Afrihealth Optonet Association (AHOA) - CSOs Network
Posté le 05/11/2026
The Risks of Excluding Evaluative Evidence from Strategic and Operational Decision-Making in Resource-Constrained Environments
- By Dr. Uzodinma Akujekwe Adirieje, FAHOA CEO and Programmes Director, Afrihealth Optonet Association (AHOA)
I have spent decades in health economics, health systems strengthening and monitoring and evaluation, in settings where every naira, dollar and working hour is stretched. One lesson from that work is that decisions made without evaluative evidence are expensive, even when they look cheap. Resource-constrained environments have the least room to absorb that cost.
STRATEGIC RISKS
Misallocated resources. Without evidence on what works, for whom and at what cost, money goes to familiar or politically attractive programmes and not to effective ones. Where budgets are tight, every misdirected dollar is a service that does not exist elsewhere.
Repeating failed approaches. Programmes that were never evaluated, or whose evaluations were ignored, are renewed and scaled unchanged. The same design flaws are paid for again.
Strategy detached from reality. Plans built on untested assumptions drift away from what communities and frontline staff actually face.
Weakened standing with funders. Organisations that cannot demonstrate results and learning lose credibility, and that hurts most when competing for scarce funding.
OPERATIONAL RISKS
Late detection of problems. Without M&E feeding into management, stockouts, low uptake, poor targeting and delays surface only after harm is done.
Duplication and inefficiency. Without mapping what is already known, teams commission studies and design interventions that repeat existing work.
Lost institutional memory. Where staff turnover is high, knowledge leaves with people unless evaluation captures it.
Inability to adapt. Fragile and fast-changing contexts demand course correction. Without evidence, adaptation becomes guesswork.
RISKS TO PEOPLE AND EQUITY
Unseen harm. Unintended effects on women, adolescents, refugees, displaced people and remote communities stay invisible if no one is looking. The least visible groups in the data are usually the most vulnerable.
Silenced community voice. Evaluation is one of the few formal channels through which communities say what is and is not working. Community Advisory Boards exist for the same reason. I chair the Community Advisory Board for the VERDI Mpox study in Bayelsa, Lagos and Rivers States, and I have seen that accountability to participants is what gives a programme its legitimacy.
Eroded trust. When communities see their feedback ignored, participation declines, and later programmes pay for it.
GOVERNANCE AND SUSTAINABILITY RISKS
Weak accountability. Without evidence there is no objective basis for judging performance, so poor results and misuse of funds are harder to detect and challenge.
Decisions by opinion or power. Evidence is the main check against decisions driven by the loudest voice, politics or convenience.
Poor sustainability. Programmes are not designed for handover, cost recovery or integration into national systems when no one has measured what sustaining them requires.
Ethical and reputational exposure. In health and research settings, skipping evidence-based safeguards and ethical review can cause harm and destroy credibility.
WHY SCARCITY MAGNIFIES THESE RISKS
Evaluation is often the first line cut in a tight budget, because its costs are immediate and visible while its benefits are delayed and diffuse. That is a false economy. A modest investment in evidence usually costs far less than the waste it prevents. Resource-constrained systems also cannot afford large-scale trial and error. Evidence is what lets them learn from other people's mistakes and not their own.
EVIDENCE MUST BE FIT FOR PURPOSE
Evidence is also excluded when it arrives too late, costs too much or is too remote from decision-makers to be used. My recommendations are:
Commission right-sized, timely evaluations built around questions that decision-makers actually need answered.
Build routine monitoring and rapid learning cycles into programme management.
Value community-generated and Indigenous evidence alongside formal data.
Place local evaluators and institutions in the lead.
Use AI for evidence mapping and synthesis to lower costs, always with human verification, so that AI extends evaluators' reach without replacing their judgment.
CONCLUSION
Leaving evaluative evidence out of decisions means steering without feedback. It wastes scarce resources, hides harm and weakens accountability to the people we serve. At AHOA we hold that artificial intelligence and every other tool must serve equity, justice and sustainable development. Evidence is how we keep that commitment honest.
