In the aftermath of the invasion of Afghanistan, the US Agency for International Development supported the Afghan Ministry of Public Health to deliver basic healthcare to 90 percent of the population, at a cost of $4.50 a head. The program played a vital role in improving the country’s health; the number of children dying before the age of five dropped by 100,000 a year. But accounting standards at the Ministry of Public Health concerned the US Special Investigator General for Afghanistan. There was no evidence of malfeasance, nor argument about the success of the program. For all that the results were fantastic, receipts were not in order. The investigator called for the health program to be suspended because of “financial management deficiencies” at the ministry.
Results Not Receipts: Counting the Right Things in Aid and Corruption explores how an important and justified focus on corruption is damaging the potential for aid to deliver results. Donors treat corruption as an issue they can measure and improve, and from which they can insulate their projects at acceptable costs by controlling processes and monitoring receipts. But our ability to measure corruption is limited, and the link between donors’ preferred measures and development outcomes is weak. Noting the costs of the standard anticorruption tools of fiduciary controls and centralized delivery, Results Not Receipts urges a different approach to tackling corruption in development: focus on outcomes.