for development actors to fall back into the trap of looking purely at cost per beneficiary.

A new paper

Today, the Bond Disability and Development Group has published a new paper on the value for money of leaving no-one behind, which we hope goes some way to filling this gap, using disability as a lens.

The paper argues that – in the era of ‘leave no-one behind’ – no intervention can be considered value for money unless it includes people with disabilities. And crucially, no value for money assessment should ignore the views of people with disabilities on what they themselves consider to be valuable.

The paper also recognises that, just because an intervention is disability-inclusive, this doesn’t automatically make it good value for money. Development actors have a responsibility to ask themselves if they could achieve the same inclusive outcomes for less money – or better inclusive outcomes for the same money.

Our paper proposes one practical way to approach this, with a simple set of questions that combine qualitative and quantitative data, and can be applied across different contexts. The questions map to the traditional value for money framework of economy, efficiency, effectiveness and equity – and particularly emphasise that equity, the extent to which interventions reach the poorest and most marginalised, should be seen as a core issue in all value for money assessments.

Measuring value for money in inclusive programmes is a huge field, and our proposals are just one of many possible approaches. Members of the Disability and Development Group, and of the Bond value for money community, have developed a range of tools to suit their different circumstances.

And we believe that’s the key. Precisely because little has been written on value for money in the context of leave no-one behind. There’s an opportunity to challenge old, simplistic, methodologies by developing innovative value for money solutions, and sharing learning, to drive the conversation forward in an inclusive way.

The global development agenda is rapidly evolving to become more equitable and inclusive: it’s essential that global thinking on value for money doesn’t get left behind.