Show Notes
When GiveWell investigates a new cause area, we’re often focused on two priorities: directing funding where we think it can help people most and generating evidence to inform larger investments later. Family planning is a clear example. Recent foreign aid cuts—including reductions from the US, UK, and Dutch governments—deepened an already substantial need and opened up new cost-effective funding opportunities.
When we published our last podcast episode on family planning, GiveWell had made only a couple of small grants. Since then, we’ve made a number of additional grants totaling around $20 million, exemplifying how our growing research capacity and expertise enable us to expand into new areas. By doing so, we aim to move more donor funding faster to global health programs where it can do extraordinary good.
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dilhan Perera about the family planning programming we’ve funded over the past year, how we’ve structured our grant portfolio, and what we’re hoping to learn.
Elie and Dilhan discuss: Funding across the family planning system: Providing people with family planning resources requires a three-tiered system: (1) purchasing contraceptives, (2) moving them through the supply chain to health facilities, and (3) delivering services to clients. We have made grants at all three levels. For example, we recommended a grant for contraceptive procurement through UNFPA Supplies, which works in dozens of countries, addressing a chronic shortfall that deepened after US government cuts. We also approved a one-year grant to MSI Reproductive Choices to help move supplies from national warehouses to local health facilities in the Democratic Republic of the Congo, Malawi, and Zambia. By funding across all three levels rather than at a single point, GiveWell aims to identify the areas of greatest need where additional funding could do the most good. Reaching people with limited access: Many people in low- and middle-income countries have limited access to modern contraception. GiveWell has made two grants aiming to increase access at the local level, each taking a different approach. The first supports MSI Reproductive Choices’ mobile outreach program, which we are funding in Nigeria and Sierra Leone. Small teams, typically two nurses and a driver, travel to communities identified as having limited access to services. The nurses offer a group information session and individual counseling, after which people who are interested can obtain a range of contraceptive methods, including long-acting options like implants and IUDs that health workers at nearby facilities often aren’t trained to administer. The second supports Lafiya, which operates in northern Nigeria, where modern contraceptive use is among the lowest in the world. Lafiya trains nurses, midwives, and community health workers who already live in these communities to provide family planning counselling, short-term contraceptives, and referrals for other methods. By funding both approaches, we hope to learn more about differing strategies for delivering family planning and the programs’ cost-effectiveness, potentially leading to opportunities to help people in need even more. Building evidence alongside the grants: There are relatively few randomized trials of family planning programs and limited rigorous evidence on the specific programs we’re funding. As a result, we have a number of uncertainties. We’re particularly interested in getting better answers to the following questions: Does providing family planning commodities actually increase use, or does it substitute for what people would’ve gotten another way? Do the commodities we help procure actually reach facilities? And to what extent are people making informed choices about whether or not they want to take up contraception? We’ve built learning opportunities into all of our family planning grants, including, for example, separatel
More from GiveWell Conversations
In an effort to direct substantially more funding to the most cost-effective opportunities we can find to help people, GiveWell’s research is expanding in two directions at once: going broader, to cover more areas of global health and development, and going deeper, to improve the inputs that inform our decision-making.
GiveWell works to continually improve our research so we can make better grant decisions and direct donations where we believe they can do the most good. GiveWell’s Cross-Cutting research subteam is an important part of that effort—it investigates the impact of the programs we fund, works to resolve our largest uncertainties, and aims to improve our research. As GiveWell’s grantmaking grows, the Cross-Cutting subteam is strengthening our data collection and analysis to support that growth. In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Program Director Alex Cohen, who leads the Cross-Cutting subteam, about how better data can improve our decision-making, our work to gather stronger evidence, and the ways we’ve tested AI as a tool to increase our research capacity and quality.
GiveWell, with co-funding from Coefficient Giving, recently made our largest grant to date: $276 million to the Against Malaria Foundation (AMF) to support the procurement and distribution of 92 million nets in the Democratic Republic of the Congo (DRC) from 2027 through 2029. We estimate that the nets, 46 million of which we think would not otherwise be distributed, will avert roughly 67,000 deaths. We have supported AMF’s work for more than 15 years, and the insecticide-treated nets it procures and distributes remain one of the most cost-effective ways we've found to save lives.
Diarrhea is one of the leading causes of death for children under five, killing more than 400,000 children every year. GiveWell has funded several programs to prevent and treat diarrhea, and we recently expanded our work by making a grant to support the implementation and evaluation of WASHmobile in the Democratic Republic of the Congo (DRC) and South Sudan. The program, which was developed by Johns Hopkins University, delivers water treatment supplies and hygiene messaging to households at the highest risk of diarrheal disease. It has shown promising results in randomized controlled trials (RCTs) but hasn’t yet been implemented at scale in the challenging settings where the need is greatest.
GiveWell tends to be known for its work in areas like malaria prevention, water treatment, and nutrition. But as our research team has grown, so has our ability to search for cost-effective programs across a much wider range of issues.