GiveWell and IDinsight: Cataract Surgery Project
Published: April 2017
As part of our Incubation Grants program, GiveWell is partnering with IDinsight (http://idinsight.org/) to support the identification or development of a GiveWell top charity focused on cataract surgery.
Over the past year, we have had conversations with 17 organizations that work on cataract surgery to explore whether they meet our criteria and ways that IDinsight might design monitoring and/or evaluation of the program.
We have decided to put this project on hold. Now that we better understand how these organizations operate, our next step would be to work with IDinsight to design and implement one or more evaluations to answer the following question: "How many additional (high-quality) surgeries does the organization cause to happen that would not have happened in the absence of its work?" We have not identified a strong option for conducting an evaluation that would provide an answer. In particular, we believe that the types of evaluations that would be feasible would likely be expensive both in cost and in staff time, and that there is a significant chance that they would not sufficiently attribute causality to a particular organization. Therefore, we have decided not to continue this project at this time. We hope to return to it in the future.
Notes from some of our conversations with organizations that work on cataract surgery:
- Aravind Eye Care System in May 2017
- CBM in February 2016
- Fred Hollows Foundation in March 2016
- International Eye Foundation in June 2017
- Kilimanjaro Centre for Community Ophthalmology in June 2017
- Light for the World in May 2017
- Lions Clubs International Foundation in June 2017
- Mercy Ships in August 2017
- Operation Eyesight Universal in May 2017
- Seva Foundation in January 2016 and May 2017
- Sightsavers in April 2016 and May 2017
We completed an intervention report on cataract surgery in 2016 in which we classified cataract surgery as a "priority program" for GiveWell. We also spoke with several organizations that support cataract surgeries to consider whether they might be a fit for a GiveWell top-charity recommendation. Based on those conversations, we did not expect that any would have sufficient monitoring and evaluation information available to qualify as a GiveWell top charity.
GiveWell is partnering with IDinsight, an international NGO that helps generate and use rigorous evidence to improve social impact, to identify a cataract surgery organization to work with. The aim will be to improve the monitoring and evaluation data the surgery organization can share so that it can qualify as a GiveWell top charity.
More on GiveWell and IDinsight's work together here.
We expect this work to proceed in the stages described below.
- Stage 1: scoping calls with each organization: We and IDinsight plan to contact the organizations listed below to ask for a phone conversation to answer basic questions about each organization's work. We plan to ask them:
- What specific intervention(s) do you implement (e.g., training surgeons, funding hospitals, creating mobile units to increase demand) to increase the volume of cataract surgeries?
- What monitoring and evaluation information do you have available?
- What work do you support other than cataract surgery? How do you make decisions about how to allocate funding across programs?
- How do your programs differ across locations where you work?
- Approximately how much additional funding could you absorb in the next three years?
This stage may include limited requests for documents (i.e., requests for a small number of documents that organizations already have available).
- Stage 2: deeper investigation of 1-3 organizations: Our impression, based on initial conversations with some organizations, is that many largely operate as funders of a diverse set of local organizations (e.g., hospitals, community-based organizations, other health facilities), so Stage 2 may require asking questions similar to those in Stage 1, but to specific parts of single organizations (e.g., country offices). This stage may include site visits by IDinsight staff and will likely include more substantial requests for documents.
- Stage 3: implement with one organization: In this stage, IDinsight would work closely with an organization to develop a monitoring and evaluation system and/or conduct an impact evaluation aimed at qualifying the organization for a GiveWell recommendation.
Number of organizations we expect to work with at each stage
We believe we are likely to identify 1-3 organizations with which to proceed to Stage 2 above. We are uncertain whether we will choose to proceed to Stage 3 with any organization. Even if we proceed to Stage 3 with an organization, there remains a significant possibility that this work will not result in a new GiveWell top-recommended charity.
Funding for the project
GiveWell expects to recommend grants to Good Ventures that will fully fund IDinsight's work on this project. To enable participation, we will need to ask for organizations to allocate some staff time to the project. GiveWell welcomes conversations about how to minimize the burden placed on participating organizations.
Consistent with our general approach to transparency, we plan to write publicly about this project. As we normally do, we will keep all non-public documents organizations share with us confidential until we have explicit approval to publish them.
Organizations we plan to contact
Note that in some cases, we have already completed an initial conversation.
- Aravind Eye System
- Brien Holden Vision Institute
- Eye Care Foundation
- Fred Hollows Foundation
- Helen Keller International
- Himalayan Cataract Project
- International Agency for the Prevention of Blindness (IAPB)
- International Centre for Eye Health (ICEH)
- International Eye Foundation
- Kilimanjaro Centre for Community Ophthalmology
- Light for the World
- Lions SightFirst
- Magrabi Foundation
- Mercy Ships
- Operation Eyesight Universal
- Peek Vision
- Rotary International
- Seva Foundation
- World Optometry Foundation