Dimagi — Mother-Baby Wellness Coaching CommCare Connect (CCC-MBW) Program Design (November 2024)

Note: This page summarizes the rationale behind a GiveWell grant to Dimagi. It reflects our understanding at the time we recommended the grant in November 2024. Dimagi staff reviewed this page prior to publication.

Published: March 2025

The organization

Dimagi is a for-profit social enterprise that builds software to assist frontline workers (FLWs) – also known as community health workers (CHWs) – when visiting households in underserved communities, primarily through its CommCare platform.1 Dimagi has more recently developed a new digital healthcare platform, CommCare Connect (CCC), which is used by FLWs to deliver, verify, and receive payment for delivering various health interventions.2 (In contrast, the standard CommCare platform is intended for a wider set of use cases and doesn’t offer funding/payment functionality for verified intervention delivery.3 )

The intervention

CommCare Connect (CCC) aims to increase commodity or intervention coverage by better organizing and paying FLWs to provide highly cost-effective health interventions to people who aren’t being reached by existing health systems.4 Our general understanding is that by default, it is common for FLWs to receive little, or no, remuneration for their work.5 CommCare Connect pays FLWs per verified visit to provide interventions in these low coverage areas.6 Dimagi works with locally-led organizations, who hire and train the FLWs.7

To date, Dimagi has developed CCC programs focussed on interventions including child health commodities (CCC-CHC, which GiveWell is supporting a pilot in), group therapy, kangaroo mother care, and early childhood development.8

The Mother-Baby Wellness CommCare Connect program (CCC-MBW) that will be designed under this grant will focus on breastfeeding promotion and maternal mental health.9 We think that breastfeeding support programs (which educate and support mothers who choose to breastfeed) are a potentially cost-effective intervention because it may reduce infant diarrhea and mortality. See our intervention report for more.

The grant

Grant activities

We are recommending a grant of $320,356 to Dimagi for the design and testing of a Mother-Baby Wellness CommCare Connect program (CCC-MBW), as well as scoping an evaluation.10

The first component of this funding is for Dimagi to design the content and intervention for the CCC-MBW program.11 More specifically, this will involve content design and digitization (including training modules, job aids, verification rules and FLW supervision modules)12 , some user acceptance training with FLWs13 , and the development of AI chatbot aids.14 This would also involve testing the CCC-MBW design with around 100 FLWs and up to 2,000 parent-baby pairs.15 This testing would be done in Nigeria, with a small number of yet-to-be-identified local organizations.16 While the materials have not yet been developed, CCC-MBW is expected to focus on:

• Breastfeeding promotion, by providing six counseling visits to breastfeeding parents, beginning in the antenatal period and lasting through to the introduction of complementary feeding.17
• Improving maternal mental health, by providing coaching around resilience and empowerment.18

The second component of this grant is to support Dimagi to identify an external evaluator and develop an evaluation plan for an evaluation of a large-scale operational pilot of the program.19 We expect to make a decision about funding of both an operational pilot and an evaluation following this initial grant.20

Timeline

The grant activities will last for 15 months. This is broken down as follows21 :

• Months 1–4: Consultation period with experts to design content and intervention
• Months 2–8: Building application, testing iteratively, and validating with pilot cohorts.
• Months 9–14: Testing of application with a full 5-6 month cohort.
• Months 12–15: Analysis and reporting.
• Throughout the project: development of an evaluation plan for an evaluation of a potential large-scale operational pilot.22

Budget for grant activities

The $320,356 grant includes:23

• $57,000 in payments to locally-led organizations. This includes:
  • $40,000 for user acceptability testing;
  • $18,000 for verified visits by FLWs during a testing phase, paid to the local organizations.
• $262,356 for Dimagi’s project costs. This includes:
  • $250,256 for staff costs;
  • $7,600 for travel;
  • $4,500 for Dimagi’s costs during the testing phase.

