Foreign Assistance: Better Guidance for Strategy Development Could Help Agencies Align Their Efforts

More than 20 federal agencies spend billions of dollars on U.S. foreign assistance each year. Six agencies—the Departments of Agriculture, Defense, Health and Human Services, and State; the Millennium Challenge Corporation; and the U.S. Agency for International Development—implement most of this assistance, using multiple strategies. State is responsible for coordinating their efforts. Questions have been raised about potential inefficiencies in implementing multiple foreign assistance strategies.

GAO was asked to review the alignment of U.S. foreign assistance strategies. This report examines the extent to which strategies include key elements GAO identified, related to interagency coordination, strategic integration, and assessment of progress, that help ensure alignment. These elements are based on GAO's prior work on strategic planning and interagency collaboration. GAO reviewed 52 strategies related to health, security, and democracy assistance that were current in 2017. These included government-wide, agency, multi-agency, and regional strategies as well as strategies for two countries. GAO also reviewed agency guidance and interviewed agency officials.

Many foreign assistance strategies related to health, security, and democracy assistance that GAO reviewed at least partially addressed key elements GAO identified that help ensure the strategies are aligned. Prior work has found that consistently addressing these elements, related to interagency coordination, strategic integration, and assessment of progress, is important for, among other things, better managing fragmentation in strategic planning. However, some strategies did not address these elements (see figure). For example:

Interagency coordination . Twenty-three percent of the strategies (12 of 52) did not address agencies' roles and responsibilities, and 38 percent (20 of 52) did not identify specific interagency coordination mechanisms.

Strategic integration . Twenty-one percent of the strategies (11 of 52) did not address linkages with other related strategies, and 25 percent (13 of 52) did not address linkages with higher- or lower-level strategies.

Assessment of progress toward strategic goals . Twenty-one percent of the strategies (11 of 52) did not include milestones and performance indicators, and 21 percent (11 of 52) did not outline plans for monitoring and evaluation.

The six agencies implementing most U.S. foreign assistance do not have consistent guidance for strategy development that could help ensure their strategies address these key elements. Some agencies' guidance addresses many of the elements but does not apply to all of their foreign assistance strategies, while other agencies have no such guidance. The Department of State (State) plays a significant role in interagency coordination. By collaborating with other agencies to establish guidance that addresses the key elements GAO identified, State could help the agencies improve their ability to align future strategies and identify and manage fragmentation in foreign assistance planning.

GAO recommends that State lead an effort to establish, in collaboration with the five other agencies, guidance for developing foreign assistance strategies that addresses the key elements GAO identified related to interagency coordination, strategic integration, and assessment of progress. State concurred with GAO's recommendation.

More than 20 federal agencies and departments spend billions of dollars  each year on various types of U.S. foreign assistance—health, security,  and democracy assistance as well as education, energy, environmental  protection, food aid, refugee assistance, water and sanitation assistance,  and countering illicit activities. These agencies implement foreign  assistance with, in some cases, separate strategies—including  government-wide and country-level strategies—guiding their efforts.  Questions have been raised about potential inefficiencies stemming from  the multiplicity of strategies related to foreign assistance as well as about  the ability of agencies to demonstrate progress in achieving strategic  goals.

You asked us to assess alignment among U.S. foreign assistance  strategies. This report examines the extent to which foreign assistance  strategies address key elements we identified that help promote  alignment of agencies’ efforts—specifically, elements related to  interagency coordination, strategic integration, and assessment of  progress toward strategic goals and objectives. We focused on strategies  identified by the six largest providers of U.S. foreign assistance: the  Department of State (State); the U.S. Agency for International  Development (USAID); the Millennium Challenge Corporation (MCC); and  the Departments of Defense (DOD), Health and Human Services (HHS),  and Agriculture (USDA).

In a June 2017 report, we listed 63 foreign assistance strategy documents  that these six agencies had identified; the agencies subsequently  identified 9 additional strategies. For our current report, we conducted a  detailed review of 52 of the 72 strategies identified. The 52 strategies we  reviewed had been issued by December 2017 and were current in 2017.  In addition, the strategies incorporated goals and activities related to the  health, security, or democracy assistance sectors, which accounted for  the majority of foreign assistance obligations in fiscal year 2016, the most  recent year for which data were available. The strategies we reviewed  include government-wide, agency-specific, multi-agency, regional,  sectoral, and multisectoral strategies as well as country-level strategies  for Afghanistan and Kenya, which are among the largest recipients of  U.S. foreign aid. We limited our review to strategy documents that  agencies provided. We did not review agencies’ efforts to implement the  strategies and did not assess the overall effectiveness of such efforts.  Instead, we focused on the extent to which the strategies we reviewed  provided a clear picture of the organization and management of U.S.  foreign assistance efforts.

We reviewed the strategies to determine the extent to which each  addressed nine key elements we had identified as important for helping to  ensure that agencies’ foreign assistance is well aligned in terms of  implementation approach and desired results. These elements related to  (1) delineation of agencies’ roles and responsibilities and coordination  mechanisms; (2) integration with other related strategies; and (3)  assessment of progress toward strategic goals, including identifying  activities to achieve results, performance indicators, and monitoring and  evaluation plans. We developed these elements on the basis of prior work  related to U.S. government strategies and interagency collaboration as  well as prior work on addressing fragmentation, overlap, and duplication  in the federal government. Our prior work suggests that strategic  documents offer an opportunity to consider the relationship among goals  outlined in the strategies, the roles and responsibilities of various  stakeholders involved in achieving those goals, and information on how  progress toward those goals will be measured. Each strategy was  reviewed and rated by two analysts, including a subject-matter expert in  the strategic area that the strategy addressed. Given the variety of  strategies we reviewed and reviewers’ varying expectations for the detail  and emphasis accorded to the key elements we identified, we rated the  strategies using a three-part scale focused on their presence in each  strategy. We rated a strategy as generally addressing an element if the  strategy provided sufficient detail to understand the element within that  strategy, as partially addressing the element if the strategy mentioned the  element but did not provide sufficient detail, and as not addressing the  element if the strategy did not mention it. We also reviewed agency  guidance for developing foreign assistance strategies. See appendix I for  further details of our scope and methodology, and see appendix II for a  list of the 52 strategies we reviewed.

