
Sounds logical right? Then why do so few companies measure the ROI and impact of their corporate social responsibility (CSR) initiatives with the same level of rigor? That is the question on the mind of Dr. Jeffrey L. Sturchio, CEO of Rabin Martin, a global health strategy consulting firm that helps a wide range of clients in the biopharmaceutical industry with initiatives in global health and CSR. I sat down with Jeff recently to chat about the importance of measurement in CSR and who is leading the way.
MK: Why is it so critical to measure the
outcomes of corporate social responsibility (CSR) initiatives? Aren’t they
“doing good” by their very nature?
JS: Whether you are working on the CSR or commercial side
of business, you must think carefully before you start (a project) about what
you’re trying to accomplish. No self-respecting business would think of
operating without having financial metrics in place to be able to tell if their
sales and marketing efforts are achieving targets or if their people are meeting
their objectives. It should be the same in CSR: Are your CSR programs helping
you to accomplish what you are trying to do? Are social business initiatives
delivering on intent?
It should be accepted practice in CSR to design a
monitoring and evaluation (M&E) framework for every project. This shows that
you have the same discipline and rigor that the other parts of the business do.
It demonstrates you are serious about the work. And it allows you to speak the
same language as the other decision makers in the company in terms of ROI and
impact. If you can monetize the work you are doing, you can go to leadership with
a persuasive case for additional resources to invest.
Another reason effective
measurement is so important is that it’s the only way you will know if a
program is well-designed and to allow for mid-course corrections when needed.
What you expect to happen when you design a project will rarely be what actually
happens when implemented. But if you have an M&E framework, you can see if
you are on track or not and the information allows you to adjust. One company
that is doing this well is Novartis (see sidebar below).
Another is Merck with Merck for Mothers (MfM), an initiative
launched in 2011 to help eliminate preventable maternal mortality
worldwide. (Rabin Martin has worked
closely with MfM since the outset.) Last
year, Merck for Mothers published its
first Research
Compendium with links to more than 100 publications it has supported over
the past six years. The questions these publications explore and the answers
they uncover have been invaluable in informing the initiative’s work. It only
resulted because there was a strong M&E framework at the project level from
the beginning.
Measuring Impact: Novartis Access Program: One company that has put a rigorous M&E
framework in place to measure the outcomes of its CSR efforts is the Swiss
pharmaceutical giant Novartis. It is working with Boston University to evaluate
the impact of Novartis Access, which offers a portfolio of
non-communicable disease (NCDs) medicines at a price of US$1 per treatment per
month to public and NGO customers in low-income and middle-income countries. Starting in 2016, study investigators conducted
a cluster-randomized controlled trial in eight counties in Kenya. As presented in the Lancet
Global Health
earlier this year, results from the initial baseline showed that “after 15
months, [Novartis Access] had a positive effect
on availability of amlodipine and metformin at facilities, but had no effect on
availability of the other medicines in the Novartis Access portfolio.” It noted, however, that “access programs
operate within complex health systems and that reducing the wholesale price of
medicines might not always or immediately translate to improved patient access.
The evidence generated by this study will inform Novartis's efforts to improve
their program going forward. The study also contributes to the public evidence
base on strategies for improving access to medicines globally.”
MK: How do you see
most companies measuring their CSR programs today?
JS: Too
many companies spend millions of dollars on programs and hardly anything on
measuring impact. That can result in throwing good money after bad if you
expand a program that isn’t actually working. Instead, people talk vaguely
about how important a project is and that it will ultimately be good for the
company’s reputation. But they can’t be exact about the extent to which the
program is helping its intended beneficiaries or talk about the timeline for a
reasonable return on investment. This
lack of precision about ROI puts CSR executives at a disadvantage to their
business colleagues when senior management has to make decisions about resource
allocation.
MK: But companies are
reporting to some degree on their CSR programs, aren’t they?
JS: Yes, but most CSR metrics focus on inputs – e.g., how much money did we
invest? Some companies go further to look at outputs – e.g., how many products did we distribute, how many
health care workers did we train? This shows what you got for your investment.
But few companies think about the outcomes
and impact their investments actually
had – if, for example, they have improved the health and wellbeing of the people
they were supposed to reach.
