Note: This page summarizes the rationale behind a GiveWell grant to Innovations for Poverty Action. Innovations for Poverty Action staff reviewed this page prior to publication.
Summary
In May 2025, GiveWell recommended an $83,079 grant to Innovations for Poverty Action (IPA) to conduct household visits that will audit Dimagi's CommCare Connect pilots in Nigeria. This audit will help us determine whether Dimagi's remote verification system reliably confirms that reported household visits actually occurred and that health commodities were delivered. IPA will visit 24 villages where Dimagi’s local partner organizations are distributing health commodities, and sample 15-20 households per village.
We recommended this grant because:
- This is a low-cost way to validate the $1 million pilot grant we made to Dimagi in May 2024. By independently assessing whether reported visits occur, the audit addresses a key uncertainty about the reliability of Dimagi's verification system.
- The timing aligns well with our decision-making needs. We expect to receive Dimagi's pilot results in October 2025 and IPA's audit report in September 2025, providing timely input for decisions about potential future funding for CommCare Connect, such as a randomized controlled trial or implementation funding.
Our main reservations are:
- This was a very quick investigation, and some objectives still need alignment between IPA and Dimagi, including which Nigerian states IPA can safely work in and the specific scope of the audit.
- The sample size (360 households in 24 villages) may be too small to fully validate the verification system, though it should detect major issues.
- We have not formally modeled the cost-effectiveness of this grant.
Published: July 2025
Background
Dimagi is a for-profit social enterprise that builds software to assist frontline workers (FLWs) – also known as community health workers (CHWs) – employed by locally-led organizations to visit households in low- and middle-income countries, primarily through its CommCare platform.1 Innovations for Poverty Action (IPA) is a research and policy nonprofit that aims to discover and promote effective solutions to global poverty problems.2
In November 2023 and June 2024, we recommended grants to scope and pilot, respectively, Dimagi’s new healthcare platform, CommCare Connect (CCC), for use for child health campaigns (CHC) that consist of the paid door-to-door delivery of health commodities to children under five in communities with high child mortality and low prior health commodity coverage. (In contrast, the standard CommCare platform is intended for a wider set of use cases and doesn’t provide donors with the option of paying for outputs like verified child visits.3 )
A key implementation question from the pilot we funded is whether Dimagi can convincingly verify that the reported child visits actually occur (for more, see here). While Dimagi is developing its own remote verification procedures, we believe it is important to have independent validation of these systems before considering recommending larger grants for CommCare Connect.
The grant
This grant will fund IPA to conduct field-based household visit audits to validate Dimagi's remote verification data for the pilot that GiveWell funded last year.
Grant activities
IPA will conduct audits in 24 villages across Nigeria, once Dimagi’s partner locally-led organizations have completed their household visits. The audit will involve:4
- Village mapping and household identification. In each village, IPA field officers will meet with local leaders to map the village and identify households with children under 24 months. They will collect GPS coordinates and conduct a basic wealth categorization exercise.
- Household sampling and verification visits. IPA will randomly sample 15-20 households per village for auditing. Field officers will visit selected households to confirm:
- Whether and when visits from locally-led organization representatives took place
- What services were provided during the visits
- The eligibility criteria of the household
- Methodology refinement. The audit will help refine IPA's household listing protocol, eligibility screening, and sampling methodology for potential future evaluations of Dimagi's platform.
The grant activities will run from May until September 2025.
Budget
The $83,079 budget for this grant breaks down as follows:5
- Personnel – $33,585
- Audit data collection – $14,677
- Household listing – $6,922
- Supplies and IT – $2,624
- Travel – $174
- Other direct costs – $9,071
- Overhead costs – $16,026
The case for the grant
We are recommending this grant because:
- This is a low-cost check on Dimagi’s CommCare Connect platform, and the pilot we funded last year. We think this platform has the potential to be a cost-effective method for increasing healthcare commodity coverage in high mortality (and low coverage) areas through verified household visits by frontline health workers, but this is still a fairly early stage program. A key implementation question we have is whether Dimagi can convincingly verify child visits, which is important for establishing the platform’s reliability before any larger-scale evaluation or implementation. This grant will help to answer this by independently assessing whether household visits reported remotely are actually occurring, identifying potential discrepancies, and validating the number of eligible households (for calculating accurate coverage rates)
- This grant is likely to influence future grantmaking decisions. We expect to receive Dimagi's pilot results in October 2025 and IPA's audit report in September 2025. This timing means we will have IPA's independent verification data available when making decisions about whether to investigate additional grants for CommCare Connect, such as a full randomized controlled trial, or further implementation support.