We conducted this performance audit from May 2017 to July 2018 in  accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives.

U.S. agencies implementing foreign assistance have individually and  jointly developed strategies to guide their efforts. While State’s, USAID’s,  and MCC’s strategies focus exclusively on foreign affairs or foreign  assistance, DOD’s, HHS’s, and USDA’s strategies—as well as those of  other agencies—address foreign assistance as part of larger portfolios of  programs.

State and USAID, which provide the majority of all foreign assistance,  develop joint foreign assistance-related strategies. The State-USAID  Joint Strategic Plan outlines top-level goals for State and USAID  efforts, including the use of foreign assistance, to inform strategies  developed by State and USAID bureaus, offices, and country teams.  Six joint State-USAID regional strategies (e.g., the State Bureau of  African Affairs–USAID Bureau for Africa Joint Regional Strategy)  identify regional bureau priorities that are intended to align with the  State-USAID Joint Strategic Plan and guide country-level planning for  joint integrated country strategies.

State, the lead U.S. foreign affairs agency, also develops strategies  for its functional bureaus, which implement foreign assistance  programs, and has participated in the development of a number of  multisectoral and global strategies. State’s Office of U.S. Foreign  Assistance Resources is responsible for coordinating foreign  assistance programs, including providing strategic direction for both  State and USAID. According to State documents, the Office of U.S.  Foreign Assistance Resources strengthens the integration of foreign  assistance with U.S. foreign policy priorities by guiding the  development of coordinated strategic plans for each U.S. overseas  mission at the country level (i.e., integrated country strategies), aiming  for a holistic, whole-of-government approach. It provides tools and  resources to assist bureaus, offices, and country teams in designing  foreign assistance programs, projects, and processes that can help  align with, and advance, broader strategic goals as well as monitoring  and evaluation of progress and results.

USAID, the lead U.S. foreign assistance agency, develops global,  regional, and country strategies in the areas of health, democracy and  human rights, water and sanitation, food security, education, poverty,  and the environment, among others.

MCC has developed one overall strategy document, related to its  mission of reducing poverty through country-led economic growth.  MCC also collaborates with stakeholders in and outside government  to develop and implement foreign assistance programs.

DOD performs security cooperation strategic planning,  implementation, and oversight to achieve national defense strategy  objectives. DOD also develops country-specific strategies for security  cooperation and other assistance, including humanitarian assistance  and efforts to build foreign partner security capacity.

HHS has developed, or is a party to, a number of strategies related to  global health, including strategies for specific diseases, such as  HIV/AIDS, malaria, and Ebola, and for immunization and emergency  preparedness. The Centers for Disease Control and Prevention  (CDC), a component of HHS, develops its own strategies, which  discuss CDC’s plans to combat infectious diseases worldwide.

USDA has contributed to jointly issued strategies in food security  related to two food aid programs that it administers—the Food for  Progress program and the McGovern-Dole International Food for  Education and Child Nutrition program.

In addition, these agencies implement foreign assistance programs under  the auspices of government-wide foreign assistance strategies developed  by the National Security Council, the Executive Office of the President,  and the Office of Management and Budget. These government-wide  strategies include, for example, the National Security Strategy and the  National Action Plan for Women, Peace, and Security.

The geographic focus of these six agencies’ foreign assistance strategies  ranges from country level to regional to global. For example, State,  USAID, and DOD have developed integrated country strategies, country  development cooperation strategies, and country cooperation plans,  respectively, applicable to the countries where they implement foreign  assistance. Similarly, State and USAID have six joint regional strategies  and DOD has strategies focusing on its various geographic areas of  command. In addition, various agencies, working both jointly and  independently, have developed a wide variety of sectoral, multisectoral,  agency-specific, and multi-agency strategies to guide global assistance  efforts.

Foreign assistance strategies are continuously developed and updated.  Some strategies emerge after the launch of a specific initiative, such as  the President’s Emergency Plan for AIDS Relief (PEPFAR), while others  are updated as part of agencies’ strategic management processes. For  example, State’s functional bureau strategies and its joint regional  strategies with USAID are periodically updated as bureau-level  components of State’s planning, budgeting, and performance  management cycle. Planning at the agency level is reflected in the State- USAID Joint Strategic Plan, updated most recently in February 2018, with  which bureau- and country-level strategies are expected to align. As we  have previously reported, strategies that consider relationships among  goals and objectives, interagency collaboration, and performance  assessment can improve federal management. In particular, these  considerations can help identify, eliminate, or better manage  fragmentation, overlap, and duplication in the federal government.

Many Selected Foreign Assistance Strategies Addressed Key Elements We Identified That Help Promote Alignment, but Some Did Not

While many of the 52 foreign assistance strategies that we reviewed at  least partially addressed the key elements we identified related to  alignment of foreign assistance strategies, some did not address these  elements. Regarding interagency coordination, 40 percent of the  strategies generally identified roles and responsibilities for implementing  the strategies, while 33 percent generally identified interagency  coordination mechanisms; 23 percent and 38 percent, respectively, did  not address these elements. Regarding strategic integration, 58 percent  of the strategies we reviewed described linkages with U.S. foreign  assistance strategies in the same sector and 54 percent generally  described linkages with relevant higher- or lower-level U.S. foreign  assistance strategies; 21 percent and 25 percent, respectively, did not  identify such linkages. Regarding assessment of progress toward  strategic goals, almost all of the strategies generally established desired  results and a framework of goals and objectives and described activities  to achieve results; however, 21 percent did not identify milestones or  performance indicators and 21 percent did not outline plans for monitoring  and evaluation. We also found that the six agencies implementing most  U.S. foreign assistance do not have consistent guidance for strategy  development that could help ensure their strategies address the key  elements we identified.

