The purpose of this investigation is to gain greater understanding of high-stakes examination instruments (i.e., tests used for progression or certification) in primary and secondary school in developing countries. This allows us to be better informed as to their potential as a lever for reform. The RISE working paper 16/010, The Good, the Bad, and the Ugly - Testing as a Key Part of the Education Ecosystem, explored how assessment, especially in high stakes examinations, is an integral part of an education system and exerts a strong influence on what actually happens in the classroom. Others have also identified assessment as an important lever for reform. However, for assessment to be an effective lever for improving learning outcomes, the assessment must be tightly coupled to (i.e., effectively measure) the desired learning outcomes. This paper looks at how effectively high stakes examinations in a small sample of representative countries (two in Africa and two in South Asia) perform in terms of assessing higher-order skills as well as reviewing, generally, how well they perform as assessment tools.