Charity Science Health — Exit Grant

Published: December 2019

Note: This page summarizes the rationale behind a GiveWell Incubation Grant to Charity Science Health. Charity Science Health staff reviewed this page prior to publication.

Summary

Charity Science Health (CSH) has previously received GiveWell Incubation Grants in July 2017 and November 2016. In May 2019, GiveWell decided to discontinue support of CSH and to no longer pursue the goal of eventually evaluating it as a potential GiveWell top charity.

In July 2019, GiveWell recommended that the Open Philanthropy Project make an exit grant of $214,425 to CSH, which is intended to cover CSH's operational costs through May 2020 while it seeks other sources of funding.

Table of Contents

Background

GiveWell previously recommended two grants (in July 2017 and November 2016) to Charity Science Health (CSH), with the goal of eventually determining whether or not to invite CSH to apply for a top charity recommendation.

CSH operates a Short Message Service (SMS) reminders for vaccination program in India, which aims to avert deaths by increasing vaccination rates.1 CSH's strategies for enrolling participants in its program have included partnering with hospitals and sending surveyors door-to-door to search for mothers of infants less than one year of age.2 In March 2019, CSH told us that it planned to expand its program by sending SMS reminders on additional topics and by delivering other health interventions through door-to-door surveyors.3

We had been expecting that CSH would need to conduct a randomized controlled trial (RCT) to estimate the impact of its program before we would consider inviting CSH to apply for a top charity recommendation.4 GiveWell Incubation Grants (GIG) would have been the most likely source of funding for the RCT.5

Case for not continuing our support

We are not recommending another grant to CSH to continue its operations with the goal of preparing for a GIG-funded RCT. The key reasons for our decision are:

  • The expected costs of continued support are high (more).
  • We do not believe there is a strong quantitative case that continuing to support CSH would have a larger impact than directing additional funding to our current top charities (more).
  • We do not believe there is a strong qualitative case for continued support of CSH (more).

High expected costs

We expect that continuing to fund CSH until we had results from an RCT would require a substantial amount of funding and GiveWell staff time.

We have not specifically estimated the costs of funding CSH through the completion of an RCT,6 but we note that the total costs of getting New Incentives to a similar stage will be more than $10 million (plus substantial staff time).7

Lack of a strong quantitative case

In May 2019, we wrote that one of our top priorities is to maximize the impact per dollar of the funding we direct. We do not believe that there is a strong quantitative case that continuing to fund CSH is likely to have a larger impact than directing additional funding to our current top charities.

In our last published cost-effectiveness analysis of CSH, we estimated that its program was roughly seven times as cost-effective as cash transfers ("7x cash" for short),8 which is moderately lower than our cost-effectiveness estimates for funding we have recently directed to our top charities.9 We estimate that our current top charities focused on the same outcome as CSH (averting deaths) have large remaining funding gaps at around 7x cash.10

Our cost-effectiveness model for CSH is also underdeveloped compared to our cost-effectiveness analyses for our top charities—even if our current estimate were higher, we would place limited weight on it when deciding whether to continue supporting CSH. We believe our quantitative model of CSH is underdeveloped because:

  • We were unable to draw broad conclusions about the effectiveness of SMS reminders for immunization based on the evidence reviewed in our interim intervention report.
  • CSH's model for enrolling participants in its program has changed over time—we would guess that its enrollment model may continue to change going forward.11 Because we are uncertain about CSH's enrollment model going forward, we have limited information on what specific populations CSH would eventually reach and about CSH's expected cost per person successfully enrolled.12
  • We are uncertain about current vaccination rates (and other characteristics relevant to the likelihood that CSH's program will have an impact) of populations CSH may target in the future.13

Lack of a strong qualitative case

We do not believe that CSH has had standout operational success to date:

  • As mentioned above, because CSH has been in the process of experimenting with different approaches, we do not have a clear understanding of how CSH will enroll participants in its program going forward and
    we are uncertain how much additional operational funding CSH would require before it would be prepared to conduct an RCT of its program. 14
  • Joey and Katherine Savoie, the founders of CSH, are focused on a new project (Charity Entrepreneurship) and are no longer directly involved with CSH's operations. The case for the previous incubation grants to CSH was based in part on our positive impressions of Katherine and Joey.15

Case for an exit grant

In general, we believe it is a good practice to offer exit grants, in order to:

  1. Enable organizations we have supported to remain operational long enough to seek out other sources of funding.
  2. Reduce potential harms to the staff, partners, and program beneficiaries of organizations that we have supported which might result from a sudden shut down.
  3. Maintain a reputation as a responsible funder.

