Great Question

Thomas Abraham, writing for The New York Timesasks:

[Why are] global health programs… fragmented along disease-specific lines, rather than addressing multiple diseases and helping to strengthen basic health services. The same children who need to be vaccinated against polio also need to be reached by other immunization programs, receive bed nets from the malaria program, and benefit from nutrition and safe-water initiatives.

While donors have often pledged to work together to integrate disease initiatives, the way global health programs are structured makes integration, or even cooperation, difficult.

Most aid and donor funding is earmarked for specific health issues; the campaigns in turn are required to meet specific targets related to the diseases for which they have received money.

Thus the malaria program has no real interest in helping polio immunization, since this is not what its funding is for. The polio program similarly has no stake in helping measles immunization, which it would see as a distraction from its primary aim of eradicating polio.

Could the same be said about literacy here in the U.S.? There are a lot of different programs working to improve literacy in this country, but these programs are also fragmented—in this case, along age-specific or need-specific lines. Some programs are focused on getting books to kids, while others provide tutors for adults, and others concentrate on showing parents how to enhance the development of their children’s early literacy skills—to cite three examples.

Further, I’d argue that these efforts are not structured in a way that makes integration between them easy. Efforts to improve children’s literacy don’t usually coordinate with programs for adults, groups that work to get books to kids don’t necessarily connect with efforts to engage parents, and groups that work to engage parents don’t necessarily work with adult literacy groups. And so on. Even within adult education, community-based organizations are sometimes working separately from institutional programs at community colleges or public schools. We’re often competing for the same dollars, too, and often from the same funders.

If I were to design, from scratch, a community-based model to improve literacy skills, I’d provide incentives for all of these groups to not only coordinate, but to organize that collective effort around the specific needs of community members.

via The