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This is an archived USAID document retained on this web site as a matter of public record.
DIALOGUE
In this section:
First Person
Mission of the Month: Asia Regional Mission—Bangkok
Notes from Natsios
First Person
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Dr. Tole Frrenaj
Dina Cernobregu, USAID/Kosovo |
“As a mother, listening to your baby’s heartbeats
in the initial weeks of your pregnancy is the same as listening
to the first cry of your newborn baby. And as a doctor, by
listening I can monitor the development and heart condition
of the unborn baby.”
—Dr. Tole Frrenaj, Main Family Health Center, Kosovo,
commenting on USAID-donated medical equipment.
While pregnant with her third child, Dr. Tole Frrenaj heard
the unborn baby’s heartbeat for the first time. Several
months ago, Dr. Frrenaj, a pediatrician at the Family Health
Center in Gjakovë/Djakovica Municipality (named in Albanian
and Serbian, respectively), received equipment to monitor
her baby’s heartbeat as well as the heartbeats of her
soon-to-be patients.
A fetal Doppler instrument was donated to the health center
through a USAID project that is outfitting this Kosovo clinic
with much needed equipment and training health workers in
prenatal care.
Dr. Frrenaj is part of the Primary Health Care Team, a unit
that was established recently with help from the USAID-supported
Health Alliance Project, a joint venture of Dartmouth Medical
School, the American International Health Alliance, and the
Gjakovë/Djakovica Family Health Center.
She used a fetal Doppler instrument during her university
training, but never as a practicing physician. Now she performs
routine pregnancy examinations and also listens to the heartbeat
of unborn babies. This allows her to closely monitor changes
during babies’ early development and recommend treatment
based on the equipment’s findings.
With 35 deaths per 1,000 live births—a rate two to
three times higher than in neighboring countries—Kosovo
has one of the highest infant mortality rates in Europe. In
some areas of Kosovo, almost half of the infant deaths occur
before the baby reaches 27 days old.
* Dr. Frrenaj has given birth to a daughter since this
article was written.
Mission of the Month: Asia Regional Mission—Bangkok
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Woman runs water from a tap in Bali, Indonesia. USAID
has worked with local governments and utilities on increasing
tariffs.
USAID/Indonesia |
Challenge
Many countries around the world are threatened by a looming
crisis in water supply and management. The vast majority of
poor people without adequate water services live in Asia,
where some 830 million people lack access to safe drinking
water and more than 2 billion live without sewers to dispose
of wastes.
Through its regional mission based in Bangkok, USAID is
working with government officials, water and sanitation utilities,
and other donors to address the looming water crisis.
Innovative Approach
This summer marks the start of the Blue Revolution, a regional
program for water conservation and management; dispute settlement;
efficient use of water; and the development of alternative
sources of water in Thailand, Indonesia, Malaysia, Philippines,
and Vietnam.
USAID’s Regional Development Mission/Asia improves
access to clean water and sanitation, especially for the urban
poor.
In Indonesia, for example, the mission has worked with water
utilities to improve relations with local governments to ensure
much needed tariff increases.
In the Philippines, the mission works with cities to design
and install new low-cost sewer systems.
At the regional level, the mission works with the Southeast
Asian Water Utilities Network (SEAWUN), a network of water
supply and sanitation utilities and national water associations
that helps its members improve their services. Since 2002,
the mission has worked with the Asian Development Bank to
support the establishment of SEAWUN and assist with training
and full cost recovery programs.
Full cost recovery is at the heart of long-term sustainability
for water service providers and expanded access to water for
the poor, said Winston Bowman, program manager with the mission.
Financially strong utilities are efficient and provide good
service. This contributes to consumer satisfaction and increases
willingness to pay, he said.
Utilities achieving full cost recovery are in a better position
to expand access to the poor because they have resources to
invest and more effective management.
But achieving full cost recovery remains a significant challenge.
Political pressure against tariff increases is strong, operating
costs are high, poorly maintained pipes leak, and management
systems are weak.
Results
To identify strategies for achieving full cost recovery, USAID’s
regional mission in Southeast Asia and SEAWUN completed a
survey of 15 utilities in Indonesia, Malaysia, the Philippines,
Thailand, and Vietnam in 2004. Survey results showed that
maintaining good relationships with government, training core
staff, and offering customer-oriented services are critical
to achieving full cost recovery. Increasing revenues and cutting
costs requires reducing water losses; increasing tariffs;
improving metering; and minimizing power, labor, and other
costs.
These results were shared with government, financial, and
municipal water specialists for seven Asian countries in December
2004. As a result, the mission is now expanding its work on
promoting full cost recovery to support several new regional
programs, including a program to pair American and Asian water
utilities.
The mission’s support “to SEAWUN and other regional
initiatives provides a platform for sharing and replicating
experiences and technical innovations,” said Regional
Mission Director Tim Beans. “It also improves cooperation
between Asian countries, cities, and communities.”
Some 24 percent of USAID’s water and sanitation budget
for 2005 is spent in Asia and the Near East.
Notes from Natsios
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Andrew Natsios
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OMB Scores Agencies on Management Practices
As I have often said, good management practices are key to
effective development. The Agency has been working to improve
its management practices by working on the President’s
Management Agenda (PMA), which looks at five areas:
- strategic management of human capital
- competitive sourcing
- improved financial performance
- expanded electronic government
- budget and performance integration
Since 2002, the Office of Management and Budget (OMB) has
quarterly graded federal agencies using a color-coded scorecard.
Green means success, yellow means mixed results, and red means
serious flaws. OMB also measures the effort agencies put into
their management reforms with “progress” scores.
As of June 30, USAID had earned three yellow status scores
(budget and performance integration, expanded e-government,
and human capital) and received green for progress in all
other areas.
Last year, when USAID achieved yellow status for the first
time for performance and budget integration, OMB described
us as a “vanguard agency.” This was an important
recognition of our progress, largely attributable to the quality
of data collected for the Agency’s annual report over
the last two years.
USAID also moved from 21st place in FY 2003 to 9th in 2004
in the Mercatus rankings of federal agency performance and
accountability reporting. Our Agency was the most improved,
and we were recognized in four different areas for our efforts.
Clearly, these are positive signs. However, at the end of
the second quarter of this year, OMB downgraded the Agency
from a “green light” in progress toward improving
performance and budget integration to a yellow.
To achieve green light status in this area, we must meet
key budget and performance integration standards. We need
to regularly examine performance information and demonstrate
improvements in performance and efficiency, show the full
cost of achieving our performance goals, and direct program
improvements based on performance assessments.
The after-action review of the FY 2004 annual report is
currently underway, and will help the Agency determine how
effectively the missions and bureaus adopted the changes.
As the Agency continues down the path of improving its new
strategic planning, the information gathered in the annual
reports is essential, not only to achieve the efficiencies
inherent in the goals for the PMA, but also to improve the
Agency’s own management effectiveness.
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