PHC uses five distinct methods of measuring ourselves:

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  1. ‘Good to Great’ Internal Report Card
  2. Cost-effectiveness
  3. Process Indicators
  4. Fortification-Specific Management Information System
  5. Program Reach

 
 

1. ‘Good to Great’ Internal Report Card

Based on Jim Collin’s 2001 management book ‘Good to Great’, PHC developed a self-rating report card to remain focused on how to become the best at what we do.

We rate ourselves internally every quarter. Grades are presented at Board of Directors meetings where we are held accountable for any changes.

Collin’s outlined seven characteristics of companies that went from ‘good’ to ‘great’:

  • Level 5 Leadership
    • Leaders who are humble, but driven to do what’s best for the company.
  • First Who, Then What
    • Get the right people on the bus, then figure out where to go. Finding the right people and trying them out in different positions.
  • Confront the Brutal Facts
    • The Stockdale paradox: confront the brutal truth of the situation, yet at the same time, never give up hope.
  • Hedgehog Concept
    • Three overlapping circles: What lights your fire (“passion”)? What could you be best in the world at (“best at”)? What makes you money (“driving resource”)?
  • Culture of Discipline
  • Technology Accelerators
    • Using technology to accelerate growth, within the three circles of the hedgehog concept.
  • The Flywheel
    • The additive effect of many small initiatives; they act on each other like compound interest.

Using the theory and language from Collin’s research, we grade ourselves on the ability to ‘keep it simple’, ‘get our three circles right’, and ‘act with understanding not bravado’.

2. Cost-Effectiveness

Our cost-effectiveness metrics include: 1) Cost to PHC to reach individuals with each micronutrient and 2) Overall program costs (including government and industry costs) to reach these same individuals with each micronutrient.

Starting in September 2011, PHC calculated projected metrics based on anticipated spending and what we knew at the time about each country’s population, vehicle coverage, vehicle coverage overlap, and nutrients to be added to each vehicle.

Each quarter, we revisit our assumptions and alter numbers as appropriate. Changes over the years may be due to things such as increased or decreased PHC annual spending on a program, the inclusion or exclusion of a major staple food product after it was projected it would be included, and / or revised consumption figures.

In summary, most up-to-date costs for each country are:

Rwanda
PHC cost / MN / person: $0.01
Annual program cost / MN / person: $0.02

Burundi
PHC cost: $0.04
Annual program cost: $0.03

Zimbabwe
PHC cost: $0.03
Annual program cost: $0.08

Malawi
PHC cost: $0.06
Annual program cost: $0.11

Liberia:
PHC cost: $0.02
Annual program cost: $0.03

The chart below shows the evolution of PHC’s cost to reach individuals in each country of operation. Liberia stands out as being more expensive when compared to the others due to its smaller population and changing consumption figures. A dramatic decrease can be seen in the second year due to program costs being much lower than anticipated.

Chart 1

The chart below shows the evolution of government and industry costs to implement a program. Malawi is significantly more expensive than others due to the decision by government to purchase premix for the country’s only domestic sugar facility, Illovo Sugar, at a cost of USD 3 million. Zimbabwe’s costs are high due to the shear number of domestic staple food producers in the country. And the change seen in Liberia is due to an increase in the anticipated population reached due to updated flour consumption figures and a decrease in the actual mill costs for the country. After the second year, the figures begin to rise again slightly due to the exclusion of bouillon cubes and rice as vehicles for fortification.

chart 2

The biggest bang-for-your buck comes when implementing within larger populations and when programs ensure industry picks up the vast majority of fortification costs as opposed to government.

3. Process Indicators

PHC’s process indicators measure program implementation and monitoring for each country of operation. These indicators are used internally to track and monitor progress towards:

  • Identified industries and importers producing and importing fortified foods meet the designated national standards.
  • Samples and / or audits are performed at industry, border, and market on a regular basis.
  • Samples are tested and results are provided to industry / importers on a regular basis.
  • Non-compliance measures are taken as relevant for local industry and / or importers.
  • Surveillance mechanisms are put in place to ensure that close to 80% of the target population is consuming the fortified foods.

Red indicates benchmarks or indicators that have not yet been met; green indicates completion. This process serves as a valuable tool to keep us focused on what needs the most attention.

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chart

4. PHC’s Fortification Management Information System (Fort-MIS)

PHC uses our Fortification-Specific Management Information System (described in detail here), designed and deployed first in Malawi in 2012 and now within almost all countries in which PHC supports, to gauge whether or not a program is being implemented as designed and whether or not the fortified products actually contain the correct amounts and vitamins and minerals, per the national standard, needed to have an impact on the health of the population.

Because what is the point of all of this if we don’t have the right amount of nutrients in the food to have a nutritional impact?

An example of the data the Fort-MIS can generate is provided below. They system becomes completely owned and operated by each government that decides to adopt it.

Average Salt Iodization Level by Custom Station: Displays the average level of iodine in imported salt samples (in ppm) collected by Malawi’s Bureau of Standards (MBS) from key custom stations. The number of samples collected and tested per custom station is also displayed. This is national level data from 2008 to 2010.

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Average Salt Iodization Level by Quarter: Displays the national evolution of average salt iodization levels from imported salt samples collected from custom stations by quarter from Quarter 3 of 2008 through Quarter 4 of 2010. The number of samples tested per quarter is also displayed.

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To learn more about PHC’s Fort-MIS, click here.

5. Reach

Taking the highest potential coverage staple products from each large-scale country and excluding salt:

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