LIBERTY UNIVERSITY
Helms School of Government
Assessing the Cost-Effectiveness of Interventions within
a Humanitarian Organisation by Chloe Puett:
A Journal Article Review in Social Policy
Submitted to
in partial fulfillment of the requirements for the completion of
PLCY 700 -
By
Introduction
Social policy is a complex domain of public policy perceived with controversy on issues
regarding poverty and inequality.1,2 In the US, the fundamental disagreement between social
policy and economic policy stems from the lack of a commonly accepted definition of poverty
and its scope, causes, and solutions.3 Due to this problem, assessment to measure the quality of
life and whether welfare has contributed to improving its quality, and determining the relative
worth of welfare in converging elements such as health, housing, Medicare, and nutrition cannot
be analyzed or compared.4
Most societies view poverty based on its economic and behavioral malfunction
dimensions. However, the US approved the economic dimension as the sole determinant of
poverty.5 This partly explains the perceived superiority of economic policy and its reliance on
economic instruments for assessing social policy’s effectiveness.6 Political ideology undergirds
any discussion about social issues such as health, education, wellbeing, and social entitlements of
indigent populations. The liberal, conservative, and radical views are at odds on the perspective
of causes and solutions to poverty that only major social policy (the Personal Responsibility and
1 Kahleb Fischer, Module/Week 5—Social policy reading and study introduction, PLCY 700 B02,
Liberty University, undated.
2 Chloe Puett, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation. Disasters 43, No. 3, July 2019, 575–90.
3 Clark E. Cochran, Mayer, C. L., Carr, T. R., Cayer, N. J., McKenzie, M. J. and Peck, R. L.,
American Public Policy- An Introduction, 11th Ed. 2016 (Boston, Massachusetts: Cengage Learning), 193.
4 Charles Murray. Losing Ground. American Social Policy, 1950-1980 (New York: Basic Books),
203.
5 Clark E. Cochran, Mayer, C. L., Carr, T. R., Cayer, N. J., McKenzie, M. J. and Peck, R. L.,
American Public Policy- An Introduction, 11th Ed. 2016 (Boston, Massachusetts: Cengage Learning), 193.
6 Kahleb Fischer, Module/Week 5—Social policy reading and study introduction, PLCY 700 B02,
Liberty University, undated.
Work Opportunity Reconciliation Act of 1996) was developed through a compromise among the
major political parties the last two-and-a-half decades.7 Until 1996, US social policies were a
continuation or a slight modification of outdated policies dating back to the 1940s, and issues
around social policy such as access to education and health were caught in a never-ending
ideological debate over “rights” versus “privilege” over welfare entitlements.
Literature about the impact of social policy in the US is limited. Efforts to define the
meaning of poverty and draw its scope boundary are challenged by larger issues linked to ethical,
ideological, racial, and moral considerations. Public opinion related to certain political beliefs
also plays a strong influence in setting the tempo of social policy debate.8
Overseas, the increased frequency of disasters over the past two decades and the sheer
volume of aid spent in humanitarian assistance caused humanitarian aid funding to rise,
prompting donors to impose stricter disbursement regulations and apply cost-effective measures
in spending.9,10 Donors are increasingly called by their benefactors such as governments,
taxpayers, and private entities to demonstrate the cost-effectiveness of every aid they provide.11
7 Clark E. Cochran, Mayer, C. L., Carr, T. R., Cayer, N. J., McKenzie, M. J. and Peck, R. L.,
American Public Policy- An Introduction, 11th ed. 2016 (Boston, Massachusetts: Cengage Learning), 202-
203, 209-215.
8 Clark E. Cochran, et. al., American Public Policy- An Introduction, 11th ed, 132, 138-139.
9 Chloe Puett, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation. Disasters 43, No. 3, July 2019, 575–90.
10 André Griekspoor, Egbert Sondorp, Theo Vos, Cost-Effectiveness Analysis of Humanitarian
Relief Interventions: Visceral Leishmaniasis Treatment in the Sudan, Health Policy and Planning, Volume
14, Issue 1, 1999, 70–76, https://doi.org/10.1093/heapol/14.1.70
11 Chloe Puett, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation. Disasters 43, No. 3, July 2019, 575.
Methodology of the Assignment
Due to increased donor pressure, humanitarian and development agencies tried several
approaches to demonstrate value for money in their humanitarian work. Action Against Hunger
US is one of the few aid agencies to apply the concept of “value for money” in a humanitarian
setting.12,13
In 2019, Action Against Hunger US launched academic research to assess its programs'
effectiveness using the Cost-Effectiveness method. The article was published during the same
year entitled, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation by Chloe Puett.14 The article Assessing the Cost-Effectiveness of Interventions is
reviewed and evaluated below based on its strengths and weaknesses. Action Against Hunger's
experience should provide a lesson for understanding welfare transfer that can be adapted to the
US social policy context.
Finally, at the conclusion of this assignment, a reflection of government and
statesmanship based on the Bible will be offered. A Christian worldview undergirds the review of
the article. As Charles Studd said, "Only one life,’twill soon be past, only what’s done for Christ
will last"—a quotation that captures the student’s belief that any work on earth should reflect the
work and purpose of God.
12 For information about Action Against Hunger, please visit:
https://www.actionagainsthunger.org/, https://bit.ly/2ZhKbKk, accessed on February 13, 2021.
Information is based on self-reporting.