The case for the grant

Cost-effectiveness

We think this grant could open up future funding opportunities both in the near term through an operational pilot and evaluation, and into the future through scale-up activities. If Dimagi is able to design a breastfeeding promotion tool with input from external experts, this could lead to a future funding opportunity to support an operational pilot and evaluation. If that pilot and evaluation then implies the program is successful at increasing breastfeeding and reducing infant diarrhea rates, we think there could be opportunities to scale the program more widely. A preliminary CEA indicates that a program could plausibly be cost-effective in some countries.24 Therefore, this grant could lead us to make one or more highly cost-effective grants to Dimagi in future.

We have also attempted to roughly estimate the value this grant creates through opening up future cost-effective funding opportunities. Our rough best guess is that this "optionality value" is around 13 times as cost-effective as GiveWell’s funding benchmark, though this is based on highly uncertain assumptions.25

Dimagi has piloted CommCare Connect programs addressing other health focus areas across several countries.26 We think it could be relatively easy for locally-led organizations already working with Dimagi to layer CCC-MBW onto their existing programming. In particular, organizations supporting CommCare Connect for Kangaroo Mother Care (CCC-KMC) may find it simple to also train their front-line workers (FLWs) on CCC-MBW, so it is possible there could be opportunities to support combined programs in the future which could be even more cost-effective.27

Alignment with strategic scoping goals

Globally, nearly half of deaths among children under five occur during the first month of life.28 While the mortality rate of children under five has more than halved in recent decades,29 neonatal mortality rates have declined at a slower rate.30 We expect that, in coming years, neonatal mortality may become an even larger share of mortality among children under five, so we think it is strategic to prioritize scoping maternal and neonatal health interventions. This grant is a relatively small investment which could open up opportunities for more cost-effective funding in this high impact area.

We have a positive qualitative impression of Dimagi

We have a strong qualitative impression of Dimagi. Based on both our direct experience of communicating with Dimagi and the feedback we have received from experts who have worked with Dimagi before, we believe Dimagi is well-aligned with GiveWell’s values of transparency and impact.

Even if we don’t fund the follow on pilot and evaluation, funding the design of this product could still have a positive impact

Even if we don’t fund an operational pilot, it is possible that other funders may be more likely to support programming (if the tool already exists), or the materials Dimagi develops on breastfeeding could support other programming run by organizations using CommCare tools.

Dimagi aims to create resources from this project that can be used independently of the CommCare Connect program. For example, they plan to open source their digital learning materials which can be used in a variety of maternal and neonatal health programs, whether or not those programs adopt the CCC payment and verification systems.31

Risks and reservations

• It is possible that we may subsequently choose not to fund the full operational pilot or associated evaluation. This is most likely to occur if we do not believe the proposed evaluation would be valuable due to concerns with the scale of the addressable market (see below) or limited scope to apply learnings to other programs.
  • Additionally, we might decline to fund the full pilot and evaluation if later updates to our intervention-level work on breastfeeding promotion and the CommCare Connect platform indicate that the program would not meet our bar for cost-effectiveness. While our initial BOTEC indicates that scaling up CCC-MBW could be cost-effective in some countries (Nigeria, Burkina Faso), we have not yet done an in-depth review of the contexts where a potential program could operate.32 Because of this, we aren’t sure if (or to what extent) we may be overestimating cost-effectiveness. However as mentioned above, we think there could be some positive outcomes of this grant even if we decline further funding for any of these reasons.
• We conducted a lighter investigation into this grant opportunity, so it is possible we missed a key consideration. However, we think the key uncertainties about the program will be directly addressed through Dimagi's work on the evaluation plan and subsequent pilot (if funded). We expect to do a deeper investigation of the opportunity to fund the pilot and evaluation, which will be informed by Dimagi's initial feasibility testing and evaluation proposal, at the end of this grant period.
• Dimagi could plausibly fund this design work without our support. Our understanding is that Dimagi has previously used some of their unrestricted funding for designing CCC programs. However, they told us the current unrestricted funding they have available for CCC is most likely to be allocated to development and scale up of existing CCC programs. They are currently unlikely to use unrestricted funds for the development of new programs without external donor support because new programs would have a more uncertain path to scale without external support.33