We Identified Nine Key Elements That Help Ensure Strategies Are Aligned and Planning Is Not Fragmented

On the basis of our prior reporting about U.S. government strategic  planning and interagency collaboration, we identified nine key elements  that are important for helping to ensure that agencies’ foreign assistance  strategies are well aligned in terms of implementation approach and  desired results and that planning among multiple agencies is not  fragmented. The nine elements we identified are associated with (1)  interagency coordination, (2) strategic integration, and (3) assessment of  progress toward strategic goals (see table 1). As we have previously  reported, fragmentation in the U.S. government refers to circumstances in  which multiple federal agencies are involved in serving the same broad  area of national need and opportunities exist to improve service delivery.

Many Strategies We Reviewed Addressed Elements Related to Interagency Coordination, Strategic Integration, and Assessment of Progress, but Some Did Not

Implementing foreign aid involves the collaborative efforts of multiple U.S.  agencies, each of which brings specific contributions and statutory  authorities and has its own organizational structure, culture, and priorities.  Our prior work has shown that foreign assistance strategies that  consistently address (1) agencies’ roles and responsibilities and (2)  interagency coordination mechanisms can help guide the implementation  of various aspects of a strategy and the identification of agreed-on  processes for effective collaboration to resolve conflicts and better  manage fragmentation. Strategies that do not consistently address  elements related to interagency coordination miss opportunities to ensure  that agencies’ roles and responsibilities are clear and distinct and that  coordination mechanisms are well defined. As figure 1 shows, of the 52  strategies we reviewed, 40 percent generally identified agencies’ roles  and responsibilities and 23 percent did not address this element. In  addition, while 33 percent generally identified interagency coordination  mechanisms, 38 percent did not identify any such mechanisms.

Agencies’ roles and responsibilities. Forty percent (21 of 52) of the  strategies we reviewed generally defined agencies’ roles and  responsibilities. For example, USAID’s Strategy on Democracy, Human  Rights and Governance identified all agencies involved in its  implementation and laid out the roles and responsibilities of each agency  as well as USAID offices. Thirty-seven percent (19 of 52) of the strategies  partially defined agencies’ roles and responsibilities, which suggests the  potential for improvement in this area. For example, State-USAID joint  regional strategies identified the partners and stakeholders and  enumerated the activities that State and USAID or the embassy and  missions would undertake. However, most of those strategies did not  specify the individual agencies’ roles and responsibilities. Twenty-three  percent (12 of 52) of the strategies contained no information about  agencies’ lead, support, and partner roles.

Interagency coordination mechanisms. Thirty-three percent (17 of 52)  of the strategies we reviewed generally identified interagency  coordination mechanisms. For example, USAID’s Multi-Sector Nutrition  Strategy identified joint planning, funding, and programming mechanisms  for coordination among development and humanitarian assistance  agencies at country and regional levels in USAID and the U.S.  government as a whole. Twenty-nine percent (15 of 52) of the strategies  partially identified coordination mechanisms. For example, CDC’s Global  Health Strategy and USAID’s Global Health Strategic Framework both  described the agencies’ respective unique roles in global health but did  not specifically discuss how the agencies would work together to achieve  their goals. Thirty-eight percent (20 of 52) of the strategies did not discuss  interagency coordination mechanisms.

Integration with Other Related Strategies

As our prior work has shown, agencies that establish strategies that align  with partner agencies’ activities, processes, and resources are better  positioned to accomplish common goals, objectives, and outcomes. Our  prior work has also determined that collaboration among federal agencies  working toward similar results can help ensure consistent goals and  mutually reinforcing program efforts that effectively manage  fragmentation. These agencies can use higher-level strategic plans as a  tool to drive interagency collaboration to ensure complementarities in  goals and objectives. To improve alignment of related strategies, each  strategy should address (1) integration with relevant sectoral strategies  and (2) integration with relevant higher- or lower-level strategies.  Strategies that do not consistently address elements related to strategic  integration do not clearly show whether objectives and activities align with  existing strategic priorities at the government-wide, sectoral, regional, and  country levels. As figure 2 shows, 58 percent of the strategies we  reviewed generally described linkages with at least one relevant sectoral  strategy, while 21 percent did not mention such linkages at all. In addition,  54 percent of the strategies generally described linkages with at least one  higher- or lower-level foreign assistance strategy, while 25 percent did not  describe any such linkages.

Integration with relevant sectoral strategies. Fifty-eight percent (30 of  52) of the strategies we reviewed generally identified or described  linkages with other, related U.S. government strategies. For example,  State’s Strategy for Women’s Economic Empowerment discussed how its  activities are designed to complement and reinforce those of the U.S.  National Action Plan on Women, Peace and Security, the U.S. Strategy to  Prevent and Respond to Gender-Based Violence Globally, and the U.S.  Global Strategy to Empower Adolescent Girls. About 21 percent (11 of  52) of the strategies we reviewed partially addressed this element. For  example, the strategy PEPFAR 3.0—Controlling the Epidemic: Delivering  on the Promise of an AIDS-Free Generation explicitly referred to the  PEPFAR Blueprint for Creating an AIDS-Free Generation and stated that  targeting interventions for populations at greatest risk for HIV incidence is  an important activity. However, the strategy did not discuss how its goals  and objectives relate to the strategies of the various agencies  implementing PEPFAR and did not refer to the other strategies pertaining  to PEPFAR. The remaining 21 percent (11 of 52) of strategies did not  mention any other relevant U.S. government strategies. (See app. II for  additional analysis of strategies by sector.)

