Open Data in Developing Economies

In essence, the book seeks to answer the following key questions: • What makes open data uniquely relevant to developing economies? • How can the impact of open data in developing economies be captured and evidence be developed? • How can open data be leveraged as a new asset for development? Toward that end the book begins, in Part I, by providing examining the use of open data for development. This includes a brief assessment on the theories and narratives of open data in development; a change theory and a logic model to capture and develop evidence on open data in developing economies; and an examination of open data’s impacts across various development sectors. In Part II, we present the 12 open data in developing countries case studies, organized according to the four different types of open data impacts. The book concludes in Part III with a set of key takeaways and recommendations for aid organizations, governments, private sector entities, and others that are considering replicating or using open data as an asset for development.

the United Nations 2010 Human Development Index, 88 and the national GDP per capita was under USD 210 in 2015. 89Health outcomes are poor, with a heavy disease burden characterized by infectious and communicable diseases, primarily HIV/AIDS, malaria and diarrhea.Life expectancy in 2016 was just 50 years (for both men and women). 90,91National healthcare expenditures are estimated at 9 percent of GDP. 92In addition to low public health expenditures, Burundi's national healthcare system faces significant challenges, including a scarcity of health professionals, poor quality of health services, poor access to essential medicines throughout the country, and a weak health information system. 93sults Based Financing (RBF) Results based financing (RBF) is a method that links development financing with pre-determined results. 94Payment is made only when the agreed-upon results are shown to have been achieved, an approach that seeks to shift the focus from inputs to results.According to one report that outlines the benefits of RBF: "By only paying for results once they have been achieved, we partly avoid the risk that the donor contribution is not used effectively." 95BF is used across developing countries in cooperation with the private sector, the public sector, and civil society organizations.It is used in a range of sectors, including health care, education, security, and energy.RBF is emerging as a particularly important mechanism in efforts to scale up provision of essential health care services, including child and maternal health care, for example in countries like Cambodia and Rwanda.The OECD has designated RBF as a key tool for achieving WHO Universal Health Coverage goals. 96tudies also show that RBF increases health care provider performance, with important differences identified "before and after" the introduction of RBF.RBF was further shown to strongly influence health system development at the operational level in RBF projects in some countries. 97urundi was one of the first African countries to introduce results based financing (RBF).Second on the African continent only after Rwanda, it began implementing RBF in its health care systems in 2010.In 2015, Burundi also began using RBF in the education sector. 98

Technology and RBF
The key to a successful RBF program is effective daily management, and information management tools are essential for this.Large amounts of data have to be entered, verified, and validated for RBF programs to function, and that data must then be processed against pre-set criteria to calculate and disperse subsidy payments.Technology plays a vital role in ensuring that this is all done effectively and accurately.
While many RBF programs use Microsoft Excel for this purpose, an increasing number use Open RBF, a customizable financing management tool designed specifically for RBF projects.Because this tool easily makes data open and machine readable, it has the added benefit of making RBF data accessible for public consumption and analysis.

KEY ACTORS Key Data Providers
The key data providers are Burundian health service providers who participate in RBF programs that use the Open RBF tool.These service providers generate qualitative and quantitative data relating to the services provided, and the Open RBF tool manages and processes that data and the different stages it passes through.These stages include recording, verification, processing, and calculation and dispersal of payments.Outcomes are also shared in the public domain.

Key Data Users and Intermediaries
Several entities make use of the data.Primarily, participating RBF programs use it to ensure accurate and timely recording, verification, processing, and publication of data, as well as payments dispersal.Also, funding organizations use the data to oversee program progress and to determine allocations.In addition, Burundi's Ministry of Public Health and the Fight Against AIDS uses the data to coordinate their nation-wide health sector improvement efforts.Medical practitioners and policymakers also use the data.Finally, citizens have access to the data (although, as explained elsewhere in this case study, citizen uptake seems somewhat limited).
The key data intermediaries are Burundi's Ministry of Public Health and the Fight Against AIDS, which together spearhead Burundi's national health system improvement efforts.In addition, Cordaid, a Netherlands-based organization that works to create "opportunities for the world's poorest, most vulnerable and excluded people," 99 has implemented community health and education sector RBF programs in Burundi using the Open RBF tool.

