The Social Return on Investment (SROI) for Evaluation of the Impact in International Cooperation Health Project in Albania: A Case Study

In the last years with the affirmation of the Theory of Change (ToC-Connel and Kunisch in New approaches to evaluating community initiatives 2:1-16, Connell andKubisch, New Approaches to Evaluating Community Initiatives 2:1-16, 1998), a lot of tools for the evaluation of projects having social relevance have been developed. The need to measure their impact has led to leave the use of traditional qualitative measurement instruments joints for quantitative tools, which calculate the effectiveness of the resources employed and the generated impact by social projects (Anderson in The community builder's approach to Theory of Change, Anderson, A.A., (2006). The community builder's approach to Theory of Change.). Among them, recently it is paid attention on the Social Return on Investment (SROI-Lingane and Olsen in California management review 46:116-135, Lingane and Olsen, California Management Review46:116-135, 2004), a model to account for created value. It includes not only the return of investments but also the benefits for the broader public in the social, economic and environmental spheres. The research aim is to verify and calculate SROI as a valid tool to measure the impact generated by social projects in transitional countries, especially those of health international cooperation. Indeed, the economic quantification of the SROI rate appears as an important element to improve reporting and accountability both to the lender, the gesture and the users. The case study has been identified as appropriate methodology for conducting this research (Yin 2003; Eisenhardt in Academy of Management Review 14:532550, Eisenhardt, Academy of Management Review 14:532-550, 1989). The project 'Introducing Health Information System (IHIS): a modern approach to transparency and accountability in the Albanian public health' conducted by the Tuscany Region resulted relevant for the involvement of different actors and its action in a transition country as Albania. This projectwas realized from 2014 to 2016 using financing from IADSA (Italian Albanian Debt for Development Swap Agreement) to support the Albanian government in the NHS technological and accountant development. Now it's possible to adequately observe the generated impact 5 years after the conclusion of IHIS project. The necessary data for the calculation of SROI was collected by desk analysis of project's documents and reports and the conduction of interviews and focus groups to a specimen of involved stakeholders. Results show the good capability of SROI to quantitatively evaluate the impact produced by a health international cooperation project, also if complex and articulated as that studied. In particular, the SROI rate of this project is 9.4, an optimal rate (for 1.00(sic) invested, the project generated an economic impact of 9.40(sic)). Therefore, it is demonstrated the optimal use of the allocated resources obtaining a strong effective impact in the Albanian health care system and on the network of involved stakeholders. Another important aspect is the reinforcement of results dissemination in the society, for the simplicity and easy comprehension of the SROI rate and the internal restitution promoted by SROI analysis. So SROI proves as a good instrument both to measure and to share the economic value of generated impact.