Bill Gates: My Plan to Fix The World’s Biggest Problems

When Ethiopia signed on to the Millennium goals in 2000, the country put hard numbers to its ambition to bring primary health care to all of its citizens. The concrete goal of reducing child mortality by two-thirds created a clear target by which to measure success or failure. Ethiopia’s commitment attracted a surge of donor money toward improving the country’s primary health-care services.

With help from the Indian state of Kerala, which had built a successful network of community health-care posts, Ethiopia launched its own program in 2004 and today has more than 15,000 health posts staffed by 34,000 workers. (This is one of the greatest benefits of measurement—the ability it gives government leaders to make comparisons across countries and then learn from the best.)

Last March, I visited the Germana Gale Health Post in the Dalocha region of Ethiopia, where I saw charts of immunizations, malaria cases and other data plastered to its walls. This information goes into a system—part paper-based and part computerized—that helps government officials see where things are working and to take action in places where they aren’t. In recent years, data from the field have helped the government respond more quickly to outbreaks of malaria and measles. Perhaps even more important, the government previously didn’t have any official record of a child’s birth or death in rural Ethiopia. It now tracks those metrics closely.

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