Key Beneficiaries
Entities working directly and indirectly with RBF programs benefit from the technological functions Open RBF provides.Also, governments, policymakers, funding organizations, students, and citizens benefit from the publicly-available data and data comparisons.
Most broadly, all citizens of Burundi benefit from any health and education sector improvements that have been achieved as a result of Open RBF platforms.delivered in Burundi in 2010, in response to a request from the Burundian government and coinciding with the national-level embrace of results-based financing. 101The Burundian Ministry of Health was seeking ways to improve health care functioning at the national level and strengthen accountability mechanisms. 102,103Early returns were positive and Open RBF then entered into a longer-term partnership with the government.Open RBF has also been applied to both the health and education sectors in Burundi. 104,105pen RBF in Burundi operates in a similar way to Open RBF around the world.Its broad aims are to improve the openness of data to enable its access by a range of stakeholders in healthcare, thereby promoting the overall RBF goals of efficiency, transparency, accountability, and good governance.106 The platform is built as an open-source, web-based solution, using a combination of technologies, including Php, Mysql, Jquery, Bootstrap, Highcharts, and Dompdf.The tool also integrates with Google Maps.107 To access the Open RBF tool, users visit a portal that has both a private and a public interface.The private area contains dashboards that display project data from the field-data that has been recorded and verified by different parties, and only then published on the platform.Data in this area includes information relating to project progress, including quality, quantity, and performance indicators.

Project Description
The public, front-end interface (image shown below) includes slightly more data than the private interface.The public area allows users to view information at a province or national level, for example, information related to vaccination rates, reproductive health, preventative health, and HIV/AIDS.In the representative image included here, the interface shows that 100 percent of children attending participating clinics were verified as having been fully vaccinated in March 2015, while 80.36 percent were fully vaccinated in November of that year.It also shows that, in September 2015, almost 50 percent of patients were screened for TB. 108Each key indicator is compared with regional and global figures.All the information contained within the portal (especially the private area) is used to determine the progress of projects, and whether they are eligible for performance-based subsidies.Once subsidies have been calculated and paid, this information is displayed on the public interface, which includes provider performance indicators that allow citizens and policy makers (and anyone else interested) to gauge progress of particular projects or groups and see how public funds are being allocated.One goal of the public interface is to open up data to encourage greater civic ownership and participation.109 Image from http://www.fbpsanteburundi.bi/which displays health data for Burundi as generated by Open RBF.

Demand and Data Use
As mentioned above, demand for Open RBF comes primarily from within RBF programs.Such programs could be managed by non-profit organizations, civil society groups, or government departments.In Burundi, additional demand comes from Burundi's Ministry of Public Health and the Fight Against AIDS.All these organizations use the data available on the portal not only to track the progress of their own projects, but also of other projects throughout the country.Civil society actors and journalists also draw on Open RBF data to inform their work, but neither group represents a prime target audience for the platform. 110

Impact
Measuring the impact of open data projects is never easy, especially as some projects may have indirect effects that are harder to capture.Nonetheless, a range of indicators suggest that Open RBF has not only had a positive impact Burundi, offering important lessons for the potentially transformative role of data in improving healthcare and more generally solving complex public problems in the developing world.

Improving Health
Overall, as noted, the state of healthcare in Burundi remains poor.But there are encouraging signs of improvement within RBF programs in particular that suggest the positive impact of Open RBF.One example can be found in Cordaid's work with community health workers in Makamba province, which has resulted in a significant reduction in cases of severe malaria. 111In addition, Cordaid's work in 81 Burundi preschools, which includes 27 local organizations verifying community education indicators and a network of 12 regulatory boards, has been found to correlate with improved educational access for students of all ages, a better gender balance in programs, better teaching methods, and improved academic performance scores among students. 112hese improvements are of course the result of many factors, but people familiar with the results cite the important role played by Open RBF.For example, Dr. Etienne Nkeshimana, RBF and health system strengthening expert in Burundi who currently coordinates a Cordaid community RBF project, says: "I cannot scientifically say that Open RBF has led to some of the positive results we see in RBF programs.However, I can say that without Open RBF, we would not have achieved these positive results.