A good example of this is a pharmaceutical company we
worked with that was trying to address hypertension in sub-Saharan Africa. They
spent a lot of time looking at how many people they screened for high blood pressure,
how many people were diagnosed, and how many were put on treatment. But they didn’t
place a similar effort into capturing the ultimate impact of their program –
were they and their implementing partners reducing the number of strokes from
hypertension? Were the people using their anti-hypertension medicines (or
others) able to go back to work and be more productive?
MK: Many CSR
initiatives that tackle tough social issues are conducted in complex
environments with many intertwined factors. In such environments, how can
measurement show causality of a program’s intervention? How can you
build an evaluation process that allows you to claim appropriate
attribution for your program or intervention?
JS: Skeptics will often say that your intervention won’t solve the problem because there are all
these other contributing issues. But, if
you are thoughtful – by examining and understanding the health care ecosystem
in the country you are in and what’s connected to what – it is possible to understand and measure
the contribution of your intervention. It’s simply nihilistic to say at the outset
that you can’t possibly measure the
impact. In fact, you have an obligation to try to measure your contribution for
at least three reasons:
- To illustrate to other stakeholders that you’re making a positive contribution,
- To persuade your internal colleagues that this is a good way to use resources, and
- To know what you’re doing right and what you’re doing wrong.
If you have a
robust M&E framework – even if you
can’t be 100 percent specific about what
impact your program is having – it still
adds to the knowledge base. You will undoubtably find other problems going on
in the health care environment that need to be fixed and this will help reach the
overall goal you and others are trying to attain. That is the unintended consequence
of M&E programs – they uncover other information on how health systems
operate and over the long run this leads to improvements in population health
overall.
A good example of the work being done in this area is by Boston University and leading global pharmaceutical companies through the
Access Accelerated project. (See side bar below).
MK: How should an
organization get started measuring impact?
JS: You must design the M&E framework before you start the project. You can’t
start it mid-course. Companies should start by thinking about what it is they
are trying to affect and work back from there using a logic model that
specifies inputs, outputs, outcomes and impacts. You need metrics along the project’s entire
trajectory. And, you must have a system to collect the data in a reliable and
sustainable way, so you’ll be able to analyze it.
Access Accelerated: Through the Access Accelerated initiative, 26
biopharmaceutical companies are tackling the growing burden of non-communicable
diseases in low and middle-income countries by co-creating scalable and
sustainable solutions to improve people’s health. A team from Boston
University is working with the companies to integrate a robust measurement
framework into the project to serve as a common language for categorizing,
understanding and comparing access programs. The framework includes three main
components: 1) A taxonomy of 11 strategies
that describes common approaches used by access programs; 2) A series of logic
models—one for each strategy—detailing the pathways by which programs may
achieve impact; and 3) A set of clearly defined
indicators for reporting program activities and achievements. The team has developed the Access Observatory, an online public
repository of information on access programs, structured according to the
measurement framework. To date, the Observatory has compiled reports on 63
programs in 103 countries. For more information,
see their 2018 report.
MK: What types of
skills does Rabin Martin have to help clients develop M&E frameworks?
JS: We bring a unique mix of skills to bridge research,
evaluation, programming and policy, with an unwavering commitment to measurable
results. We have experts in public
health program design and implementation, often with hard-won experience on the
front lines establishing and operating programs. They understand what you need
to do to collect data and analyze it. We also have people who understand the
art of program evaluation and the nuts and bolts of managing an M&E
framework. It helps to have done this kind of work when counseling clients on
the best approaches for building M&E into their program designs at the
outset – and to do so in a nuanced way.
MK: How do you ensure
that impact measurement becomes a means to an end rather than an end in itself?
JS: M&E must be part of the discipline of how you
manage your entire portfolio, with an emphasis on becoming a learning
organization. It is a mindset of looking quantitively at data to inform
decision-making. Everything you do is a question of allocating scarce resources
to accomplish what you are responsible for – in that context, without the right
data, it’s not possible to tell which investments are yielding the most health
for the money. There is truth in the old
cliché that you can’t manage what you
don’t measure.
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