• There may be a smaller total addressable market for the Mother-Baby Wellness program via CommCare Connect than we currently expect. Because this program is at an early stage, we haven't looked into how many locations a breastfeeding promotion program may be promising to scale up in. It is possible that we could learn that there isn’t a large addressable market to support this program, either if Dimagi isn't able to identify sufficient locally-led organizations to scale-up the program or if the populations who would benefit from this program are smaller than we expect.

• It is possible that we should wait until we receive initial results from the pilot we have funded for CommCare Connect for child health campaigns (CCC-CHC).34 It is possible that after receiving results from the pilot of CCC-CHC that we have already funded, we might learn that Dimagi fundamentally isn’t able to conduct CCC-CHC at scale, or ensure the fidelity of the program.
  • However, we have decided to fund the CCC-MBW design before receiving the CCC-CHC pilot results because (a) it is unclear how transferable some of the learnings from CCC-CHC, which is a commodity campaign program, would be to CCC-MBW, (b) waiting for these results would delay the CCC-MBW program significantly, and (c) we expect to gain some initial learnings about how the CCC-CHC program is progressing before deciding whether to fund a CCC-MBW operational pilot.

• Dimagi is a for-profit organization, and it’s possible that there are risks associated with granting them funds or that their orientation does not align with GiveWell’s values. We expect to structure the grant agreement and financial reporting requirements35 in a way that provides transparency in how the funds are spent. In this case, we’re less concerned about lack of alignment because we have a strong qualitative impression of Dimagi and its platform CommCare, and we understand they’ve received or are currently discussing grants from philanthropic donors like the Bill and Melinda Gates Foundation.36

Plans for follow up

• Biannual check-ins during the grant period, with particular focus on the content of the breastfeeding promotional material.
• We may have additional check-ins regarding the evaluation plan, to confirm that we are aligned with the goals (such as the preferred outcome measures) and expected output.
• Over this grant period, we may also update our general work on breastfeeding promotion, which could inform the likelihood of subsequent funding.

Internal forecasts

For this grant, we are recording the following forecasts:

Confidence	Prediction	By time
95%	Dimagi will successfully design a MBW-CCC module that can be deployed during an operational pilot.	April 2026
70%	Conditional on successful module design, we will fund follow on work to conduct an operational pilot and some evaluation.	June 2026.

Our process

• We received and reviewed a proposal, initial budget, and summary of the program.
• We had two conversations with Dimagi to discuss our questions about the proposal, funding, and the grant structure. We also met with another philanthropic funder to discuss their engagement with Dimagi.

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 … We design to reach the most underserved populations, especially in technically challenging contexts.” Dimagi, “About Dimagi.”

• 2

  “Dimagi is in the process of developing a new initiative, CommCare Connect, 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.”

• 3
  • Use cases listed on the CommCare site include Monitoring & Evaluation (M&E), Information and Communications Technologies for Development (ICT4D), and research. Dimagi, “CommCare.”
  • “CommCare Connect will help Frontline Workers to rapidly learn, deliver, verify, and be paid for high-impact services at scale. This will provide growth opportunities for Frontline Workers and more efficient expansion of frontline services.” Dimagi, Dimagi, “CommCare Connect - Overview Deck,” Slide 10.
  • “Governments and donors select specific services they want to fund in targeted geographies…Governments and donors can see real-time delivery of verified services, and adapt accordingly…Governments and donors fund only tasks that have been verified.” Dimagi, “CommCare Connect - Overview Deck,” Slide 16.