Better Project Management and Cost Savings
A significant benefit of Open RBF is its role in improving project management, which in turn enhances the services that use it and introduces greater cost efficiencies.Open RBF achieves better project management by allowing stakeholders to regularly and rigorously follow project results in virtual realtime, including through sophisticated visualizations.Such monitoring not only improves the outcomes of the projects but also leads to financial savings, helping organizations manage scarce development resources more efficiently.As Vincent Kamenyero, Data and Portal Manager at Cordaid, puts it: "The Open RBF portal has allowed for greater transparency in finance management, cost reduction of organizational functioning, and is a considerable time saver for our verifiers."114Rigorous project management is particularly important in the early or pilot stages of a program, when donors may be monitoring to determine the effectiveness of a method and whether or not to scale up funding.
Open RBF also helps aid agencies and governments monitor projects remotely, a factor that is of great help to foreign funding groups.The benefits of remote project management were apparent during the recent political upheaval in Burundi, when foreign agencies were more comfortable monitoring their projects from the relative safety of their host countries. 115Similarly, Cordaid's work with community health workers in the remote Makamba province is significantly facilitated by its ability to follow projects from the national capital of Bujumbara.For instance, if there is a problem with health worker data collection methods on the ground, program experts can quickly identify it and attempt to solve the issue on their dashboards in the capital. 116e Inherent Value of Data Open RBF Burundi is also a good example of the powerful role that data can play in solving public problems in the developing world.Increasingly, it is becoming clear that the data generated by specific RBF programs can be used in other situations as well; the data has inherent value.For example, in its current efforts to expand community health efforts (known as the Kira program), the Ministry of Health is making extensive use of publicly available Open RBF data generated by previous programs.The data includes various qualitative and quantitative costing indicators, as well as information pertaining to patient numbers and vaccine rates that had been used to assess earlier interventions. 117n this way, publicly available Open RBF data can serve as an important reference point and guide for developing future programs.
Several donor organizations and student groups similarly rely on publicly available Open RBF data.For example, the World Bank, which will help fund the above-mentioned Kira project, has relied on earlier existing Open RBF healthcare sector data to determine its funding packages.Likewise, students researching Burundi health or other sector outcomes regularly access Open RBF public-facing pages for their research. 118powering Citizens As indicated by the example of students, Open RBF data can play a powerful role beyond the development community, empowering citizens at large with information and insights.The Open RBF tool in Burundi provided the public with its first opportunity to review and potentially comment on healthcare (and other) projects across the country.Through community groups and other advocacy channels, citizens can contribute to healthcare planning, verify performance, track government spending, and generally ensure greater accountability."It puts communities in the driver's seat," said Dr. Rose Kamariza, Cordaid Program Officer, Burundi. 119t is of course important to mention that many citizens lack Internet access and thus direct access to the data generated by Open RBF.But organizations like Cordaid play an important role in overcoming such barriers, suggesting the important role of intermediaries in spreading the benefits of open data.For example, Cordaid organizes bi-annual feedback workshops where it shares data with citizens and allows them to engage with RBF findings and Open RBF results.

Risks
Burundi's Open RBF initiative is not intended to make any personally identifiable information accessible to the public.Some level of privacy risk does remain, however, when open data projects are active in sectors like health care.
There has been no evidence to date that Open RBF has introduced any privacy issues, but it will be important to maintain vigilance when redacting personal information from data releases or anonymizing datasets going forward.

Lessons Learned
Several important lessons with wider applicability emerge from this particular case study.These can broadly be categorized by considering the key enablers of the project, as well as the most important barriers or challenges to its success.