Our decision to make an exit grant to CSH is based mainly on the first and third reasons above (we believe the second reason is likely less relevant in this case; see below).

This grant is intended to allow CSH to continue operating from October 2019 through May 2020, under the "maintenance only" scenario described in its budget, while it seeks support from other funders.16

CSH's "maintenance only" scenario allocates funding to core costs (e.g., staff salaries, office space, sending SMS reminders to current program enrollees), but does not include funding for continuing to enroll new participants door-to-door, through hospitals, or through CSH's potential partnerships with state governments (see below for more details on government partnerships). Additional details on what we expect the grant to cover are in the following footnote.17

We do not plan to consider renewing this grant or funding an RCT of CSH's program. We may revisit our assessment of CSH if it conducts an RCT of its program (using funding from other donors).

Risks and reservations

While we think there is a fairly strong case for recommending an exit grant to CSH, we have some reservations about the grant size we have chosen, and we believe a number of considerations might reasonably have pushed us towards a smaller or larger exit grant.

Considerations in favor of providing a smaller exit grant (or no exit grant) include:

  • It does not seem likely to us that there would be major harms to CSH staff or beneficiaries if we did not provide an exit grant. CSH told us that it expects to be able to operate until October 2019 with its current funding, which would give it enough time to give its staff reasonable notice and make severance arrangements.18 CSH also told us that it would continue sending SMS messages to participants currently enrolled in the program for each participant's full immunization schedule, even if CSH stopped existing as an organization (our understanding is that former leadership would do this in their spare time).19
  • CSH originally suggested to us an exit grant extending its runway through February 2020 (rather than May 2020), which would have required $136,469 under a "maintenance only" scenario.20 We would guess that February 2020 is too tight a timeline for CSH to have a reasonable chance of securing other funding before having to decide whether to lay off staff with severance, so we have instead made a grant intended to extend its runway to May 2020. However, we do not have much experience with or many reference cases for this type of grant, so we are fairly uncertain about whether this extension provides CSH with more funding than necessary.

Considerations in favor of providing a larger exit grant include:

  • A funding runway through May 2020 might not be long enough for CSH to secure other sources of financial support.
  • CSH requested funding for a larger grant of $343,158 through May 2020 (for the "only core commitments" scenario in its budget).21 This level of funding would cover 60%22 of the costs of partnerships CSH is pursuing with state governments in Bihar, Maharashtra, and Madhya Pradesh, in addition to the costs of a "maintenance only" scenario (see the following footnote for details).23 We have reservations about not providing CSH funding for potential government partnerships for a few reasons:
    • We think that government partnerships have the potential to be more cost-effective than CSH's standard program. CSH has told us that it expects its costs per enrollee in a partnership with Maharashtra to be much lower than its standard program's costs per enrollee.24
    • There may not be funders other than GIG that are well-positioned to fund CSH's government partnership work. CSH told us that it is in active discussions with Bihar, Maharashtra, and Madhya Pradesh, and that putting those conversations on hold until CSH raises additional money would be quite harmful to its credibility.25
    • CSH told us that its discussions with the governments of Bihar and Maharashtra are fairly advanced—it has finalized its working arrangement with the State Health Society in Bihar and has received data on birth records from Maharashtra.26
  • CSH also presented a larger funding scenario (the "as planned" scenario in its budget) that would require $459,009 through May 2020.27 That level of funding would cover all costs for the other two scenarios, plus the additional costs of continuing to enroll new program participants door-to-door and through hospitals. CSH told us it expects there to be some costs associated with shutting down door-to-door and hospital enrollment and later re-starting it if it finds other funding (e.g., laying off and re-hiring field staff). 28

Notes on grant structure and restrictions

GiveWell recommended providing this grant in two disbursements of $107,212 spaced six months apart. Charity Science Health told us it would prefer this structure because it may decline to accept the second disbursement, if it has already secured adequate funding from other sources to continue its operations by that time.29

Although we are planning to provide the amount of funding required to support CSH's "maintenance only" scenario through May 2020, we do not plan to place restrictions on how CSH uses the funding. CSH may choose to spend some of the funding on pursuing a government partnership program, which would shorten its overall funding runway. Because we are not planning to consider this grant for renewal, we do not believe that there is a good justification for placing restrictions on how CSH uses the funding.

