Output –v- Outcome

[Russell Lewis]

The term “outcome” is probably the most misunderstood term in the International Development field.  Either that or it becomes the most misused term in international development and I would prefer to think it is the former rather than the latter, because the latter would imply an intent that serves no-one at all.

Mind you, the ID field is not alone when it comes to misunderstanding the term outcome.  To put it simply – if you produce something, that is an output.  An outcome occurs as a result of producing something, e.g. profit or improved service delivery.  Now some will contend that improved service delivery can be termed an output and that the result of improved service delivery is the real outcome – and I would agree with you – up to a point.  As most ID practitioners conduct training at some time, let me give the following case using training in Healthcare as an example.

1. Conduct a Performance Gap Analysis                            Output
2. Conduct a Training Needs Analysis                                Output
3. Design a course or courses                                            Output
4. Deliver a number of courses                                           Output
5. Train X participants                                                         Output
6. Y people apply skills in the workplace                             Output
7. Z extra people receive treatment                                    Output
8. Incidence of ABC disease reduced by xx%                    Outcome

Now some might argue that No 7 is an outcome and they would not necessarily be wrong, but to the purists, No 8 is the only outcome in the above series, provided that the desired result is a reduction in ABC disease.  If the desired result is an increase in life expectancy, then No 8 also becomes an output and the new No 9 is “Life expectancy of population increased by yy%.”  (Of course there would be other performance indicators and there should be timeframes etc.)

The conundrum is; the fact that all the outputs are achieved does not necessarily mean that the outcome has been achieved, nor does it mean that sustainable capacity has been built.  As a matter of fact, it is highly probable that there are other factors which may impact on whether or not the outcome is achieved.

Let’s assume for the moment that all of the outputs have been measured along the way and have met expectations.  It would be easy to presume that the ID advisors have been highly successful in their job – and they probably have been – up to the point that at this stage the outcome has not yet been met and I would contend, sustainable capacity has not yet been built.

It could be that the extra people being treated may not be given enough of the correct drugs, because there is insufficient supply due to mismanagement of procurement and logistics, which means that people develop a resistance to the appropriate drug, and the incidence of the disease actually increases.  And I would suggest that this is happening all too often across all of the ID sectors and it is happening because technical training and capacity building generally meets outputs, but for real sustainable capacity building which has the potential to meet outcomes, there must be consideration and capacity building of all of those essential underlying skills which empower people to reach their potential.

 

Part of the solution is to ensure that all parties develop a true understanding of outcomes and outputs so that programs can be properly constructed and delivered and meet their outcomes.

[Lucia Nass]

I could not agree more Russel. I have developed a tool called 'impact story', which helps development practitioners to monitor the effects of their (agreed!) interventions, and stay focussed on the (shared!) goal. People use it to update team members on the progress they have made. If you collect the stories over time, it can become an evidence base in your results measurement framework.

 

Impact story (result level)

1. (input) What I was doing last month with my client or group of clients…
2. (output) Why I think this will help the client to improve performance… (e.g. to provide more/better services, or to create more production/job opportunities for the poor) 
3. (outcome) Why I think this will enable the client to change the lives of the poor (women and men, excluded groups?)…
4. (impact) The evidence I’m beginning to see / collect of how poor people are changing their lives…

 

Client here means the local organisation(s) you are working with as development practitioner. I prefer clients over the more commonly used 'partners'. 'Clients' is an attempt to put local organisations more in the driver seat, eventhough they are often in the less powerful position of having to rely on others to pay for the capacity development services.