Government support
Burundi's Ministry of Public Health and the Fight Against AIDS were significant enablers in Open RBF's success.They incorporated RBF into the government's national health program, using the Open RBF tool in delivering that program.
The ultimate impact and success of that tool has, to a large degree, flowed from the support received by the national government, which helped fund its implementation, adapt it to a range of health sector categories, and generally propagated it throughout the country.In this respect, Open RBF in Burundi is a good example of how strong institutional support and political and administrative buy-in are instrumental to the success of open data projects.Many of the projects discussed in this series lack such support.
It is worth mentioning that the current political climate in Burundi may prove to be a challenge in the months and years ahead.Although this project is both beneficial and useful for the nation, the possibility of further political strife may limit the ability to monitor the efficacy of programs within the health care sector.

International development organizations
International development organizations also played a key enabling role in Open RBF's success.Cordaid, which adopted the tool for its community health, education and security sector programs, was among the most important supporters.The World Bank has helped too, especially by using and thus validating the usefulness of publicly-available Open RBF data.

Regional and Sectoral Specificity
Open RBF's use in a variety of countries is testament to technology's crossborder potential.However, it is also true that the first version of the Open RBF software used in Burundi was not entirely adapted to local conditions and the different needs of various RBF programs.Not all such programs are alike.Each has a different set of pre-determined criteria.Some may receive funds from one donor while others from several donors. 121This first version of the platform was tweaked and a second unveiled in 2014.This second version allows for the possibility of multi-management funding, includes new data visualizations, and also includes an alert system to allow auditors to update the data. 122

Technical Expertise
According to the International Telecommunication Union (ITU), the percentage of Burundian citizens who use the Internet more than tripled from 2014 to 2015.Nonetheless, fewer than 5 percent of Burundians regularly use the Internet-a low rate even by the typical standards of less developed economies.To an extent, the negative consequences can be mitigated by the use of intermediaries who share information with citizens that are not connected.But overall, the country's poor state of Internet readiness curtails citizens' and users' ability to access Open RBF-generated data.
Even among those who are connected to the Internet and generally technically proficient, a lack of data knowledge and expertise often limits the potential of Open RBF projects.Open RBF teams find that many statisticians they work with are not trained to work with data in a manner that Open RBF requires.This complicates and slows training missions.For example, statisticians at the province level in some countries are not always versed with data management beyond the use of Microsoft Excel.

Integrations and Plug-Ins
Finally, the next stage of Open RBF will feature a number of new plug ins and integrations to bring new functionalities to the platform, and to better connect it with other platforms users are likely to frequent.Likely the most important new integration will be improved geolocation capabilities and mapping features.Organizers are also pushing forward more social media integration, with Facebook and Twitter functionalities representing first priorities. 130Beyond the specific integrations under development, the plug-in and integration focus exhibited by Open RBF makes clear that a key part of the plan for evolving the platform over time involves finding ways to bring existing platform features to bear for Open RBF users.

Conclusion
The results-based financing approach is growing in momentum, especially across developing countries.The rapid expansion and scaling of the Open RBF platform shows how quickly successful open data projects can be replicated across regions and sectors when a clear value proposition can be articulated and early positive impacts can be demonstrated.Perhaps even more importantly, the Open RBF platform itself is helping to make it easier for governments to quickly roll out open data-driven RBF efforts, with the key out-of-the-box features and functionalities ready to implement once a clear problem area is identified and political will and buy-in is present.

" 113 110
GovLab interview with Elena Ignatova, Program Manager at BlueSquare, January 19, 2017.111 Republic of Burundi, Ministry of Public Health and the Fight Against AIDS, "Evaluation Final de Projet Pilote FBP Communautaire au Burundi," December 2015.
Borman correctly identified high demand for a tool that would help collect, analyze, and disseminate RBF data.As a result, Borman and a team of five partners created such a tool and named it Open RBF.100The tool is deployed and administered around the world by BlueSquare.RBF pilot projects began in Burundi in 2006 across six provinces, with such pilots covering the entire country by 2010.The Open RBF platform was first 99 See: https://www.cordaid.org/en/.100 GovLab interview with Antoine Legrand and Elena Ignatova, Program Managers at BlueSquare, August 9, 2016.