11.7 A political exercise

As mentioned earlier, relevance is a relative concept. Its meaning varies according to different groups’ perspectives or who sponsors the analysis. In an ideal world, one would engage with different community groups to elicit and unpack what a relevant intervention should be, or engage with a diversity of actors throughout the prioritization process to align with a broader definition of relevancy: “Is the program trying to achieve an outcome for society that is important?” (Robinson, 2018, p. 306). “Needs assessment requires carefully analyzing a situation and building support for action” (Gupta et al., 2014, p. 33). Priorities may differ according to the groups involved (Gupta et al., 2014). Implementing the right engagement activities is a way to make sure decisions will be socially legitimate and accepted. They can also contribute to making programs known and building meaningful relationships with a diversity of actors (Gupta et al., 2014).

Needs assessments, because they can support priority-setting and budgetary decisions, can be very political exercises (McDavid et al., 2019). Needs assessment is, for example, one important element of spending reviews. In spending reviews, relevance is generally one criterion among others. For example, Robinson identifies six criteria employed during spending reviews to identify savings options: relevance, duplication, effectiveness, efficiency, equity, and market failure (Robinson, 2018, p. 306). Marchand and Brousselle note that in the spending review exercise which took place in the Province of Quebec in 2014, decisional criteria were (1) relevance (the objectives relate to the needs of the targeted populations and the government priorities; a program that could have been created in the current context; a program that, if dismantled, would create important negative social, economic, and environmental consequences), (2) effectiveness, and (3) efficiency (Gouvernement du Québec, 2014; Marchand & Brousselle, 2018, p. 399).

The official rationale for spending reviews has been that they ensure that the most relevant interventions are funded and others are discarded; however, spending reviews are often used when the political priority is drastic cuts in public spending. Determining relevance is more than just a technical exercise. It also involves weighing competing values and their reflections in political priorities.

It is not unusual to observe direct opposition and barriers to data access when programs are threatened by the exercise. As noted earlier, many choices must be made during a needs assessment. Its validity depends, at least in part, on whether the process is recognized as legitimate by the different parties—something that cannot be assured if the process is contentious from the outset. An evaluator’s ability to facilitate discussions and communicate effectively will be critical to the success of the process.

In scoping a needs assessment, one consideration is the diversity of values and interests in a community. Generally, homogeneous communities will present fewer challenges in terms of assessing needs. Smaller communities can also be more straightforward for the same reasons. The evaluator should anticipate that social media and other sources of information will influence community preferences in setting priorities and their understanding of the problem. Disinformation about climate change related risks can divide communities.

Finally, including socio-environmental considerations in the intervention’s analysis of relevance is likely to completely switch how priorities are identified. As these criteria have not been included in prior evaluations, their integration could lead to eliminating some interventions and choosing others with more positive impacts. Conducting evaluations on an intervention’s relevance using planetary health lenses could be an important lever towards implementing the kind of transformation that is needed for truly addressing the current socio-environmental challenges.