If you work for an NGO, you likely face the challenge of “demonstrating impact and effectiveness” to your funders. Yet donor states and international organizations no longer blindly accept that NGOs are doing what they claim to do. So the task is not only to meet expectations, but also to communicate the organization’s most significant impacts to donors, other partners, and professional colleagues. Measuring organizational effectiveness for improved health and development impact is a key element to do so in a changing landscape.

In a recently published study in Global Public Health, my colleague Courtenay Sprague and myself investigated how institutional norms and expectations influence the adoption of structures and processes by NGOs regarding Early Childhood Development (ECD) programming effectiveness in Rwanda. Our findings uncovered a disconnect in how “organizational effectiveness” is viewed from the global scale to the local scale. What also became clear is that the way we measure the success of global health programs can (unintentionally) cause issues for early ECD effort.

Perspectives on Effectiveness

Rwanda offers a unique window into the question we have researched. As a country in which 76% of children under the age of five are at risk of poor development, and 38% of children are stunted, early childhood development (ECD) programs are seen as a critical investment in the nation’s future.

Recognizing these facts, the government of Rwanda has intentionally invested in ECD services since 2016. It also has taken a holistic approach to better understanding different pillars of ECD.  For example, rather than simply focusing on nutrition or early learning, Rwandan officials have adopted an approach including pillars such as hygiene, parenting education and support, and child protection

These programs, which target the youngest and most vulnerable members of society, are designed to foster cognitive, emotional, and physical development during the most formative years of life. Despite this investment, the effectiveness of these programs remains unclear.

As we traveled across urban, peri-urban, and rural districts in Rwanda, and spoke with its people through in-depth interviews and focus group discussions, a clear divide began to emerge. What we found was that the idea of “effectiveness” looks very different depending upon whom you talk to.

International NGOs and government officials tend to define effectiveness in terms of outputs—such as the quantifiable results reflected in the number of children enrolled in ECD programs, or the percentage of planned activities completed. One of our interview participants indicated that “effectiveness is measured through monitoring and evaluation. Quality benchmarks are preemptively decided, and success is then measured on whether or not outcomes meet those benchmarks.”

This approach aligns with the global trend toward results-based management, where success is often judged by the ability to meet predefined benchmarks and deliverables.

Yet this focus on outputs may overlook more nuanced and long-term impacts that ECD programs have on the ground. For local NGOs and the communities with whom they work, effectiveness is often viewed through the lens of outcomes, particularly in terms of behavioral changes among parents and improvements in child well-being.

A participant in one of our focus group discussions in a predominately rural district observed that “the changes are people have improved their hygiene, the nutrition for the whole family, and the children, the communication in the household. The fathers started being involved in raising their children, not only to provide food, but being one of their friends, playing with their children, helping the female do family chores.

These outcomes, while less easily measured than enrollment numbers, are essential indicators of a program’s impact.

Assessing Effectiveness at Different Levels

During our time in Rwanda, we encountered the real-life struggles of bringing ECD programs to life in places where resources are scarce. In rural areas, where poverty and food insecurity are part of everyday life, families shared the challenges they face in putting the program’s teachings into practice. While these programs have done an incredible job raising awareness about the need for proper nutrition, hygiene, and early education, many families simply can’t afford the resources needed to follow through.

This disconnect between the program’s ambitions and the harsh realities some communities face forces us to rethink how we define and measure success.

And as we dug deeper into how effectiveness is understood at different levels, a clear tension emerged between efforts within the ECD sector and the broader work of NGOs.

At the global and national levels where NGOs and government officials operate, the focus tends to be on institutional norms and standards, which emphasize performance and results. Prioritizing quantitative targets becomes a main indicator of success.

On the ground level at which programs are implemented, however, effectiveness is seen through a different lens. Here, it is about real changes in the lives of children and families—better parenting practices, stronger child development, and tighter-knit communities. Yet these outcomes are not always captured by the conventional monitoring and evaluation frameworks that dominate the conversation at higher levels.

A Broader Focus

Our research offers important insights for NGOs and other stakeholders involved in ECD programs. First, it suggests that one-size-fits-all approaches to measuring effectiveness may be inadequate, particularly in contexts where cultural, economic, and social factors play a significant role in shaping program outcomes. More flexible and context-sensitive evaluation methods are needed in order to capture the full range of impacts these programs have on the ground.

NGOs struggling to demonstrate their effectiveness to donors may find such insights invaluable, particularly in a field as complex as ECD. Our investigation suggests that effectiveness should not be solely defined by the ability to meet short-term, quantifiable targets. Rather, NGOs should advocate for more holistic understandings of effectiveness that consider the long-term behavioral and social changes these programs foster, as well as the challenges and constraints that communities face in implementing them.

An examination of Rwanda’s ECD programs highlights the need for a more nuanced and context-sensitive approach to measuring effectiveness. By moving beyond a narrow focus on outputs and embracing a broader, more inclusive understanding of success, NGOs can better demonstrate the full impact of their work.

This shift is essential. Measurements of effectiveness must not only satisfy donor requirements but also for ensure that ECD programs genuinely contribute to the well-being and development of the children and families they are designed to serve.