For over a decade, the early grade reading assessment (EGRA) has been used to measure and report on students' acquisition of five reading skills. Education development initiatives funded by the US Agency for International Development, the World Bank, Department for International Development (DFID), and other agencies have facilitated the use and adaptation of the EGRA into over 100 languages in more than 65 countries (Dubeck & Gove, 2015, p. 315). Guidelines for the proper use and the limitations of the EGRA have been circulated widely. An international evidence base that challenges the theoretical underpinnings and the expanded use of the EGRA is also growing (Bartlett, Dowd, & Jonason, 2015). Not yet explored to date, however, is the use of the EGRA as a measure to determine Payment by Results (PbR) in a donor agency initiative. This chapter examines the use of the EGRA oral reading fluency (ORF) subtest as a PbR learning outcomes measure in DFID's Girls' Education Challenge (GEC) projects, and it concludes that the way in which the EGRA ORF was used for PbR was a misuse of the EGRA, and ultimately it did not serve well the PbR project beneficiaries, the marginalized girls.