Risks and reservations
Our main reservations about this grant are:
- At the time of recommending this grant, we have yet to align with IPA on all of the objectives of the study. We have investigated this quickly, due to the time-sensitivity of the funding opportunity. As a result, there are important details that IPA and Dimagi still need to work out. For example, IPA is still determining which states in Nigeria it can safely work in. It’s also possible that IPA and Dimagi have slightly different objectives: based on our correspondence, we think it’s possible that Dimagi may want more insight into the household visits themselves (to evaluate the quality and impact of the platform), whereas IPA may be more focused on validating Dimagi’s verification system (through assessing whether the visits occurred, and the number of households eligible for coverage).
- The sample size may be too small for complete validation. With only 24 villages and 360 households, we may not be able to fully validate Dimagi's verification system across all contexts. However, we believe this sample size offers a good balance between thoroughness and efficiency, and should be sufficient to detect major verification issues that would warrant concern before further investment. According to IPA's analysis, the sample of 360 households would allow us to estimate the true coverage rate with approximately ±3.5% margin of error at 90% confidence (assuming 80% coverage).6
- We have not formally assessed the cost-effectiveness of this grant. For larger research grants, we typically quantitatively assess their "value of information," and compare this to our cost-effectiveness benchmark. However, given the low cost of the grant and its importance for future CommCare Connect grantmaking, we feel confident making this grant without a formal cost-effectiveness calculation in this case.
Plans for follow up
- We will coordinate a kickoff call with IPA and Dimagi immediately after recommending this grant to align on core objectives, including whether it is possible to verify visit occurrence using GPS coordinates.
- After IPA completes their fieldwork, we will review their report and compare their verification findings with Dimagi's remote verification data, analyzing match rates and identifying any patterns by locally-led organization or geography.
- We expect to consider additional grantmaking opportunities for Dimagi’s CommCare Connect platform in the future.
Internal forecasts
For this grant, we are recording the following forecasts:
| Confidence | Prediction | By time | Resolution |
|---|---|---|---|
| 60% | We will continue funding Dimagi for work related to CommCare Connect by June 2026 | June 2026 | - |
Our process
- This was a very light-touch investigation, given the small grant size.
- This grant opportunity arose from USAID funding cuts. We had previously agreed to consider funding a randomized controlled trial of CommCare Connect after seeing Dimagi's pilot results, but when USAID terminated their funding for the trial, we reconsidered our approach.
- Dimagi suggested that ground truthing could be useful and would make our post-pilot investigations easier. After reviewing a brief two-page proposal from IPA and consulting with Neal Lesh from Dimagi, we decided to move forward with this targeted audit.
Sources
- 1
- “Dimagi is a global tech for good social enterprise enabling impactful frontline work through scalable digital solutions and expert services … at least 50% of people lack access to essential health services. We help bridge this gap by empowering Frontline Workers to deliver critical services to communities in need.” Dimagi, “About Dimagi.”
- "CommCare Connect is a software-as-as-service mobile health platform that allows community health workers to track and maintain patient data. It is designed “to provide opportunities for Frontline Workers to learn, deliver, verify and be paid for high-impact interventions”. “In our long-term vision, individual workers will create free accounts on CommCare Connect and gain access to opportunities to deliver high-impact interventions, such as participating in vaccine campaigns, leading educational programs, or disseminating important information to households about early childhood development or family planning. Every opportunity on CommCare Connect will require the worker to use a provided mobile application to ensure accurate and verifiable delivery of the intervention, as well as payment to the worker.” Dimagi, “Delivering Child Health Campaigns with CommCare Connect”.
- 2
"We are a global research and policy nonprofit committed to reducing global poverty with evidence. With a network of partners and researchers, we design and test innovative solutions, support our partners to generate and use data and evidence, and help bring proven approaches to scale across the globe." See Innovations for Poverty Action, “About”
- 3
- Use cases listed on the CommCare site include Monitoring & Evaluation (M&E), Information and Communications Technologies for Development (ICT4D), and research. Dimagi, CommCare.
- “Dimagi’s new CommCare Connect initiative will enable Frontline Workers to provide additional services, further catalyzing their impact at scale. … Service delivery is verified - leveraging biometrics, GPS, and data algorithms.” Dimagi, CommCare Connect - 2023 in Review.
- 4
Innovations for Poverty Action, email to GiveWell, May 8 2025 (unpublished)
- 5
Innovations for Poverty Action, Dimagi CommCare Connect Audit budget, 2025.
- 6
Using the formula n = (z^2 x p x (1-p)) / ME^2, where n = sample size, z = 1.645 based on a 90% confidence interval, p = expected coverage of 80%, and ME = a margin of error of 3.5%. Innovations for Poverty Action, email to GiveWell, May 9, 2025 (unpublished)