Integration with relevant higher- or lower-level strategies. Fifty-four  percent (28 of 52) of the strategies we reviewed generally described their  relationship to relevant strategies at higher or lower levels of government.  For example, the U.S. Global Strategy to Empower Adolescent Girls  discussed its relationship to a policy framework that, according to the  strategy, is embodied in three higher-level strategies establishing gender  equality as an important element of U.S. foreign policy—the National  Security Strategy, the U.S. Global Development Policy, and the  Quadrennial Diplomacy and Development Review. About 21 percent (11  of 52) of the strategies we reviewed partially addressed this element— that is, they discussed their relationship with higher- or lower-level  strategies in a limited way. For example, the U.S. Government Approach  on Business and Human Rights discussed priorities outlined in the  National Security Strategy, aligning activities of business with those  priorities, and noted efforts by State’s Bureau of Democracy, Human  Rights, and Labor to discuss human rights with businesses. However, the  U.S. Government Approach on Business and Human Rights did not  reference common goals or activities outlined in other relevant higher- level strategies, such as the U.S. Global Development Policy or the  Quadrennial Diplomacy and Development Review. The remaining 25  percent (13 of 52) of strategies did not address their relationship with  strategies at other levels of government.

Assessment of Progress toward Strategic Goals

Our prior work has shown that effective strategies clearly identify goals  and objectives and a means for assessing progress in achieving them  and that alignment of strategies and other plans can improve the  management of fragmentation. Therefore, our prior work has called for  agencies to develop strategies that identify and describe (1) desired  results, (2) activities to achieve results, (3) a hierarchy of goals and  subordinate objectives, (4) milestones and indicators, and (5) plans for  monitoring and evaluation. Strategies that do not consistently address  elements related to assessing progress may limit agencies’ ability to  specify and assess common goals and objectives and mutually  reinforcing results. As figure 3 shows, most of the strategies we reviewed  generally identified desired results, activities to achieve those results, and  a hierarchy of goals and subordinate objectives. However, fewer  strategies addressed how progress toward those goals and objectives  would be assessed. In particular, 63 percent generally identified  milestones and performance indicators, while 21 percent did not address  this element. In addition, 42 percent of the strategies generally outlined  plans for monitoring and evaluation, while 21 percent did not outline such  plans.

Desired results, activities to achieve results, and hierarchy of goals  and objectives. Ninety-two percent (48 of 52) of the strategies we  reviewed generally included a statement of desired results, and 90  percent (47 of 52) generally included a description of activities to achieve  these results. For example, MCC’s Next: A Strategy for MCC’s Future  stated the agency’s overall mission of reducing poverty through economic  growth and listed priority actions for each goal, such as exploring new  data sources for accurately identifying countries with high poverty rates.  In addition, about 83 percent (43 of 52) of the strategies generally  included a hierarchy of strategic goals and subordinate objectives. For  example, CDC’s Global Health Strategy included a clear hierarchy of  goals and subordinate objectives (see table 2). Six percent (3 of 52) of  the strategies did not identify desired results, 2 percent (1 of 52) did not  describe activities to achieve these results, and 10 percent (5 of 52) did  not include a hierarchy of goals and objectives.

Milestones and performance indicators. Sixty-three percent (33 of 52)  of the strategies we reviewed generally included milestones or  performance indicators. These strategies often incorporated milestones or  indicators as discrete components of each goal or subordinate  objective. For example, DOD’s Kenya Country Cooperation Plan  tracked discrete tasks with specific time frames, using color-coding to  designate stages of implementation. Fifteen percent (8 of 52) of the  strategies partially addressed milestones or indicators. For example, the  2016 updated joint State-USAID Strategy to Prevent and Respond to  Gender-Based Violence Globally included an annex listing indicators but  did not link them to the strategic objectives and planned actions. Twenty- one percent (11 of 52) of the strategies did not include any milestones or  performance indicators.

Monitoring and evaluation plans. Forty-two percent (22 of 52) of the  strategies we reviewed generally outlined monitoring and evaluation  plans. These strategies typically outlined such plans in a specific goal or  in a designated section or appendix. For example, USAID’s Kenya  Country Development Strategy included a section on monitoring and  evaluation planning. In this strategy, USAID committed to host donor  coordination and other stakeholder forums to monitor progress and to  establish a monitoring and evaluation “core team” to ensure that learning  is incorporated in decision making. Thirty-seven percent (19 of 52) of the  strategies partially addressed monitoring and evaluation planning. Some  of these strategies emphasized the importance of monitoring and  evaluation or made broad statements without outlining more specific  plans. For example, the State-USAID Joint Strategy on Countering  Violent Extremism noted that State and USAID will develop a results  framework for measuring progress that will be accompanied by clear,  well-developed, and well-resourced monitoring and evaluation plans. The  strategy also noted that State and USAID will, to the extent possible,  develop a common set of indicators to measure outputs and outcomes.  However, the strategy provided no additional details. Twenty-one percent  (11 of 52) of the strategies did not outline any monitoring and evaluation  plans.

