This article was published by Other News as a supplement to the review of Adam Fifield’s biography ‘A Mighty Purpose: How UNICEF’s James P. Grant Sold the World on Saving Its Children’ .
Amidst all the other achievements, it is easily forgotten that Jim Grant was also a pioneer in the use of statistics.
In the 1960S and 70s, he was one of the first people outside the academic world to realise that per capita GNP was an inadequate measure of human wellbeing. Before coming to UNICEF, as President of the Washington-based Overseas Development Council, he developed and promoted the Physical Quality of Life Index (PQLI) which measured each nation’s progress not by its economic standing but by an average of the adult literacy rate, the infant survival rate, and life expectancy at age one.
On taking over UNICEF, he began to think about changes in the way the organisation presented its statistics to the world. Until that time almost all UN statistical tables ranked countries either alphabetically or in descending order of per capita GNP. In his first State of the Children report (1980 – 1981), Grant decided that UNICEF’s ‘lead indicator’ – and the one by which all countries would be ranked in all future statistical tables – would be the Infant Mortality Rate or IMR. In 1975, the IMR gave way to the Under Five Mortality Rate (U5MR), but the principle and purpose remained the same.
Today, there is perhaps nothing surprising about this. But at the time, it was a radical change. Outside professional circles, child survival rates were little-known and there were formidable problems of data availability. Grant nonetheless made the change as a bold public statement of UNICEF’s commitment to reducing the appalling rate of child deaths across the developing world.
Throughout the 80s and 90s, Grant showed that social indicators were essential to the task of galvanising and sustaining large scale national action for children. And in doing so he breathed new life into the almost moribund idea of UN goals which, in the 1970s, were always being proclaimed and rarely attained. Today, social indicators such as the IMR, the child malnutrition rate, the immunisation rate, or the school completion rate are the very language in which the majority of global development goals are expressed. This too is a part of Jim Grant’s extraordinary legacy.
in February 1995, at the memorial service held for Jim Grant in New York’s Cathedral of St. John the Divine, I was asked to say a few words about Jim Grant’s vision. It was not the time or the place to introduce controversial ideas. But it would have felt like letting Jim Grant down not to mention that his vision did not end with child survival. And so I concluded by saying that Jim also had a vision for the next century. The shorthand name he gave to that vision was ‘equity’ – ‘This century’s struggle’ he would say, ‘is to meet basic needs. The struggle of the next century will be for equity.’
Twenty years ago, equity was not a fashionable topic. Indeed it had barely begun to be realised even in the developed world that a fifty year trend towards slowly decreasing inequality was being thrown into reverse. But Jim was aware that even as great progress was being made and average levels of child health, nutrition and education were on the rise worldwide, many were being left behind. He also knew that national averages failed to reveal the concentration of health or nutrition problems among the poorest and least served communities; a programme that reaches 75% of a given population, for example, may be judged as being three-quarters of the way to success despite the fact that the problem being addressed, whether it be a disease vector or a micro-nutrient deficiency, will almost certainly be most prevalent among the 25% unreached.
Today it would be the children who have been left behind by the progress of recent decades that would be at the centre of Jim’s concern.
As always, he would have approached this issue with the maxim ‘if you want to change something, first measure it’. And for this purpose he would, I believe, have looked for an equivalent statistical revolution to the one that he so successfully pioneered in the early 1980s when he nailed UNICEF’s colours to the child survival rate. Today he would be asking himself and others ‘What statistical measure, what change in monitoring and measurement, would make the clearest possible underlying statement that the children left behind should now be the priority? What indicators are required to advocate and monitor progress towards that goal?
He would have understood but not allowed himself to get bogged down in debates about the definitions of equity and equality. And he would have understood but been wary of complex indicators like the Gini coefficient or even the ratio between top and bottom quintiles. Complexities would have been taken in to account, but he would have known that something altogether simpler and more intuitive was needed for the purposes of sustained public and political advocacy.
He would have started by looking at the increasingly disaggregated data now becoming available from national statistical offices and from sources such as the Demographic and Health Surveys and UNICEF’s own Multiple Indicator Cluster Surveys (an initiative which Jim Grant also pioneered and which now include surveys every three years in over a hundred countries). And from this mass of complicated data, my guess is that Jim Grant would have decided that the key indicator should be a measure of what is happening to the poorest 20% of the population in any given country.
There would have followed detailed discussions to debate and refine exactly what lead indicator would best serve to focus attention and action on the progress being achieved by the poorest fifth of the world’s children.
The bottom quintile
In practice, this would mean that average national levels for such basic indicators as the child survival rate, the child malnutrition rate, the maternal mortality rate, the rate of access to education and modern health services and to improved supply water and sanitation, as well as the rate of access to specific interventions such as immunization and micronutrient supplementation, would all be eventually replaced by the equivalent rate for the children of the poorest economic quintile on each indicator and in each country.
Just as in 1980, there would be formidable difficulties. And much work would be required to refocus the basic statistics of development on the poorest. But making commitments and then finding the ways and means to fulfil them is what Jim Grant’s leadership was all about (or as he would have said – ‘first build castles in the sky, then work to put foundations under them’).
In making any such change, Jim Grant would have fully appreciated – and exploited – the fact that switching to measuring progress by what was happening to the poorest 20% would in itself constitute a powerful advocacy statement – and one that is applicable globally as old distinctions between developed and developing countries continue to blur. Today almost every country, rich or poor, is faced with the issue of accelerating inequality – and of a significant proportion of people who are being left behind by progress. And a major public commitment by UNICEF to the effect that “what happens to the poorest 20% of children is the new measure of progress” would be a substantial global advocacy platform on which much might be built.
To Jim Grant, statistics were not abstract, lifeless things. They were an essential part of the tool kit for getting the job done. It is measurement and monitoring that informs and guides policy, facilitates accountability, fuels advocacy, encourages success, reveals failure, helps make good use of scarce resources, and helps galvanise and sustain large-scale action on the ground. Over and above all of this, it is the choice of the measures used that reveals and reinforces real aims and priorities.
For those who share the vision of greater equity, new measures are needed to reflect that vision. Placing ‘what is happening to the poorest 20%’ as the first and most important consideration of developmental progress would send out the clearest of messages and one that Jim Grant would surely have endorsed: that in the years ahead, progress that leaves the poorest behind is not to be considered progress at all.