• 4
  • “Our objective is to digitally orchestrate millions of highly-cost effective interventions per year in Low and Middle Income Countries (LMICs). CommCare Connect will leverage and bolster existing health system resources and capacity while putting more money into local economies and efficiently delivering interventions where they are needed.” Dimagi, “Delivering Child Health Campaigns with CommCare Connect”.
  • “We can offer tools to existing high-performing Frontline Workers to unlock more impact, and provide an incentive for medium and low performers to improve.” Dimagi, “CommCare Connect - Overview Deck,” Slide 13.
  • “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."

• 5

  “Who Are Frontline Workers? Generally, women with limited training or education who provide health services for hundreds of people in their own communities. Often hired by governments or NGOs for little money, sometimes none.” Dimagi, “CommCare Connect - Overview Deck,” Slide 4.

• 6

  “CommCare Connect will help Frontline Workers to rapidly learn, deliver, verify, and be paid for high-impact services at scale. This will provide growth opportunities for Frontline Workers and more efficient expansion of frontline services.” Dimagi, “CommCare Connect - Overview Deck,” Slide 10.

• 7

  Locally-led organizations are Dimagi’s term for organizations (for-profit or non-profit) that organize and employ health workers.

• 8

  See slide 24 of Dimagi, Dimagi, CommCare Connect - Overview Deck.
  

• 9

  “Two pillars of the program will be increasing exclusive breastfeeding (EBF) of the baby and self-care/resilience for the mother.” Dimagi, "Scaling Mother-Baby Wellness Coaching in LMICs," p. 1.

• 10

  See row E of Dimagi’s summary budget here. Dimagi confirmed that the evaluation and scoping element is included in this budget. Correspondence from Dimagi to GiveWell, November 6, 2024. (Unpublished)

• 11

  “Step 1: Content Design and Digitization - Dimagi will work with content experts to craft content and build digital components in CommCare Connect.” Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 1.

• 12

  “Dimagi will work with content experts to craft content and build digital components in CommCare
  Connect. These will include:

  • Learn modules: self-paced offline modules that teach the FLW the content she needs to deliver the MBW coaching sessions to her clients.
  • Deliver modules: digital forms the FLW will use while delivering the coaching sessions. These are similar to the type of digital job aids that Dimagi has been making for over 15 years on CommCare. They will be designed to remind FLWs of the key counseling points and to collect some basic data from each client on each session (while not requiring FLWs to be using the app during most of the coaching session). The exact duration and number of visits in the Mother-baby Wellness Coaching program will be determined in this phase.
  • Verification rules: We will design a series of verification rules to operate on the data collected by the Deliver modules, such as those that require a minimum length of time per visit. We can also have a verification rule which expects a photo of an ANC or PNC card to be taken. When FLWs submit forms for a coaching session that trigger a verification rule, the visit will only be paid for once verified that it met established requirements.
  • Supervision modules: We will develop forms that are used when supervisors observe a FLW performing a coaching session. These standardized forms cover interpersonal skills as well as content knowledge and will provide supervisors with a means of targeted coaching to enhance the quality of the FLW sessions [example of ECD observation checklist].

  All of these digital components currently exist in our CCC-ECD program, and will be used as the template for the CCC-MBW program application.” Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 1.

• 13

  “For CCC-MBW, we expect to conduct a minimum of 15 UAT sessions to work with approximately 120 FLWs to refine our Learn, Deliver and Supervision modules. The Learn UAT sessions will test different learning approaches that will be best suited to digitally train FLWs on the CCC-MBW coaching program. We will also refine the supervision approach to check FLWs’ preparedness to deliver quality services in their communities. The Deliver UAT sessions will focus on developing an efficient job aid tool that will support FLWs during service delivery and for data collection.” Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 2.

