Deworm the World

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GiveWell aims to find the best giving opportunities we can and recommend them to donors. We tend to put a lot of investigation into the organizations we find most promising, and de-prioritize others based on limited information. When we decide not to prioritize an organization, we try to create a brief writeup of our thoughts on that charity because we want to be as transparent as possible about our reasoning.

The following write-up should be viewed in this context: it explains why we determined that (for the time being), we won't be prioritizing the organization in question as a potential top charity. This write-up should not be taken as a "negative rating" of the charity. Rather, it is our attempt to be as clear as possible about the process by which we came to our top recommendations.

Published: November 2012

Table of Contents

What do they do?

Deworm the World (DtW) provides assistance to governments to help them launch and implement school-based deworming programs. DtW has worked in Kenya, Liberia, one state in Nigeria (Ogun), and three states in India (Bihar, Delhi, and a new program in Rajasthan).1

DtW’s activities include:

  • worm prevalence mapping and helping to plan deworming campaigns2
  • assisting governments with training and creating training materials3
  • monitoring and evaluation4

Our review

Deworm the World (DtW) works on deworming, a program which we believe has a fairly strong evidence base.

In our analysis, we have sought to answer the following questions:

  1. What role has Deworm the World played in implementing deworming programs in the various countries it has worked in the past? How would these programs have been different in DtW's absence?
  2. How, specifically, would Deworm the World spend additional funds and what impact would these additional funds have on its programming?
  3. Are there cases in which funding is the primary bottleneck to Deworm the World's working in a country and helping deworming to move forward? If so, why is this funding not provided by Deworm the World's major funders?

To date, we have not arrived at what we consider to be compelling answers to the above questions. We will update this page if and when we gain a better understanding regarding our key questions.

We have been following Deworm the World since 2009 and have spoken with staff members several times. Our previous review was published in March 2011. In 2012, we spoke with Alissa Fishbane, managing director of DtW,5 Karen Levy, DtW’s regional director in Africa, and the Children’s Investment Fund Foundation (CIFF), a major funder of DtW in Kenya.6

In November 2012, we spoke with Alissa Fishbane regarding the questions above. The notes from this conversation (available here) provide some answers for Deworm the World's program in Bihar, India.

Sources

  • 1.

    “We work directly with governments to help them get school-based deworming programs up and running, and to sustain them over the longer term. Right now we're working in Kenya; Liberia; Ogun state, Nigeria; and three states in India: Bihar, Delhi, and a new program in Rajasthan. Something that's unique to DtW is that we support only school-based programs, which are extremely cost-effective in reaching high numbers of children (both enrolled and un-enrolled).” GiveWell, “Notes from Conversation with Alissa Fishbane of Deworm the World (April 23, 2012)," Pg 1.

  • 2.
    • “[Worm prevalence mapping] is one of the first activities we undertake so that the program can be targeted to kids in greatest need. We conduct worm prevalence surveys and map the results. (Some countries already have data on worm prevalence. In this case we determine whether there are any gaps or whether any areas need to be re-surveyed based on quality or length of time since previous data collection.)… This typically takes the form of maps with government administrative boundaries and/or school locations. For soil-transmitted helminths, which are widespread in transmission, deworming needs are determined at the district level. For schistosomiasis, which is much more focal, implementation is as close to the school level as possible.” GiveWell, “Notes from Conversation with Alissa Fishbane of Deworm the World (April 23, 2012)," Pgs 1-2.
    • "[We create] targeted operations plans and budgets, following results from the mapping process. When government budgets are limited, maps help focus program resources to areas with highest need. In a country like Kenya where worms are highly concentrated in few areas rather than widespread throughout the country, being able to target resources to these needy areas made the program financially feasible with government funding." GiveWell, “Notes from Conversation with Alissa Fishbane of Deworm the World (April 23, 2012)," Pgs 2-3.
  • 3.

    “[We have] a robust cascade system, which our team sometimes refers to as the “scaffolding” of the program. It enables training of personnel and efficient distribution of program materials (training kits, monitoring forms, deworming drugs, etc.) over widespread areas and reaching far into rural communities… For the prevalence surveys, we train lab technicians on the gold standard process. For soil-transmitted helminths and intestinal schistosomiasis, it is the Kato-Katz method. We bring in global experts to train local teams. Our staff trains local managers how to run a survey in the field. There is also the training for the deworming program through the cascade system. This process trains teachers, health workers and government officials on how to implement the program. We work with governments to determine the optimal structure of this cascade system within the country context. We have also developed an entire portfolio of materials to support the training cascade. They cover important aspects of the program, including training on worm transmission, effects and treatment; how the cascade works and what materials and supplies are distributed at each stage; drug administration, reporting and monitoring; education about the program for students and the community; and the role of different stakeholders.” GiveWell, “Notes from Conversation with Alissa Fishbane of Deworm the World (April 23, 2012)," Pgs 3, 5-6.

  • 4.

    “For monitoring and evaluation (M&E), we design the system and materials. (As we do for other program components such as training as well as public awareness and education.) In Kenya, the M&E system has also set the pace for other government processes. For example, the government has expressed interest in using the drug tracking forms developed for this program to track drug supply chain for other national health programs. We also do independent M&E to assess program quality and coverage, which is a process separate from the program’s M&E system." GiveWell, “Notes from Conversation with Alissa Fishbane of Deworm the World (April 23, 2012)," Pg 3.

  • 5.

    GiveWell, "Notes from Conversation with Alissa Fishbane of Deworm the World (April 23, 2012)."

  • 6.

    GiveWell, "Notes from Phone Conversation with Colin Buckley and Faith Rose of Children's Investment Fund Foundation (May 30, 2012)."

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