Dr. Uzodinma Akujekwe Adirieje, FAHOA CEO and Programmes Director, Afrihealth Optonet Association (AHOA) 2026 EvalforEarth Champion | President, African Refugees Council (ARC) Abuja, Nigeria | ceo@afrihealthcsos.org | www.afrihealthcsos.org
RE: Evaluation under pressure : Strengthening evidence use, accountability and learning amidst funding constraints (Joint EvalforEarth-ALNAP discussion)
Nigeria
Dr. Uzodinma Akujekwe Adirieje
CEO
Afrihealth Optonet Association (AHOA) - CSOs Network
Posté le 05/11/2026
The Risks of Excluding Evaluative Evidence from Strategic and Operational Decision-Making in Resource-Constrained Environments
- By Dr. Uzodinma Akujekwe Adirieje, FAHOA
CEO and Programmes Director, Afrihealth Optonet Association (AHOA)
I have spent decades in health economics, health systems strengthening and monitoring and evaluation, in settings where every naira, dollar and working hour is stretched. One lesson from that work is that decisions made without evaluative evidence are expensive, even when they look cheap. Resource-constrained environments have the least room to absorb that cost.
STRATEGIC RISKS
Misallocated resources. Without evidence on what works, for whom and at what cost, money goes to familiar or politically attractive programmes and not to effective ones. Where budgets are tight, every misdirected dollar is a service that does not exist elsewhere.
Repeating failed approaches. Programmes that were never evaluated, or whose evaluations were ignored, are renewed and scaled unchanged. The same design flaws are paid for again.
Strategy detached from reality. Plans built on untested assumptions drift away from what communities and frontline staff actually face.
Weakened standing with funders. Organisations that cannot demonstrate results and learning lose credibility, and that hurts most when competing for scarce funding.
OPERATIONAL RISKS
Late detection of problems. Without M&E feeding into management, stockouts, low uptake, poor targeting and delays surface only after harm is done.
Duplication and inefficiency. Without mapping what is already known, teams commission studies and design interventions that repeat existing work.
Lost institutional memory. Where staff turnover is high, knowledge leaves with people unless evaluation captures it.
Inability to adapt. Fragile and fast-changing contexts demand course correction. Without evidence, adaptation becomes guesswork.
RISKS TO PEOPLE AND EQUITY
Unseen harm. Unintended effects on women, adolescents, refugees, displaced people and remote communities stay invisible if no one is looking. The least visible groups in the data are usually the most vulnerable.
Silenced community voice. Evaluation is one of the few formal channels through which communities say what is and is not working. Community Advisory Boards exist for the same reason. I chair the Community Advisory Board for the VERDI Mpox study in Bayelsa, Lagos and Rivers States, and I have seen that accountability to participants is what gives a programme its legitimacy.
Eroded trust. When communities see their feedback ignored, participation declines, and later programmes pay for it.
GOVERNANCE AND SUSTAINABILITY RISKS
Weak accountability. Without evidence there is no objective basis for judging performance, so poor results and misuse of funds are harder to detect and challenge.
Decisions by opinion or power. Evidence is the main check against decisions driven by the loudest voice, politics or convenience.
Poor sustainability. Programmes are not designed for handover, cost recovery or integration into national systems when no one has measured what sustaining them requires.
Ethical and reputational exposure. In health and research settings, skipping evidence-based safeguards and ethical review can cause harm and destroy credibility.
WHY SCARCITY MAGNIFIES THESE RISKS
Evaluation is often the first line cut in a tight budget, because its costs are immediate and visible while its benefits are delayed and diffuse. That is a false economy. A modest investment in evidence usually costs far less than the waste it prevents. Resource-constrained systems also cannot afford large-scale trial and error. Evidence is what lets them learn from other people's mistakes and not their own.
EVIDENCE MUST BE FIT FOR PURPOSE
Evidence is also excluded when it arrives too late, costs too much or is too remote from decision-makers to be used. My recommendations are:
CONCLUSION
Leaving evaluative evidence out of decisions means steering without feedback. It wastes scarce resources, hides harm and weakens accountability to the people we serve. At AHOA we hold that artificial intelligence and every other tool must serve equity, justice and sustainable development. Evidence is how we keep that commitment honest.
Dr. Uzodinma Akujekwe Adirieje, FAHOA
CEO and Programmes Director, Afrihealth Optonet Association (AHOA)
2026 EvalforEarth Champion | President, African Refugees Council (ARC)
Abuja, Nigeria | ceo@afrihealthcsos.org | www.afrihealthcsos.org
+234 80 347 25 905