Note: This page summarizes the rationale behind a GiveWell grant to Spark Microgrants. Spark staff reviewed this page prior to publication.
Summary
In November 2022, we made a grant of $53,740 through GiveWell’s All Grants Fund to Spark Microgrants (Spark) to conduct scoping and develop a proposal for a pilot of participatory learning and action groups for maternal and neonatal health (PLA-MNH) in up to three countries (Rwanda, Uganda, and Malawi).1 We made this grant because we think it will allow us to address some of our uncertainties about opportunities to support implementation of PLA-MNH and could result in us funding pilots.
GiveWell recommended this grant via our policy for small discretionary grantmaking. As a small discretionary grant, this funding opportunity did not receive the same review as larger grants we recommend. Instead, we more minimally evaluated the case for the grant and any potential risks or downsides.
Published: June 2023
Table of Contents
Background
PLA-MNH consists of facilitated group meetings for community members concerned about maternal and neonatal health issues. Membership primarily targets women of reproductive age, especially pregnant women, and the facilitated meetings help them develop localized strategies to increase appropriate care-seeking and improve uptake of prevention practices aiming to improve maternal and newborn health.2 While we think that PLA-MNH may meet our threshold for cost-effectiveness in certain contexts, we have a number of uncertainties around costs of implementation and achievable levels of participation. In addition, we have not identified appropriate implementing partners.
Spark Microgrants facilitates community-driven development processes, wherein communities i) are trained to organize, conceptualize, and implement a project of their choosing and ii) receive small grants to carry these projects out.3 Spark has supported programming in six African countries.4
Planned activities
Spark will work with Women and Children First (WCF), a non-governmental organization that provides technical assistance to PLA-MNH program implementers, to develop the pilot proposal.5 Spark expects to use this grant to pay for Spark staff time, WCF staff time, and consultancy fees.6 Grant activities will include, among other things, desk research and field data collection to:7
- estimate the likely costs, participation rates, and quality of implementation (measured by outcomes such as uptake of safe birth practices, antenatal care attendance, and facility delivery rates) of PLA-MNH at scale in each of the countries of interest;8
- determine the feasibility of supporting government-run CHW networks in implementing PLA-MNH at scale in each of the countries of interest;9 and
- identify comparable PLA-MNH programs that could be used as benchmarks.10
Spark and WCF will use that information to prepare a pilot proposal that includes descriptions of the countries selected for pilot activities, planned evaluation activities, budgets, and timelines.11
Case for the grant
We made this grant because we think scoping activities may allow us to fund PLA-MNH implementation in the future. The pilot that will be proposed as an output of this grant would aim to lay the groundwork for scaled implementation of PLA-MNH in the selected countries (with groups facilitated by government-supported community health workers)12 by demonstrating the operational feasibility of PLA-MNH implementation within those contexts and addressing additional GiveWell uncertainties about PLA-MNH’s cost-effectiveness.
Given Spark’s experience with community-driven programming, we think it has the potential to be a promising implementation partner for PLA-MNH.
Reservations
Our main reservation about this grant is that we may learn from scoping that it is quite unlikely that scaled programs in these locations could meet our cost-effectiveness threshold for recommending funding. Thus the grant may not result in cost-effective investments in the future. We guess that given its relatively small size, this scoping grant would meet our cost-effectiveness threshold for recommending funding even with a relatively low chance of leading to further investment, but we have not formalized this intuition with a value of information calculation.
Forecast
We think there is a 30% chance we decide to fund pilot activities proposed as a result of this grant by December 2023.
Sources
- 1
"This scoping exercise will develop a proposal to pilot PLA for MNH in one or more countries (Uganda, Rwanda and Malawi)." Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, p. 1.
- 2
"PLA-MNH (Participatory Learning and Action – Maternal and Neonatal Health) consists of running facilitated meetings of groups of women of reproductive age, especially pregnant women, to develop localized strategies to increase appropriate care-seeking and improve uptake of prevention practices aiming to improve maternal and newborn health." GiveWell, "Participatory Learning and Action – Maternal and Neonatal Health," 2022.
- 3
“The foundation is the Spark's Facilitated Collective Action Process ("the Spark Process"), where communities are led through weekly meetings and trainings to organize, conceptualize and implement their chosen project and receive a microgrant to fund it.” Spark Microgrants, “The Spark Process”
- 4
Spark currently works in Rwanda, Uganda, Burundi, Ghana, Liberia, and Malawi. Smaller scale projects were also previously supported in additional geographies. Katherine Reynolds, Comments on a draft of this page, May 31, 2023 (unpublished).
- 5
- "We spoke with a non-governmental organization that provides technical assistance to implement PLA-MNH programs, Women and Children First (WCF)." GiveWell, "Participatory Learning and Action – Maternal and Neonatal Health," 2022.
- "Spark will collaborate with WCF in the scoping and potential pilots." Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, p. 1.
- 6
See "High-level budget" section for more information on the budget breakdown. Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, p. 3.
- 7
"Desk research assistance, field data collection." Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, "High-level budget" section, p. 3.
- 8
"How would pilot activities help address uncertainties about the following factors at scale:
- Likely costs
- Participation rates
- Quality of implementation, triangulated against intermediate outcomes such as safe birth practices, ANC attendance and facility delivery rates, etc."
Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, "Key Questions to be explored" section, p. 2.
- 9
"The presence of government-supported CHW networks, their existing remit and potential performance effects of current levels of support, supervision and compensation. Does it seem likely that CHWs could implement PLA without impeding their ability to execute on other duties?"
Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, "Key Questions to be explored" section, p. 2. - 10
"What are similarly positioned programs that can serve as quality comparisons or benchmarks?" Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, "Key Questions to be explored" section, p. 2.
- 11
"Spark and WCF will prepare the following three deliverables.
- Narrative proposal describing countries selected for proposed pilot activities and how
they will address GiveWell’s key questions. - Description of planned evaluation activities, including research / evaluation design,
primary outcome variables, proposed measurement strategies / data sources and
description of proposed selection process for external evaluator if necessary - Pilot timeline(s) with major milestones and budgets.
- Steps to finalize research design / potentially select external evaluator
- Challenges or risks for implementation according to projected timelines
If pilot activities seem unlikely to lead to national scale up in any of the countries, Spark and WCF will provide a writeup explaining why pilot activities don't appear promising." Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, p. 2-3.
- Narrative proposal describing countries selected for proposed pilot activities and how
- 12
"This scoping exercise will develop a proposal to pilot PLA for MNH in one or more countries (Uganda, Rwanda and Malawi) as a layered feature onto Spark’s facilitated collective action process (FCAP). The proposed pilot will aim to lay the groundwork for eventual scaled implementation using government-supported CHW networks." Spark MicroGrants and WCF, "Proposal to scope pilot opportunities to layer PLA onto Spark’s FCAP," November 2022, p. 1.