Agencies Do Not Have Consistent Guidance for Foreign Assistance Strategy Development That Addresses the Key Elements We Identified

The six agencies implementing most of U.S. foreign assistance do not  have consistent guidance for strategy development that could help ensure  their strategies address the key elements we identified. For example,  State and USAID guidance for strategy development includes many of  these elements but does not cover all strategies that these agencies are  involved in developing. Additionally, guidance for State’s and USAID’s  joint regional strategies, State’s functional bureau strategies, and  USAID’s country development cooperation strategies does not apply to  other State and USAID strategies, such as the joint State-USAID  integrated country strategies. DOD has also established guidance for  developing security assistance programs that addresses the key  elements we identified. However, DOD’s guidance does not explicitly  apply to the development of foreign assistance strategies. HHS, MCC,  and USDA have not established any guidance on foreign assistance  strategy development. Inconsistent guidance for developing foreign  assistance strategies has contributed to variations in the strategies’  addressing the key elements we identified related to interagency  coordination, strategic integration, and assessing progress toward  strategic goals.

Existing government-wide guidance requires agencies to address some  of the key elements of assessment of progress toward strategic goals that  we identified as being important for ensuring alignment of agencies’  foreign assistance strategies. In January 2018, the Office of Management  and Budget issued new guidance for agencies that administer foreign  assistance that includes some of the elements we used to assess the  strategies we reviewed. For example, the guidance recommends that  agencies ensure their programs have clear goals and objectives, align  their programs with higher-level strategies or objectives, and plan for  monitoring and evaluation while developing policies and strategies. In  addition, the Government Performance and Results Act, as amended,  requires agencies to submit strategic plans for program activities that  include general goals and objectives for the major functions and  operations of the agency, a description of how the goals are to be  achieved, and a description and schedule of program evaluations. The  act’s provisions were among the sources we used to develop the  desirable characteristics from which we derived the key elements we  identified. However, according to officials of State’s Office of U.S. Foreign  Assistance Resources, there is no government-wide guidance that  incorporates interagency coordination, strategic integration, and  assessment of progress toward strategic goals into the interagency  strategic planning process. In addition, the officials stated that there is no  overarching review mechanism for strategies outside of the core strategic  planning process for joint State-USAID strategies.

According to State officials, State’s Office of U.S. Foreign Assistance  Resources plays a significant role in promoting interagency coordination  by convening roundtables and working groups. By collaborating with the  five other agencies that implement most of U.S. foreign assistance to  establish guidance for developing foreign assistance strategies, the office  could help the agencies ensure that future strategies address the key  elements we identified. Consistent guidance for strategy development  could help the agencies align their strategies and better identify and  manage fragmentation in foreign assistance planning.

U.S. foreign assistance often involves multiple agencies or a whole-of- government approach. Alignment of related foreign assistance strategies  can help agencies better identify and manage fragmentation. Moreover,  consistently addressing the key elements we identified related to  interagency coordination, strategic integration, and assessment of  progress toward strategic goals can help ensure that strategies provide a  clear and comprehensive picture of alignment.

Several of the six largest providers of U.S. foreign assistance in the three  sectors we reviewed have not issued consistent guidance for foreign  assistance strategy development that incorporates these key elements.  For example, some agencies have issued guidance that addresses many  of the key elements we identified related to interagency coordination,  strategic integration, and assessment of progress toward strategic goals,  but this guidance does not apply to all of these agencies’ strategies.

State’s Office of Foreign Assistance Resources leads interagency  strategic planning for the implementation of foreign assistance. This  office—which has responsibility for, and experience in, promoting  coordination among agencies involved in foreign assistance—is uniquely  placed to collaborate with other agencies implementing foreign assistance  to establish guidance for developing foreign assistance strategies that  addresses the key elements we identified. Such guidance would improve  the agencies’ ability to align future strategies and to identify and manage  fragmentation in foreign assistance planning.

We are making the following recommendation to the Department of State:  The Secretary of State should ensure that the Director of the Office of  U.S. Foreign Assistance Resources leads an effort to establish, in  collaboration with the five other agencies that implement most of U.S.  foreign assistance, guidance for strategy development that addresses the  key elements we identified related to interagency coordination, strategic  integration, and assessment of progress toward strategic goals.  (Recommendation 1)

We provided a draft of this report to State, USAID, MCC, DOD, HHS, and  USDA for review and comment. We received substantive comments from  State, USAID, and MCC, which are reprinted in appendixes IV through VI,  respectively. In addition, we received technical comments from HHS,  which we incorporated as appropriate. State, USAID, MCC, USDA, and  DOD did not provide technical comments about our draft report.

In their substantive comments, State and MCC concurred with our  recommendation. USAID’s comments expressed support for our goal of  strengthening interagency coordination, strategic integration, and  assessment of progress across the federal departments and agencies  that implement U.S. foreign assistance. However, USAID suggested that  we issue our recommendation to the National Security Council or address  it jointly to State and USAID. We believe that our recommendation is  appropriately addressed to State, given the responsibility of State’s Office  of U.S. Foreign Assistance Resources for coordinating foreign assistance  programs, including providing strategic direction for both State and  USAID.

We are sending copies of this report to the appropriate congressional  committees and to the Secretaries of Agriculture, Defense, Health and  Human Services, and State; the Chief Executive Officer of MCC; and the  Administrator of the USAID. In addition, the report will be available at no  charge on GAO’s website at http://www.gao.gov.

If you or your staff have questions about this report, please contact me at  (202) 512-3149 or gootnickd@gao.gov. Contact points for our Offices of  Congressional Relations and Public Affairs may be found on the last page  of this report. GAO staff who made major contributions to this report are  listed in appendix VII.

This report examines the extent to which foreign assistance strategies  address key elements that we identified related to alignment of agencies’  efforts—specifically, elements related to (1) interagency coordination, (2)  strategic integration, and (3) assessment of progress toward strategic  goals. We focused on the six agencies that administer the largest  amounts of foreign assistance, according to fiscal year 2016 obligations  data: the Departments of Agriculture (USDA), Defense (DOD), Health and  Human Services (HHS), and State (State); the Millennium Challenge  Corporation (MCC); and the U.S. Agency for International Development  (USAID). We limited our review to foreign assistance strategies that were  in effect during 2017. We further focused on strategies relating to health,  security, and democracy assistance, which account for the majority of  total foreign assistance obligations, according to fiscal year 2016 data.  We excluded strategies for other assistance sectors, such as  counternarcotics and other law enforcement activities that require  interagency coordination with domestically focused agencies outside the  scope of our review, such as the Departments of Homeland Security and  Justice.