• 14

  Dimagi will build an AI coachbot for CCC-MBW which will also be tested during UATs. We have no evidence of the effectiveness of these AI coaches yet but are optimistic they can add value to many CommCare Connect programs, in a variety of ways:

  • Reinforce the content included in the Learn app and answer questions, e.g, on troubleshooting breastfeeding challenges.
  • Debrief with FLWs on issues that arise during coaching sessions. We have found our chatbots are able to guide users through effective techniques, such as motivational interviewing.
  • Identify FLWs who do not understand content and are likely not providing effective coaching. When we have more data for CCC-ECD, we plan to apply machine learning techniques to see if the coaching transcripts can be used to predict the performance ratings by supervisors on observed visits. We will experiment with inserting questions from the coach (e.g., quizzing on the material from the Learn module) to improve this further.
  • Administer dynamic user surveys. We can dynamically insert a question or two per week for the AI coach to ask all the FLWs, to help further improve the CommCare Connect program overall.

  We will also explore the possibility of providing a similar AI chatbot for clients who have phones. We are cautiously optimistic that we can create a chatbot that can help mothers mitigate common barriers to exclusive breastfeeding. Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 2.

• 15

  “Once we have Designed CCC-MBW, we will launch a test of the entire program with approximately 100 FLWs who will reach up to 2,000 mothers. This will take 6-7 months, as the coaching intervention with each mother is expected to last about 5 months (to be confirmed in the design phase). We’d expect the FLWs to only register mothers for the first 2-3 months of the pilot and then complete the coaching intervention for those registered for the remainder of time.” Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 3.

• 16

  Correspondence from Dimagi to GiveWell, November 6, 2024. (Unpublished)

• 17

  “Coaching can help women understand the benefits of EBF, and help overcome the challenges of doing so for women who opt to. There is a compelling body of evidence that a FLW-delivered, six-visit coaching program can increase EBF rates.[12,13] A recent systematic review found that counseling programs could increase EBF rates by up to 48%, and that programs with at least 4 contacts were more effective than those with less. Based on this systematic review of the evidence, the World Health Organization breastfeeding counseling guideline development group recommended provision of at least six breastfeeding counseling contacts to allow for a full range of support to breastfeeding mothers and their families, beginning in the antenatal period through to the introduction of complementary feeding and beyond.” Dimagi, "Scaling Mother-Baby Wellness Coaching in LMICs,” p. 1-2.

• 18

  “Our mother-baby coaching program will incorporate evidence-based strategies, such as Problem Management Plus (PM+), that reduce the risk of depression by enhancing their overall wellbeing. Following the WHO’s guidance on preventing and addressing mental health conditions, mothers will be coached in building competence (essential life skills for interpersonal communication, decision making, problem solving, self-care, and healthy lifestyle choices), resilience (ability to deal with stress and adapt to stressors and adversity), and empowerment (confidence, choice, mastery, agency, and hope).” Dimagi, "Scaling Mother-Baby Wellness Coaching in LMICs,” p. 2.

• 19

  Correspondence from Dimagi to GiveWell, November 6, 2024. (Unpublished)

• 20
  • Dimagi expects that an operational pilot targeting around 35,000 mother-baby pairs would cost around $710,000 and take around 18 months. See “Scale Phase,” column F of the Summary Budget tab of Dimagi, Budget for Mother Baby Wellness, 2024 and the “Initial Scale Phase” section of Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 4.
  • The evaluation component is not expected to exceed $75,000. Correspondence from Dimagi to GiveWell, November 6, 2024. (Unpublished)

• 21

  See the “Timeline” tab of Dimagi, Budget for Mother Baby Wellness, 2024.

• 22

  Correspondence from Dimagi to GiveWell, November 7, 2024. (Unpublished)

• 23

  See the “Summary Budget” tab of Dimagi, Budget for Mother Baby Wellness, 2024.

• 24

  For example, Nigeria - 18x, Burkina Faso - 14x. We have not done an in-depth review of the contexts where a potential program could operate, and are unsure to what extent we might be over/under estimating cost-effectiveness.
  Note: Our cost-effectiveness estimates are based on the benefits from breastfeeding promotion. This program will also have a maternal mental health component which we have not tried to quantify but which will plausibly lead to additional benefits.