Internal forecasts

For this grant, we are recording the following forecast:

Confidence Prediction By time
65% Charity Science Health receives enough funding from other donors to continue its operations through the end of 2020. End of 2020

Sources

Document Source
Charity Science Health FAQ Source (archive)
Charity Science Health homepage Source (archive)
CSH, 2019-20 Planning Budget Explanatory Note Source
CSH, 2019-20 Planning Budget Update Source
GiveWell, Charity Science Health CEA, 2017 Source
GiveWell's non-verbatim summary of a conversation with Joey Savoie, January 26, 2017 Source
GiveWell's non-verbatim summary of a conversation with Joey Savoie, May 17, 2017 Source
GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019 Source
Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019 Unpublished
Katriel Friedman, CEO, Charity Science Health, email to GiveWell, June 9, 2019 Unpublished
  • 1
    • "Charity Science Health (CSH) sends SMS reminders to mothers in India to help them remember when it is time to get their child vaccinated." Charity Science Health homepage
    • Charity Science Health FAQ:
      • "WHY IMMUNIZATIONS? We did extensive research and found that increasing immunization rates is one of the best and most cost-effective ways to improve human lives. By protecting children from dangerous diseases, immunizations both save lives and improve the quality of life in a population. In addition, increasing immunization rates accelerates the process of achieving 'herd immunity' in a population: when a significant proportion of a population is inoculated against a disease, the pathogens causing the disease cannot find suitable hosts and have difficulty surviving in the population. This means that increasing immunization rates can help protect even those who are not immunized. So a program that effectively increases immunization rates enjoys a 'multiplier effect' by benefiting even people that the program does not reach directly."
      • "WHY SMS REMINDERS? People’s lives are hectic, especially people who live in resource-constrained settings. For families with infants and young children, it is often difficult to fit a visit to a health clinic for a vaccination into an already hectic schedule. Research in behavioral science suggests that people often intend to do things but have difficulty following through—even on things they consider important. In these cases, a 'nudge' in the form of a timely reminder or encouragement can often help people follow through. Research suggests that text message reminders are a cheap and effective way to provide this sort of nudge."
      • "WHEN DO PEOPLE RECEIVE THESE SMS REMINDERS? Participants receive two reminders for every scheduled vaccination, one sent one week before the vaccination is scheduled, and one sent the day before."
      • "WHICH VACCINES DO PEOPLE RECEIVE REMINDERS FOR? Our reminders cover all of the vaccines recommended under India’s Universal Immunization Plan. This includes BCG (Bacillus Calmette Guerin), OPV (Oral Polio Vaccine), measles, Td (Tetanus, Diphtheria), and the pentavalent vaccine, which is five vaccines in one: Diphtheria, Pertussis, Tetanus (DPT), hepatitis B, and haemophilus influenzae. In addition, as the rotavirus vaccine is rolled out, our reminders will also cover this. People living in districts where the Japanese encephalitis vaccine is recommended will receive reminders for this vaccine as well.​"

  • 2
    • GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019:
      • "Charity Science Health has tried partnering with hospitals to enroll recipients in its SMS reminders program; by and large, this has been more difficult than Charity Science Health initially expected. Charity Science Health has gotten agreements from five hospitals to enroll patients in its program. Charity Science Health thinks working with hospitals might potentially be the most cost-effective method of enrollment if hospitals agree to it. However, the amount of staff time required and low success rates at reaching agreements with hospitals have so far made this strategy not worthwhile." Pg 3.
      • "Charity Science Health has been acquiring the bulk of recipients for its Short Message Service (SMS) immunization reminders program by partnering with other charities or third-party survey firms to perform door-to-door enrollment, which involves surveyors visiting houses to enroll children below the age of one and pregnant mothers. Surveyors typically collect a) the mother’s name, b) the child’s name and date of birth, and c) the phone numbers of the mother, father, and possibly other family members; they then send this information to Charity Science Health." Pgs 1-2.