13 Chloe Puett, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation. Disasters 43, No. 3, July 2019, 575–90.
14 Chloe Puett, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation. 575.
Discussion
Research Question
The article Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation aims to answer the following two questions:
1) Is the cost-effective analysis (CEA) method in assessing Action Against Hunger
programs the right tool?
2) What are the challenges in using the CEA tool, and how these can be addressed?
Methodology and Approach
The Assessment completes several steps, as follows:15
1) Selection of analytical tool for the assessment. Under this process, the choice tool and
data—whether actual or predictive data were examined. The Article utilized actual
data which gave a clear status of actual and planned cost categories. Economic costs
were also needed for analysis extending accounting data to a larger societal
contribution of the program beyond the community level,
2) Identification of direct cost, indirect cost, and hidden costs such as the distance of
actual services and travel time to the project location given the transparency
principles, which are important determinants of service utilization,
3) Perform micro-costing analysis, which consists of placing costs in proper categories
and analyzing the cost and quantities of program inputs to allow decision-makers to
compare costs and decide which ones to change or improve. Activity-based costing-
costing which allocates costs that can be shared across activities, programs and
organizations is recommended in most studies.
15 Chloe Puett, Assessing the Cost-Effectiveness of Interventions within a Humanitarian
Organisation. Disasters 43, No. 3, July 2019, 576-577.
4) Determining and analyzing cost-effectiveness ratios and comparing the ratios across
activities and programs. This is a rigorous process that allows for the identification of
the most effective activities, and programs. Chloe Puett recommends subsidiary tool
such as incremental cost-effectiveness ratio, quality-adjusted life years, and disability-
adjusted life years.
The cost-effective analysis (CEA) method recommends a combination of quantitative
(use of accounting data across activities, aggregated by program) as well as the qualitative
approach (interviews, community pulse survey, public opinion survey) to deepen the
understanding of the program’s results.
Data Collection
Data collected are activity costs aggregated into program cost, poverty data, beneficiary
profiles, and baseline surveys. Operational and activity costs are collected from the program’s
accounting department duly certified by Management and interview with project beneficiaries,
stakeholders, and program staff and management. Monitoring and evaluation reports are also
obtained that indicate the beneficiary’s status before and after availing of the program’s services.
Conclusion
The Assessment of Cost-Effectiveness conducted internally by Action Against Hunger
represents a renewed effort to find solutions to the never-ending debate about the role and
contribution of welfare to reducing poverty by providing evidence-base data for an objective
policy analysis and decision making. The application of the Cost-Effective Assessment method
showed a potential for wider application, although as revealed in this assignment that in the US,
political ideology takes a preeminent role in policy decisions over welfare matters. Evidence to
this is the unresolve definition and scope of poverty, as shown above.
Additionally, the poverty variables analyzed and presented by Clark Cochran et. al., and
Charles Murray are more comprehensive than those mentioned by Chloe Puett. Although no
quantitative example was provided, the presentation of the computational formula and the
information to gather are clear. Chloe Puett’s review and analysis of the Cost-Effective
Assessment method is overall useful and relevant to the lesson at hand.
Biblical Worldview
The Bible calls on every Christian to use resources wisely and to care for the poor (Deut.
15:11, NIV, 1 Peter 4:10, ESV, Leviticus 25:35–37, ESV, Psalm 41:1–3, ESV). God commanded
man to care for one another (1 Samuel 8, NIV). He condemns oppression (Proverbs 14:31/NIV,
Ezekiel 22:29, NIV). The issue of “taking care for the poor” invokes the need to reflect on the
role of state. The failure of welfare policy affirmed by Charles Murray and Clark Cochran, et al
requires a rethinking of the state's role in caring for the poor in a free-market economy.16 Firstly,
the poor (in the US) is mostly undifferentiated. Some indigents need help from the state, but the
provision of psychosocial support and feeding the poor should be the role of charitable
organizations.17
16 Clark E. Cochran, Mayer, C. L., Carr, T. R., Cayer, N. J., McKenzie, M. J. and Peck, R. L.,
American Public Policy- An Introduction, 11th Ed. 2016 (Boston, Massachusetts: Cengage Learning),
202-203, 209-215.
Charles Murray. Losing Ground. American Social Policy, 1950-1980 (New York: Basic Books),
203.
17 Kahleb Fischer, Module/Week 5—Social policy reading and study introduction, PLCY 700
B02, Liberty University, undated.
References
Griekspoor A, Sondorp E., Vos Theo, Cost-Effectiveness Analysis of Humanitarian Relief Interventions:
Visceral Leishmaniasis Treatment in the Sudan, Health Policy and Planning, Volume 14, Issue 1,
1999, 70–76, https://doi.org/10.1093/heapol/14.1.70
Murray Charles, Losing Ground. American Social Policy, 1950-1980 (New York: Basic Books), 203.
Puett Chloe, Assessing the Cost-Effectiveness of Interventions within a Humanitarian Organisation.
Disasters 43, No. 3, July 2019, 575.
Cochran C E., C. L. Mayer, T. R. Carr, N J Cayer, J M McKenzie, and R L Peck, American Public
Policy- An Introduction, 11th Ed. 2016 (Boston, Massachusetts: Cengage Learning),
132, 138-139.
Fischer Kahleb, Module/Week 5—Social policy reading and study introduction, PLCY 700 B02,
Liberty University, undated.
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