• 25

  These assumptions include:

  • There is a 67% chance that we fund a subsequent operational pilot.
  • There is a 60% / 50% / 30% chance that we conclude the program is > 8x / 10x / 12x our bar after an operational pilot and evaluation
  • The change in funding per year based on the operational pilot and evaluation would be around $2m
  • We also apply a 30% downward adjustment to the current guess of the direct program benefits to account for this being a light investigation.

  For more detail, see the optionality BOTEC.
  A note on GiveWell’s funding benchmark:

  • To date, GiveWell has used GiveDirectly's unconditional cash transfers as a benchmark for comparing the cost-effectiveness of different funding opportunities, which we describe in multiples of "cash” (more). In 2024, we re-evaluated the cost effectiveness of direct cash transfers as implemented by GiveDirectly and we now estimate that their cash program is 3 to 4 times more cost-effective than we’d previously estimated. (more)
  • For the time being, we continue to use our estimate of the effectiveness of unconditional cash transfers prior to the update to preserve our ability to compare across programs, while we reevaluate the benchmark we want to use to measure and communicate cost-effectiveness.
  • Note that a) our cost-effectiveness analyses are simplified models that are highly uncertain, and b) our cost-effectiveness threshold for directing funding to particular programs changes periodically. See GiveWell’s Cost-Effectiveness Analyses webpage for more information about how we use cost-effectiveness estimates in our grantmaking.

• 26

  Through the CCC-CHC program: Nigeria, India, Kenya, Zambia, Tanzania. Through CCC-KMC program: Uganda, Ethiopia, Kenya. As described here: “One of the key pathways for the field implementation of CommCare Connect was working with locally-led organizations (called the Direct-to-Frontline-Organization pathway) across programmatic areas to deliver key services to vulnerable populations. As part of the D2Org pathway, one of the most widespread programs so far has been Dimagi’s CommCare Connect Child Health Campaign (CHC) under which we have provided Vitamin A and Deworming(VAS+D) supplementation, MUAC screening and referrals, and basic infant vaccine checks. In our recent pilots in Nigeria, we have also included dropping off ORS and zinc sachets for all children under 5 years of age. After the initial pilot in Rajasthan, India, Dimagi conducted three small pilots of 5000 children each in Kenya, Tanzania and Zambia. Our partners in these countries were Cohesu, Sujukwa and LiveWell respectively. After this, Dimagi launched a Request for Proposal (RFP) and selected two partners, the Center for Wellbeing and Integrated Nutrition Solutions (C-WINS), in Nigeria and Sanmat in Jharkhand, India. Both organizations conducted a major campaign to deliver the Child Health campaign to 40,000 children each in Katsina in Nigeria and in the Dumka district of Jharkhand in India. Dimagi was supported by Vitamin Angels, India with doses of VAS+D for our campaigns in India and Zambia…In March 2024, Dimagi furthered this initiative by launching a program to deliver ORS+Zinc treatment in addition to VAS+D to 5000 children in Nigeria. Two co-packs of 2 ORS sachets and 1 strip of 10 Zinc sulphate tablets were handed over to children between the ages of 0-59 months. Dimagi achieved a milestone of reaching 1,00,000+ children across seven countries; Kenya, Tanzania, Zambia, Nigeria and India for the child health campaign and Uganda and Ethiopia for the mental health and kangaroo mother care pilots respectively.” Dimagi, CommCare Connect Reaches a Milestone of 100,000 Service Deliveries, May 31, 2024.

• 27

  We do think there is likely a limit to how many CCC programs the same FLW could be trained on. Our understanding is that Dimagi is currently thinking about how CCC can most effectively be used. At this stage, our best guess is that CCC-KMC and CCC-MBW are particularly well-suited for layering since they both target newborn care.

• 28

  “In addition to the 4.9 million lives lost before the age of 5 – nearly half of which were newborns – the lives of another 2.1 million children and youth aged 5-24 were also cut short.” Unicef, “Levels and trends in child mortality,” March 12, 2024.

