Introduction

Global environmental health efforts are motivated by a sense of common responsibility and opportunity. These programs take forms large and small, from community groups to the World Bank. The methods likewise take varying, and sometimes competing forms, from watershed restoration to road building to community engagement, with funding provided by charities, loans, microfinance and big business. Once these projects are installed, typically the implementers are their own evaluators. When resources allow, some may invite external experts to visit the projects. Under the best of circumstances, funding is available to run a randomized controlled trial to rigorously evaluate if the projects are improving the intended environmental, health or other outcomes. But, usually sooner rather than later, the funding runs out for that particular project, and often organizations move on. This has resulted in sad statistics. For example, half of the water pumps installed in some African countries are broken a few years after they’re installed. We propose an alternative - Moving the mindset of funders toward pay-for-performance models of humanitarian and environmental interventions, backed by objective measurement tools and metrics. Instead of pushing money toward projects based on promises, pay interventions for successfully demonstrating impact that meets a stated intent.