  • 3

    "Charity Science Health plans to take advantage of its contact with households during door-to-door enrollment to provide other health interventions with a strong evidence base, such as: prenatal vitamin supplementation (e.g. iron and folic acid, other micronutrients), vitamin A supplementation (for children older than six months), and deworming tablets (for households with children over one year old). Vitamin Angels has agreed to provide Charity Science Health with training materials and supplements for this purpose. Charity Science Health plans to train its field teams to administer supplementation and then roll out the program. Charity Science Health is also planning to roll out SMS reminders about exclusive breastfeeding and prenatal checkups at the appropriate ages. For the most part, those reminders would be fairly widely spaced out from its core vaccination reminders to reduce the risk of causing recipients to start disregarding messages." GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019

  • 4

  • 5

    Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019

  • 6
    • This spreadsheet includes a rough estimate of $1,600,000 for the total cost of a CSH RCT (cell B3).
    • Our IDinsight — Embedded GiveWell Team (2018) page notes that this total does not include implementation costs.
    • We have not attempted to create an estimate of the total costs of funding CSH through the completion of an RCT (including both research and implementation costs).

  • 7

    The grants we have recommended to New Incentives and to IDinsight to conduct an RCT on New Incentives' program total $9.9 million; see this spreadsheet, cell C10. We expect to recommend one additional grant to New Incentives before deciding whether to add it to our top charity list.

  • 8

    GiveWell, Charity Science Health CEA, 2017, "Charity Science Health" sheet, cell B4

  • 9
    • We directed discretionary funds from Q4 2018 to Malaria Consortium's seasonal malaria chemoprevention program and we directed discretionary funds from Q1 2019 to the Against Malaria Foundation.
    • "The most recent version of our published cost-effectiveness model at the time we made this decision (2019 version 2) estimates that Malaria Consortium is 8.5 times as cost-effective as unconditional cash transfers (“8.5x cash” for short) and AMF’s work in DRC is 10x cash (calculated by making a copy of the spreadsheet and selecting DRC in the “Country selection” tab for AMF).

      Our best guess of the cost-effectiveness of these two opportunities incorporates several additional adjustments." Allocation of discretionary funds from Q4 2018.

    • See our Allocation of discretionary funds from Q4 2018 blog post for more details on our adjustments to our published cost-effectiveness estimates.

  • 10
    • For our three top charities implementing programs focused on averting deaths, we estimated in November 2018 that, after taking our recommended allocation to Good Ventures into account:
      • AMF had a $72.5 million funding gap over the next three years at 7.3 times as cost-effective as cash transfers.
      • Malaria Consortium's seasonal malaria chemoprevention program had a $43.9 million funding gap over the next three years at 8.8 times as cost-effective as cash transfers.
      • Helen Keller International's vitamin A supplementation program had a $20.6 million funding gap over the next three years at 6.4 times as cost-effective as cash transfers.
    • We expect substantial funding gaps to remain for these charities after taking into account funding we directed to them in 2019. We plan to publish updates on each charity's room for more funding in a blog post in November 2019.
    • We note that our estimates of the amount of funding that our top charities focused on averting deaths could absorb have risen over the past several years. In 2013 and 2014, one of GiveWell's major concerns was whether AMF, our only top charity at the time focused on averting child deaths, had room for more funding. We removed AMF from our top charities list in 2013 because we did not believe it had capacity to effectively use additional funding, and re-added it to our list in 2014, but still noted we had concerns about the amount of funding it would be able to absorb. By 2016, we had added Malaria Consortium's seasonal malaria chemoprevention program to our top charities list and noted that we estimated that AMF had capacity to absorb substantially more funding than in previous years. In 2017, we added Helen Keller International (HKI)'s vitamin A supplementation program, another program focused on averting child deaths.

  • 11
    • In early 2019, CSH told us that it had shifted its primary program model from hospital-based enrollment to door-to-door enrollment due to difficulties with partnering with hospitals:
      • "Charity Science Health has been acquiring the bulk of recipients for its [SMS] immunization reminders program by partnering with other charities or third-party survey firms to perform door-to-door enrollment… Charity Science Health has tried partnering with hospitals to enroll recipients in its SMS reminders program; by and large, this has been more difficult than Charity Science Health initially expected… the amount of staff time required and low success rates at reaching agreements with hospitals have so far made this strategy not worthwhile." GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019, Pg 1-3
    • As of March 2019, CSH had paused its work on door-to-door enrollment in order to switch from paper-based to digital data collection processes:

