Previous authors in this series have made a strong case for using evidence-based approaches to strengthen human rights interventions. Indeed, in other sectors where an evidence-based approach has been implemented, researchers have found that it more fully empowers professionals in the field and provides a “bounce” in their effectiveness. The question, then, is not whether evidence-based approaches can support human rights efforts. Rather, it is how to implement systems effectively for evidence-based practice across an organization.
Many of the key best practices in this field—such as having a steering committee composed of experts and stakeholders that provide widespread training and create an effective repository of evidence—come primarily from Evidence-Based Medicine (EBM). EBM has been widely adopted internationally in the medical field, including the World Health Organization, because it promotes optimal clinical outcomes and improved quality of life for patients. However, like evidence-based strategies in human rights, EBM was not always so widely accepted. According to the pioneers of EBM, doctors, nurses and other health professionals initially resisted the approach. Some worried that it would be too hard to implement. Others were concerned with the danger of turning their work into “cookbook” medicine. These apprehensions, along with loss of autonomy and suspicion that “snapshots” could lead to faulty comparisons, sound very similar to the concerns human right workers have expressed about evidence-based practice. Over time, the concerns of the medical community have been answered through effective implementation of systems that rely on EBM as a supplement and amplifier, never a substitute, for expertise.
Fortunately for human rights practitioners, evidence-based practice is not new. We can learn much from successful implementation in other fields, which include medicine, business management, teaching, criminal justice and political policy making, to name just a few examples.
Since the introduction of EBM about 25 years ago, it has become a critical component in modern clinical medicine, informing the creation of many effective treatment guidelines. One example is the implementation of a new procedure to treat asthma at the Royal Children’s Hospital in Victoria, Australia. The EBM-based approach was able to achieve an unusually high success rate of 95.5 percent during the first three months of transition. The reasons for this success are credited both to a scientific evaluation of the procedure and to a structured approach to implementing the change. Beyond the years of lessons learned, EBM is also instructive for human rights practitioners because of its specific goal: “The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” Replace “the care of individual patients” with the “rights of individuals and people groups”, and this goal corresponds neatly with the objectives of human rights organizations.
As noted above, effective EBM systems require creating governance boards or steering committees that can oversee the development and implementation across organizational functions. This internal group is primarily responsible for overseeing the cultural shifts that may be needed for full implementation. This board or committee also oversees organization-wide training programs; the development of tools such as databases that enable professionals to store, implement and share evidence; the collection of a group of EBM experts for staff support; and the creation of user-friendly tools for evaluation.
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Using models developed in the medical and business world, evidence-based approaches can be applied to human rights with proper governance, staff support, and development of user-friendly tools and technology.
There is a lot of useful foundational work that has been done on which to build such user-friendly tools of evaluation. For example, the information and communications technology (ICT) approach covers a range of tools to aid in evaluations, including the use of smartphones, tablets and web-based text mining. Many general-purpose analytical tools are available for the analysis of evaluation data. In addition, there are specialized software products for analyzing qualitative data, such as EZ-Text from the Center for Disease Control (CDC) and commercial products like NVivo. The next step is to develop a platform or shell that can help human rights organizations access these tools in such a way that their own (non-IT specialists) can tune them to their specific needs similar to the way that TurboTax or Quicken can help individual tax-payers navigate the peculiarities of the tax code. While the humanitarian response field has made some progress developing standardized tools, efforts to do the same for human rights programs have generally been housed within specific organizations.
The core value of evidence-based business management—continuous learning—is shared by many human rights organizations.These same tips are echoed in the successful implementation of evidence-based management for business processes. Similar to EBM, evidence-based management of businesses also rely on data collection, storage, analysis, access, and evaluation. While this may not seem transferrable to human rights work at first, the core value of evidence-based business management—continuous learning—is shared by many human rights organizations. In the business world, this continuous learning process is represented as a “virtuous cycle” in which the organization improves its services and goods through careful, ongoing documentation and dissemination of knowledge. This is similar to what some practitioners call “learning based management”.
In this cycle, it’s important to first examine the quality of the data. This is key in order to evaluate the cost of poor quality data and to help prioritize improvement project. Next, we must define performance metrics in order to identify the critical needs and support reporting of activities. Then, to make needs visible and focus resources, we connect data quality to activities and improve the overall quality of data. Finally, it is crucial to manage the flow of information in order to detect and correct issues in a timely fashion.
As medicine and business increasingly adopt human rights-based approaches in their fields, the distinctions between these various approaches to monitoring, evidence-based management and continuous learning are blurring. The most relevant examples for human rights practitioners will come from these places of most intense connection. For example, some researchers in maternal and reproductive health rights are expanding and adapting the EBM approach to include explicit human rights criteria.
These examples from just two fields illustrate the wealth of knowledge and expertise available and show that human rights organizations should not hesitate to reach out to experts from other sectors. One source for this type of assistance is the AAAS On-Call Scientists initiative, a pro bono referral service that connects human rights organizations with scientists, engineers, and health professionals. The On-Call Scientists roster includes volunteers with experience developing different types of metrics, as well as systems for data collection, management, analysis, and dissemination.
Perhaps partnerships between human rights organizations and advisors from other fields can help the “virtuous cycle” earn a double meaning as a methodology that supports, but does not supplant, the guiding principles of ethical and effective human rights practice.