• 29

  “The report reveals that more children are surviving today than ever before, with the global under-5 mortality rate declining by 51 per cent since 2000. And several low- and lower-middle-income countries have outpaced this decline.” Unicef, “Levels and trends in child mortality,” March 12, 2024.

• 30

  “The world has made substantial progress in child survival since 1990. Globally, the number of neonatal deaths declined from 5.0 million in 1990 to 2.3 million in 2022. However, the decline in neonatal mortality from 1990 to 2022 has been slower than that of post-neonatal under-5 mortality. Moreover, the gains have reduced significantly since 2010, and 64 countries will fall short of meeting the Sustainable Development Goals target for neonatal mortality by 2030 unless urgent action is taken.” WHO, “Newborn mortality,” 14 March, 2024.

• 31

  “Dimagi is interested in generating reusable resources from this project that can be used independently
  of the CommCare Connect program itself. For example, we will open source our digital learning
  materials which themselves can be used in a variety of programs, whether or not they adopt our
  payment and verification schemes.” Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024, p. 4.

• 32

  For example, we are unsure about:

  • The relevant risks to not breastfeeding in various contexts (i.e. based on the specific water quality or other pathogen exposure risks);
  • What barriers to breastfeeding are relevant in specific contexts;
  • What counterfactual programming may be occuring. Dimagi has expressed that they would launch the program in areas with low exclusive breastfeeding (EBF) and no access to a comparable service, alongside LLOs that have experience in this area but aren't already actively involved in a similar program. We have not validated this. Correspondence from Dimagi to GiveWell, October 17, 2024. (Unpublished)

• 33

  Dimagi in conversation with GiveWell, October 13, 2024. (Unpublished)

• 34

  Note: USAID DIV is funding an RCT of the CCC-CHC program that we are supporting expansion of. See USAID, “Dimagi Inc. Testing a Digital Platform and Incentives to Deliver Child Health Care,” 2024.

• 35

  Dimagi in conversation with GiveWell, October 13, 2024. (Unpublished)

• 36

  Dimagi, Responses to GiveWell’s Questions, August 22, 2023 (unpublished).

Document	Source
Correspondence from Dimagi to GiveWell, November 6, 2024. (Unpublished)	Unpublished
Correspondence from Dimagi to GiveWell, November 7, 2024. (Unpublished)	Unpublished
Correspondence from Dimagi to GiveWell, October 17, 2024. (Unpublished)	Unpublished
Dimagi	Source (archive)
Dimagi in conversation with GiveWell, October 13, 2024. (Unpublished)	Unpublished
Dimagi, “About Dimagi.”	Source (archive)
Dimagi, "Budget for Mother Baby Wellness," 2024.	Source
Dimagi, “CommCare Connect - Overview Deck.”	Source (archive)
Dimagi, "CommCare Connect Reaches a Milestone of 100,000 Service Deliveries," May 31, 2024.	Source (archive)
Dimagi, “CommCare.”	Source (archive)
Dimagi, “Delivering Child Health Campaigns with CommCare Connect.”	Source (archive)
Dimagi, “Proposal: CCC for Mother-Baby Wellness Coaching,” 2024.	Source
Dimagi, "Scaling Mother-Baby Wellness Coaching in LMICs."	Source (archive)
Dimagi, Responses to GiveWell’s Questions, August 22, 2023 (unpublished).	Unpublished
GiveWell, "Dimagi — CommCare Connect Pilot (June 2024)"	Source
GiveWell, Breastfeeding Promotion Programs.	Source
GiveWell, Optionality BOTEC for Dimagi Mother-Baby Wellness Coaching Comm Care Connect program design, November 2024 (Public)	Source
Unicef, “Levels and trends in child mortality,” March 12, 2024.	Source (archive)
USAID, “Dimagi Inc. Testing a Digital Platform and Incentives to Deliver Child Health Care,” 2024.	Source (archive)
WHO, “Newborn mortality,” 14 March, 2024	Source (archive)