  • 12
    • Going forward, we are uncertain whether CSH would primarily continue to enroll participants in its program through door-to-door data collection processes (see footnote above), partnerships with other non-governmental organizations, or government partnerships. GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019:
      • "Some large NGOs have expressed interest in collaborating with Charity Science Health, including:
        • IDinsight's "Data on Demand" team, which has a network of 800 surveyors across eight states in India. Those surveyors currently work on projects for about six months out of the year; IDinsight would ideally like the network to be working year-round in order to avoid needing to fire and re-hire surveyors. IDinsight has set up hiring and quality control procedures that make it easy to run surveys with this team at a relatively low cost of management time.
        • Noora Health, which promotes child health practices, is working across health facilities in Madhya Pradesh. Charity Science Health is in discussions about working with Noora Health staff at hospitals to enroll new SMS reminder recipients, which could potentially offer a way to scale the SMS program rapidly. Noora Health also sends messages to mothers through WhatsApp and Charity Science Health is working to add vaccination reminders to this system.
        • A nationwide federation of women's self-help groups, which has significant surveying capacity and a broad membership base." Pg 3.
      • "Charity Science Health is working on partnering with government agencies. It has been prioritizing reaching out to state-level governments rather than smaller administrative units (e.g. districts), in part because it has found it relatively easy to get meetings with state-level officials. Charity Science Health also has the impression is that state governments are generally more involved in the oversight of routine immunization than the central Indian government is. (For instance, while the databases used for immunization and vaccine delivery are somewhat centralized, the program is administered via separate systems in each state.)" Pgs 3-4.
    • CSH has told us that it estimates that paper-based door-to-door enrollment costs around $0.60 to $0.70 per person successfully enrolled. We have not seen detailed documentation on this estimate, and we are uncertain about the extent to which this estimate would apply to a scaled-up CSH program:
      • "Charity Science Health was motivated to design and implement better procedures in part by running a phone survey which found a wide range in the degree of accuracy in enrollment data collected. Under the old procedures, the best door-to-door data was about a) 70% confirmed valid (i.e., the enrollee is a child below the age of one or a pregnant woman, the phone number is valid, and the information is linked to the correct person), b) about 12% confirmed incorrect, or c) of uncertain validity (if e.g. recipients did not answer the phone during the phone survey). Charity Science Health estimates the total cost of working with third-party surveyors, including management time, monitoring and evaluation, overhead, etc., was about $0.60 to $0.70 per valid entry." GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019, Pgs 2-3.

  • 13
    • Charity Science Health told us that it expects vaccination rates, mobile penetration, and literacy rates of populations it targets to be relevant to the expected impact of its program:
      • "Charity Science Health has ranked the geographies it currently works in based on its best intuitive predictions about how impactful it expects its SMS program to be in those areas, taking into account, e.g., rates of vaccination, mobile penetration, and literacy. Charity Science Health plans to do some additional research on current vaccination and literacy rates in the communities it serves in order to better inform its program." GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019, Pgs 4-5.
    • Charity Science Health has told us it is somewhat uncertain about current immunization rates among populations where it works:
      • "The Indian government reports fairly rapid increases in immunization rates due to government vaccination programs. Charity Science Health is trying to gather as much up-to-date information as possible about immunization rates in the areas where it works. The government claims a substantially higher vaccination rate as of the end of 2018 than what was found by the last major round of household surveys, in 2015-16. Charity Science Health plans to do more research to understand how much room for improvement in immunization rates there currently is. It also plans to try to estimate how well households' vaccination cards reflect children's actual vaccination status by comparing the cards to administrative data from health facilities." GiveWell's non-verbatim summary of conversations with Charity Science Health, March 6 and March 11, 2019, Pg 6.
    • Our cost-effectiveness analysis for CSH generally uses national-level data from India for baseline vaccination rate estimates—we are not confident that these estimates are representative of populations CSH would target.
    • We have not investigated literacy rates or mobile penetration rates among populations CSH may target with its program, or attempted to estimate the impact that literacy rates or mobile penetration rates would have on CSH's cost-effectiveness.

  • 14

    CSH has told us several times throughout its history that it was nearly prepared to conduct an RCT.

  • 15

    In our rationale for a grant made to CSH in November 2016, we stated the following:

    • "We are impressed by the Charity Science: Health team's track record of transparency, and we are confident that they will communicate well with us and that it will be easy for us to learn from their work."