To identify the strategies for this review, we asked the six agencies to  update a list of 63 government-wide, agency, multi-agency, regional,  sector-specific, and multisectoral strategies that they had provided for a  related report that we published in June 2017. We also asked the  agencies to provide country-level strategies for Afghanistan and Kenya,  two of the largest recipients of U.S. security and development assistance,  based on fiscal year 2016 obligations data. We obtained and initially  reviewed 72 strategies, which included the 63 strategies we identified for  the June 2017 report; 6 country-level strategies for Afghanistan and  Kenya; and 3 updated strategies covering national security, the  President’s Emergency Plan for AIDS Relief, and water and sanitation.  We determined that 52 of these 72 strategies incorporated goals or  activities related to health, security, or democracy assistance (see fig. 4).  These 52 strategies, which had been issued by December 2017 and were  current in that year, include 44 of those listed in our June 2017 report and  8 of those subsequently identified by the agencies.

We reviewed the 52 strategies to determine the extent to which they  addressed nine key elements we identified relating to the alignment of  multiple strategies. We identified these nine elements by reviewing prior  reports focused on foreign assistance in the security sector that assessed  the quality of various U.S. government strategies; articulated practices for  enhancing collaboration among federal agencies; or discussed  fragmentation, overlap, and duplication among government programs.  Those reports identified six desirable characteristics for government-wide  strategies and practices for enhancing agency collaboration. For the  purposes of this report, we selected three of these characteristics, related  to interagency coordination, strategic integration, and assessment of  progress toward strategic goals. We excluded three characteristics— purpose, scope, and methodology; detailed discussion of problems, risks,  and threats; and description of future costs and resources needed— because we did not consider them to be directly related to alignment of  strategies. The three characteristics we included comprised 15 elements,  9 of which we considered to be directly related to the alignment of health,  security, and democracy assistance sector strategies across multiple  agencies. We excluded 6 elements—for example, potential changes to  structure and details on subordinate strategies and plans for  implementation (e.g., enterprise architecture)—that we did not consider to  be directly related to this topic.

We reviewed the selected strategies using NVivo, a qualitative data  analysis software package. For each strategy, two reviewers, including at  least one with expertise in the area of foreign assistance addressed by  each strategy, independently identified text related to each of the key  elements we had identified. We used a standardized set of criteria in an  assessment instrument to consistently judge whether each strategy  sufficiently addressed these elements. This instrument contained  evaluative questions intended to gauge the presence of each element— for example, “To what extent does the strategy address the agencies  involved and their roles and responsibilities?”. Given the variety of  strategies we reviewed and reviewers’ varying expectations for the detail  and emphasis accorded the key elements we had identified, we rated the  strategies using a three-part scale focused on the presence of these  elements. We rated a strategy as generally addressing an element if the  strategy provided sufficient detail to understand the element in that  strategy; as partially addressing an element if the strategy mentioned it  but lacked sufficient detail; and as not addressing an element if the  strategy did not mention it. The two reviewers for each strategy  independently documented their judgments on the extent to which the  strategy addressed the key elements we had identified. Our initial coding  shows that the reviewers agreed in about 78 percent (363 of 468) of  these initial judgments. The reviewers reconciled their judgments, with  resolution of differences split roughly evenly between accepting the  higher and lower of the initial ratings. A supervisor reviewed each set of  ratings for internal consistency. The supervisor related any identified  issues, as appropriate, to the reviewers, who addressed them before the  supervisor recorded the review as final.

We examined these strategies and any appendixes included in the  documents that the agencies submitted, because these strategic  documents should broadly describe objectives and efforts—including  interagency coordination, strategic integration, and assessment of  progress toward strategic goals—needed to achieve them. We did not  review agencies’ efforts to implement the strategies and did not assess  the overall effectiveness of such efforts. Instead, we focused on the  extent to which the strategies we reviewed provided a clear picture of the  organization and management of U.S. foreign assistance efforts.

To measure the extent of strategies’ integration with other relevant  sectoral strategies and with higher- and lower-level strategies, we  performed a word search for references to the other selected strategies in  the same sector and to other strategies or sets of strategies (e.g.,  regional or country-level strategies) that we classified as either higher- or  lower-level strategies. We searched for such references in each of the 14  strategies that we classified as covering the health sector, the 12  strategies that we classified as covering the security sector, and the 8  strategies that we classified as covering the democracy assistance  sector. See appendix III for the results of this analysis.

We also reviewed agency guidance related to foreign assistance  strategies. We requested current versions of any relevant documentation  from each of the six agencies. State provided us with agency guidance for  developing its functional bureau strategies and joint State-USAID regional  strategies as well as a related template. State also provided guidance  documents related to its monitoring and evaluation policy and  performance management. USAID provided strategic planning and  implementation guidance for its country development and cooperation  strategies. HHS, USDA, and MCC did not provide—and, according to  agency officials, do not have—specific guidance related to what  constitutes a foreign assistance strategy. DOD provided guidance for  developing security assistance programs.

