ICTworks

What comes to mind when you hear about an epidemic sweeping the field of international development over the last several years?

No, I’m not referring to COVID-19 but rather “pilotitis,” an illness most commonly presenting when small projects are continuously pursued but never scaled, leading to duplication and short-lived benefits. We can all agree that piltoitis wastes precious funds and fails to create population-level changes in health and equity – and that it is a disease that must be avoided.

The prevention of pilotitis, like any other aliment, necessitates a look into the etiology of the disease and how it progresses. Lessons learned from countless webinars and conference presentations note that pilotitis can be avoided through, among other preventative measures, designing with the user, designing for scale, and the application of a series of strategic behavior change interventions we collectively refer to as the Principles for Digital Development.

While there is no cure for pilotitis in international development, the work done over the last decade to identify pilotitis and articulate these preventative measures must urgently be reexamined as we turn our focus to a new emerging infection in the global digital development space, identified only recently as assessmentitis.

A New Disease: Assessmentitis

Assessmentits does not have an ICD-10 (or 11!) code, cannot be included in a FHIR bundle and has not yet been documented in any peer reviewed journal. Yet the symptoms of this disease are real and, as an urgent matter of global health security, collective action must be immediately taken. An initial attempt to define the disease – and a call to action to work together to prevent its’ pervasive spread – are outlined below:

Emerging Definition

Assessmentitis, as it is colloquially known, is the act of repeatedly conducting similar and overlapping assessments of a country’s digital landscape, enabling environment, deployed tools and technologies, and/or other surveys or series of key informant interviews used to develop a baseline of a country’s digital maturity along a continuum. This can also be referred to as benchmarking.

Causes and Risk Factors

While not yet confirmed, assessmentitis may first manifest as a side effect of strict adherence to the aforementioned Digital Principles protocol for the prevention of pilotitis, when well-intended practitioners from varying backgrounds repeatedly conduct similar activities in an effort to understand a country’s existing ecosystem. Assessmentitis can increase the risk of practitioner burn out, Ministry tune-out, implementer fatigue, and donor investment wastage.

Symptoms

Presenting most consistently within those individuals self-identifying as associated with government Ministries, symptoms include ignoring well-meaning, but duplicative requests, avoidance of enumerators, low to no survey responses, staff burn out, and Ministerial irritation over repeated inquiries. Diagnosing professionals also note frustration with an inadequate use of resources across donors and implementing partners, due to duplication of effort and delays in the completion of assessments, many of which are outdated well before they are disseminated. This constellation of symptoms can be loosely summarized as Assessment Fatigue Disease (AFD).

Diagnosis

While there are no rapid diagnostic tests yet developed, there has been an uptick in self reporting as individuals begin to discuss symptoms of AFD with others in the industry. 

Preventative Measures

Assessmentitis may be preventable but will require the collaboration and collective engagement of Ministries, donors, implementing partners and others who advocate for assessments (whether directly or tacitly through the approval of workplans) for true infection prevention and control. Potential means to prevent assessmentitis could include:

• Greater Efficiency: Development of rapid assessment tools whose results can be used immediately, obviating the need for text-heavy and time-consuming reports, or the creation of flexible methodologies that enable updates and revisions from government as desired, creating living documents and agile feedback loops rather than static snapshots in time.
• Assessment Coordination: Creation of a process for peer-reviewed or coordinated co-assessments, enhancing transparency and collaboration among and across Ministry, donors and implementing partners to save time and funding while reducing AFD. This could include a step where planned assessments are logged, encouraging timely collaboration and serving as a building block for donor coordination across country-specific activities.
• Assessment Database: Use of a global repository of completed assessments available to those endeavoring to understand a country’s existing ecosystem. Practitioners undertaking assessments could explore and cite an existing evidence base, building upon previous work. Existing digital economy assessment guides and digital health assessment tools and repositories to track country investments and country maturity could be adapted to avoid the pitfalls of non-adherence.
• Government Ownership: Repositories of assessments should also sit within an appropriate government ministry and could include validated digital health roadmaps, digital transformation strategies and other plans and available public documentation related to enablers and deployed information systems, including links to open-source code repositories like GitHub and other sources of technical documentation. A centralized source of such public information may lessen AFD.
• Government Leadership: Recognition that many countries are moving forward implementing their digital transformation without self-assessing. A reconsideration of the need to conduct extensive assessments before providing support or technical assistance may be merited.

Assessmentitis Management

This attempt at identifying and preventing assessmentitis and the larger AFD is a first step in the disease management process. We must understand this new threat to development efficiency if we ever hope to prevent, control and eliminate it.

Please join us in identifying assessmentitis. Where have you seen it? Who might be suffering from AFD? How can we work together to stop it from spreading?

Emily Nicholson is on a quest to combat AFD in international development..