  • 16
    • See CSH, 2019-20 Planning Budget Update, "Overview" sheet, "Maintenance only" column of the table, lines 19 through 33.
    • Note: Although GiveWell has recommended the amount of funding required to support CSH's "maintenance only" scenario through May 2020, we have not placed restrictions on how CSH uses the funding. CSH could choose to spend some funding on, e.g., pursuing a government partnership program, even though this would shorten its overall funding runway.

  • 17
    • Monthly cost categories in CSH, 2019-20 Planning Budget Update, "Core" sheet, are: core staff salaries, partner/field staff costs, SMS messaging costs, office expenses, and other miscellaneous costs (including travel).
    • The CSH, 2019-20 Planning Budget Update, "Core" sheet, also includes the following fixed costs and obligations: severance pay commitments, outstanding messages, obligations to Lumbini, and obligations to Katriel. Our understanding is that "outstanding messages" refers to the cost required to continue to send SMS reminders to current program enrollees throughout infants' full immunization schedules, even if CSH shuts down (former leadership would plan to do this in their spare time). Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019. CSH explained the other fixed costs and obligations as follows:
      • "Obligations to Lumbini: Lumbini Consultancy Services is our government relations consultant in Bihar, with whom we have an outcomes-based contract obliging us to pay about $3000 if they successfully negotiate access to health records in Bihar for CSH to enroll mothers. This payout is divided into two milestones with equal disbursements, the first of which has just been achieved and paid.
      • Obligations to Katriel: CSH structured my [Katriel's] compensation so that I would receive $25,000 in salary for the first year with a $25,000 signing bonus if CSH retained me after 1 year.
      • Severance pay commitments: This refers to a single staff member, our former regional manager." Katriel Friedman, CEO, Charity Science Health, email to GiveWell, June 9, 2019
    • The budget also includes an additional 10% buffer as a contingency fund for unexpected expenses. CSH, 2019-20 Planning Budget Update, "Overview" sheet, line 30

  • 18

    Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019

  • 19

    Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019

  • 20
    • Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019
    • CSH, 2019-20 Planning Budget Update:
      • To see the total funding required for a "maintenance only" scenario through February 2020, make an editable copy of this spreadsheet and change the "Months to project" in cell B2 on the "Overview" sheet 12 to 9. Funds required for the "Maintenance only" scenario are displayed in cell B33.

  • 21

    CSH, 2019-20 Planning Budget Update, "Overview" sheet, "Only core commitments" column of the table, lines 19 through 33.

  • 22

    CSH requested 60% of the total funds required for all three partnerships because it believed that there was roughly a 60% probability of reaching agreements with the three states, given that CSH had sufficient funding. CSH told us that it believed the most likely outcome was that Bihar and Maharashtra would sign MoUs with CSH, but that Madhya Pradesh would not. Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019

  • 23
    • Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019
      • CSH has told us that the government of Maharashtra already collects data on phone numbers for women giving birth in the state. Maharashtra may be interested in sharing this data with CSH and allowing CSH to enroll women in the registry in its SMS reminders program.
      • In Bihar, data on phone numbers for women giving birth in the state is not yet digitized. A government partnership would likely involve CSH hiring field staff to begin to digitize the state's data.
    • In Madhya Pradesh, a government partnership would likely involve CSH assisting with setting up an SMS reminder system within the state's health department.
    • See CSH, 2019-20 Planning Budget Explanatory Note for more details on these potential partnerships.

  • 24

  • 25

    Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019

  • 26
    • CSH has told us that the state health department in Maharashtra has already shared data on recent births in two districts from the past year (~20,000 birth records). CSH believes that Maharashtra's initial data sharing indicates interest in partnering with CSH. In Bihar, CSH told us that it has received a letter expressing interest in working with CSH from the Executive Director of the State Health Society. Our understanding is that discussions in Madhya Pradesh are not as advanced as in Maharashtra and Bihar. Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019
    • CSH also told us that the Bihar health department, the State Health Society, has circulated an order to district officials and health facilities to give CSH access to health records. Erik Hausen, COO, Charity Science Health, comments in response to a draft of this page, August 27, 2019
    • CSH told us that it has not yet has not secured final government authorization for its work with the Maharashtra health department. Katriel Friedman, CEO, Charity Science Health, comments in response to a draft of this page, September 6, 2019

  • 27

    CSH, 2019-20 Planning Budget Update, "Overview" sheet, cell D33.

  • 28

    Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019

  • 29

    Katriel Friedman, CEO, Charity Science Health, and Erik Hausen, COO, Charity Science Health, conversation with GiveWell, March 6, 2019