Appendix II: Listing of 52 Selected Foreign Assistance Strategies

The following list shows the 52 foreign assistance strategies that we  reviewed.  1.  Quadrennial Diplomacy and Development Review: Enduring  Leadership in a Dynamic World (2015)  2.  U.S. Global Development Policy (Sept. 22, 2010)  3.  State-USAID Joint Strategic Plan FY2014-2017 (Mar. 17, 2014)  4.  State Department, Office of U.S. Foreign Assistance Resources (F),  Functional Bureau Strategy (2016)  5.  Millennium Challenge Corporation, NEXT: A Strategy for MCC’s  Future (Feb. 24, 2016)  6.  USAID Multi-Sectoral Nutrition Strategy 2014-2025 (May 2014)

Regional strategies (not specific to any single sector)  7.  State Bureau of East Asian and Pacific Affairs/USAID Bureau for Asia  Joint Regional Strategy (approved May 24, 2016)  8.  State Bureau of African Affairs/USAID Bureau for Africa Joint  Regional Strategy (approved Apr. 5, 2016)  9.  State Bureau of Near Eastern Affairs/USAID Bureau for Middle East  Joint Regional Strategy, FY 2016-2018  10. State Bureau of European and Eurasian Affairs/USAID Bureau for  Europe and Eurasia Joint Regional Strategy, FY 2015-2018  (approved April 2015)  11. State Bureau of Western Hemisphere Affairs/USAID Bureau for Latin  America and the Caribbean Joint Regional Strategy, FY 2015-2018  12. State and USAID Joint Regional Strategy for South and Central Asia,  and Afghanistan and Pakistan, FY 2015-2018 (June 2014)  13. PEPFAR: Strategy for Accelerating HIV/AIDS Epidemic Control 2017- 2020 (September 2017)  14. 2016-2020 CDC Strategic Framework for Global Immunization (May  2016)  15. “U.S. Government Strategy for Reducing Transmission of the Ebola  Virus Disease in West Africa” (draft strategy, Sept. 30, 2015)  16. President’s Malaria Initiative Strategy 2015-2020 (April 2015)  17. President’s Emergency Plan for AIDS Relief (PEPFAR) Human  Resources for Health Strategy PEPFAR 3.0 (February 2015)  18. CDC Division of Parasitic Diseases and Malaria Strategic Priorities  19. The Global Strategy of the U.S. Department of Health and Human  Services (2015-2019)  20. State Department, Office of the U.S. Global AIDS Coordinator,  21. PEPFAR 3.0 Controlling the Epidemic: Delivering on the Promise of  an AIDS-Free Generation (December 2014)  22. HHS Strategic Plan, 2014-2018 (updated March 10, 2014)  23. HHS Assistant Secretary for Preparedness and Response Strategic  Plan (February 2014)  24. PEPFAR Blueprint: Creating an AIDS-Free Generation (November  2012)  25. USAID’s Global Health Strategic Framework: Better Health for  26. CDC Global Health Strategy 2012-2015 (June 29, 2012)  27. National Security Strategy of the United States of America (December  2017)  28. State Bureau of Political-Military Affairs, Office of Weapons Removal  and Abatement, Conventional Weapons Destruction Strategic Plan,  2017-2019  29. Department of Defense Guidance for Security Cooperation (Aug. 29,  2016)  30. Department of State & USAID Joint Strategy on Countering Violent  Extremism (May 2016)  31. State Department, Arms Control, Verification and Compliance,   Functional Bureau Strategy (approved December 2015)  32. State Bureau of Political-Military Affairs, Office of Plans & Initiatives,  Peace Operations Capacity Building Division, U.S. Global Peace  Operations Initiative Strategy: Strengthening the Effectiveness of  United Nations and Regional Peace Operations (October 2015)  33. National Security Strategy (February 2015)  34. State Department, Bureau of International Security and  Nonproliferation, Functional Bureau Strategy, FY 2015-2018 (January  2015)  35. State Department, Bureau of Political-Military Affairs, Functional  Bureau Strategy, FY 2015-2018 (January 2015)  36. State Department, Bureau of Counterterrorism, Functional Bureau  Strategy, FY 2015-2017 (January 2015)  37. National Strategy for Counterterrorism (June 2011)  38. Security Sector Reform (February 2009)  39. State Department, The Secretary’s Office of Global Women’s Issues,  Functional Bureau Strategy (approved Mar. 27, 2017)  40. United States Strategy to Prevent and Respond to Gender-based  Violence Globally (June 2016)  41. United States National Action Plan on Women, Peace, and Security  (June 2016)  42. U.S. Department of State Strategy for Women’s Economic  Empowerment (June 2016)  43. United States Global Strategy to Empower Adolescent Girls (March  2016)  44. State Department, Bureau of Democracy, Human Rights, and Labor,  Functional Bureau Strategy, FY 2015-2018 (approved 2014)  45. U.S. Government Approach on Business and Human Rights (2013)  46. USAID Strategy on Democracy, Human Rights and Governance  (June 2013)

Country strategies (for Afghanistan)  47. Department of Defense, Enhancing Security and Stability in  Afghanistan. Report to Congress in Accordance With Section 1225 of  the Carl Levin and Howard P. “Buck” McKeon National Defense  Authorization Act for Fiscal Year 2015 (P.L. 113-291), as Amended  (June 2017)  48. USAID Afghanistan Plan for Transition 2015-2018 (Jan. 6, 2016)  49. State/USAID Integrated Country Strategy: Afghanistan (February  2015)

Country strategies (for Kenya)  50. State/USAID Integrated Country Strategy: Kenya (approved Feb. 1,  2017)  51. DOD/USAFRICOM: Kenya Country Cooperation Plan FY 2017-2021  (Nov. 8, 2016)  52. USAID Kenya Country Development Cooperation Strategy 2014-2018  (May 2014)

Appendix III: Extent to Which Sectoral Strategies Addressed Interagency Coordination, Strategic Integration, and Assessment of Progress toward Strategic Goals

Our analysis of strategies we reviewed in the health, security, and  democracy assistance sectors found inconsistency in the extent to which  the strategies addressed selected, or key, elements that we identified  related to interagency coordination, strategic integration, and assessment  of progress toward strategic goals.

As figure 5 shows, about 30 percent (4 of 14) of the strategies in the  health sector and about 17 percent (2 of 12) in the security sector  generally identified interagency coordination mechanisms, while about 33  percent (4 of 12) in the security sector addressed agencies’ roles and  responsibilities. In contrast, 75 percent (6 of 8) of the strategies in the  democracy assistance sector generally addressed interagency  coordination mechanisms and 63 percent (5 of 8) addressed agencies’  roles and responsibilities.

As figure 6 shows, in the health sector, 50 percent (7 of 14) of the  strategies generally addressed their relationship with at least one other  strategy in the same sector and about 43 percent (6 of 14) generally  addressed their relationship with at least one higher- or lower-level  strategy. In the security sector, about 58 percent (7 of 12) of the  strategies generally addressed their relationship with at least one other  strategy in the same sector and their relationship with at least one higher-  or lower-level strategy. In the democracy assistance sector, about 75  percent (6 of 8) of the strategies we reviewed generally addressed their  relationship with at least one other strategy in the same sector, while  about 63 percent (5 of 8) generally addressed their relationship with at  least one higher- or lower-level strategy.

Figures 7, 8, and 9 show the strategies in the health, security, and  democracy assistance sectors, respectively, that refer to higher- and  lower-level strategies as well as to other strategies in the same sector.

As figure 10 shows, most strategies in the health, security, and  democracy assistance sectors generally identified desired results, a  hierarchy of goals and subordinate objectives, and activities to achieve  results. However, strategies in all three sectors were less consistent in  identifying milestones and performance indicators. Specifically, 57  percent (8 of 14) of health sector strategies, 50 percent (6 of 12) of  security sector strategies, and 50 percent (4 of 8) of democracy  assistance strategies generally addressed this element. In addition, while  71 percent (10 of 14) of strategies in the health sector outlined plans for  monitoring and evaluation, 17 percent (2 of 12) of security sector  strategies and 50 percent (4 of 8) of democracy assistance sector  strategies generally addressed this element.

Appendix IV: Comments from the Department of State

Appendix V: Comments from the U.S. Agency for International Development

Appendix VI: Comments from the Millennium Challenge Corporation

Appendix VII: GAO Contact and Staff Acknowledgments

In addition to the contact named above, James Michels (Assistant  Director), Gergana Danailova-Trainor (Analyst-in-Charge), Timothy  Young, Kay Halpern, Steven Putansu, Mona Sehgal, Drew Lindsey,  Judith Williams, Leslie Holen, Ming Chen, Aniruddha Dasgupta, Mark  Dowling, Giff Howland, Neil Doherty, and Reid Lowe made key  contributions to this report.

Over 20 U.S. agencies provide foreign assistance for activities ranging from promoting democracy and better health to building the capacity of local security forces.

We looked at 52 strategies used by the 6 agencies that provide most foreign assistance and found they had well-defined goals. However, they did not always address how agencies will cooperate and measure progress toward those goals. Also, the strategies’ relationships to each other were sometimes unclear.

We recommended that the Department of State lead an interagency effort to establish guidance for developing foreign assistance strategies.

Question: What do foreign assistance strategies relating to health, security, and democracy address?

Answer: Many foreign assistance strategies related to health, security, and democracy assistance that GAO reviewed at least partially addressed key elements GAO identified that help ensure the strategies are aligned.

Question: How can consistently addressing these elements be beneficial?

Answer: Prior work has found that consistently addressing these elements, related to interagency coordination, strategic integration, and assessment of progress, is important for, among other things, better managing fragmentation in strategic planning.

Many Selected Foreign Assistance Strategies Addressed Key Elements We Identified That Help Promote Alignment, but Some Did Not

Question: What do the six agencies implementing most US foreign assistance lack?

Answer: The six agencies implementing most U.S. foreign assistance do not have consistent guidance for strategy development that could help ensure their strategies address these key elements.

Question: What role does the Department of State play?

Answer: The Department of State (State) plays a significant role in interagency coordination.

Question: How could State play a better role?

Answer: By collaborating with other agencies to establish guidance that addresses the key elements GAO identified, State could help the agencies improve their ability to align future strategies and identify and manage fragmentation in foreign assistance planning.

Agencies Do Not Have Consistent Guidance for Foreign Assistance Strategy Development That Addresses the Key Elements We Identified

Question: What do federal agencies do for US foreign assistance?

Answer: More than 20 federal agencies spend billions of dollars on U.S. foreign assistance each year.

Question: What agencies are responsible for most of this assistance?

Answer: Six agencies—the Departments of Agriculture, Defense, Health and Human Services, and State; the Millennium Challenge Corporation; and the U.S. Agency for International Development—implement most of this assistance, using multiple strategies.

Question: What issues are there with implementing multiple foreign assistance strategies?

Answer: Questions have been raised about potential inefficiencies in implementing multiple foreign assistance strategies.

Many Strategies We Reviewed Addressed Elements Related to Interagency Coordination, Strategic Integration, and Assessment of Progress, but Some Did Not

Question: What was GAO asked to review?

Answer: GAO was asked to review the alignment of U.S. foreign assistance strategies.

Question: What does this report examine?

Answer: This report examines the extent to which strategies include key elements GAO identified, related to interagency coordination, strategic integration, and assessment of progress, that help ensure alignment.

Question: How did GAO get information for this report?

Answer: GAO reviewed 52 strategies related to health, security, and democracy assistance that were current in 2017. GAO also reviewed agency guidance and interviewed agency officials.

Integration with Other Related Strategies

Appendix II: Listing of 52 Selected Foreign Assistance Strategies