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Episode 49: Introducing Impact Delivery: Raising the Bar for Digital In Global Health Development - Dimagi


Introducing Impact Delivery: Raising the Bar for Digital In Global Health Development

Episode 49 | 36 Minutes

Social impact organizations and governments worldwide are under immense pressure to do more with less. We are confronting an array of complex, constantly-evolving pressures ranging from economic uncertainty, humanitarian crises, inflation, pandemics, and climate change. All of this means we need to deliver more services to more people. And, we often need to do it with flat or decreasing levels of funding. 

Digital solutions have the potential to help us do more with less, to create more value for every dollar invested.  But most digital transformations either fail outright, or fail to create this sustained value.

In today’s episode, Jonathan Jackson and Amie Vaccaro explore a new approach called Impact Delivery designed to address the challenges we are facing in global health and development and the ways technology can and must step up to better deliver on its potential in creating a world where everyone has access to the services they need to thrive. 

Topics discussed:


  • How technology is failing global health and development
  • Why a new approach is needed
  • The three pillars of Impact Delivery: Better Impact, More Impact and Sustained Impact
  • Tangible examples of what each pillar looks like in practice
  • What this approach means for social impact organizations and government

Show Notes


This transcript was generated by AI and may contain typos and inaccuracies.

Amie Vaccaro: All right. Welcome to High Impact Growth. So I am here with Jonathan Jackson and today we’re going to dig into something that we’ve touched on lightly in a couple other episodes, but it’s really at the heart of what we’re doing here at Dimagi and it’s called Impact Delivery. So Impact Delivery is a different approach to technology for global health and development that optimizes long term impact while accepting the constraints and realities of working in these industries.

But before we get into what this is, I want to talk a bit about the problem that we’re seeing and trying to address with this new approach. And I want to tee it up actually with a quote from one of our most recent episodes that we just put live from Dr. Girma, JSI’s project manager for Ethiopia and has been working on rolling out a national scale community health information system.

And what he said was, when thinking about the technological benefit to humans, The world is falling short of delivering what’s expected. We have a lot of technological advancement, but it’s not reaching and helping people. I think technology information systems should facilitate better reach to underserved people.

I thought that was such a beautiful distillation. And Jon, I want to hear from you. What problem or problems do you see when it comes to technology and advancing development goals?

Jonathan Jackson: Yeah, thanks, Amie. Really excited to chat about this topic today. And we’ve talked on this in previous episodes with Raj with a couple other guests, and the problem that we see is there’s a huge amount of potential. We all recognize it. You know, digital health exploded during COVID. We were doing it long before that, as many firms were.

So we’re huge believers in the power of digital to help improve health outcomes. But as we look all around us in high income markets and low income markets, you see lots of projects where we added this huge administrative burden. Or we created this big data collection system and we digitize this program.

When you look at the outcome and you’re like, providers are less happy. Outcomes aren’t obviously better. A ton of money went to some it vendors. And it’s not obvious that we like really drove higher impact. And it’s certainly not obvious that we’re on a trajectory to improve the impact and get more value for money over time.

So as we look at the problem, you know, we think there’s huge potential for where digital can be improving the SDGs, improving health outcomes, improving other outcomes. But we look around and we see lots of projects, including some of our own unfortunately, that just don’t seem to be having the impact or the value for money that people expected.

Amie Vaccaro: And Jon, what are some of the mistakes that you see organizations, maybe even just Dimagi making that leads to this?

Jonathan Jackson: Well, you know I want to start by saying like we are facing as a community, as an ecosystem, whether you’re the funder, the government, an implementing partner, the tech provider, we’re all facing really hard problems, so I’m not claiming any of these mistakes are like easy to avoid. But some of the mistakes we see, we often go for digitizing a program within the constraints of how the program currently exists.

And one of the purposes and benefits of technology is to think about redesigning programs. So they take advantage of the latest technologies, the approaches we can now do with mobile, things we can do with AI and the cloud and others. And so if we digitize programs as they stand today, we miss out on a lot of opportunities to create much higher value for money by incorporating updates or changes to the program that are now possible with different uses and alternative uses of technology. But within that digitizing space, one of the biggest mistakes we see is when people, as I mentioned earlier, just go after really getting administrative data back, they’re just trying to figure out what happened, where it happened, who did it, but then nothing’s done with that data or the things that are done with that data aren’t feeding back into providing better services, providing better support for providers, providing better support for clients. And so that move to just digitizing or just doing data collection or just doing administrative data is a huge challenge we see. And our argument with Impact Delivery is saying look we know you need that data. We know there are valid reasons, contractual, legal, many reasons why you need to collect certain data elements, certain components of data in a complex service delivery. But if you focus on making the provider’s job easier, making the client’s experience better, with technology and make that focus on data collection and administrative data the second priority as opposed to the first priority, you get a two-for-one you both improve the service delivery, you both improve the experience for the provider and you’re getting the data you need back, you know, so that’s one common mistake we see. A second is around not recognizing that these programs are obviously going to expand into you know other programs. Obviously most funding is vertical you get funded for TB, for epidemiology, for disease surveillance. But, these things interact in the real world in very complex ways. And so we can’t design technology solutions or technology approaches that plan to be vertically stove piped forever. We need to understand and plan for interacting with other projects and programs and expanding over time. Do we need to do that from day one? No. Like, it’s hard enough to do it in a single stove pipe, but you need to plan eventually to be able to do that. And when you need to do that, you can’t plan on it costing a lot more money, right? Because the big initial energy, the big initial investment that’s got to not only fund the initial stand up of these programs, but take you through the integration and the expansion into other program areas. And if we don’t plan like that, we’re kind of setting ourselves up for failure because we know if we don’t handle that complexity, we’re not really going to meet the needs of providers or clients in the complex real world that they’re experiencing these service delivery moments in. And then the third is really around thinking about the long term nature of these platforms we’re putting in place.

We need to be planning for how these investments into technology are going to not just meet the immediate needs in front of us, but be sustained over a five or ten year period. And so often we see a lot of wishful thinking around, okay, we’ll build it and the funding will come. And we’ve been at the, you know, forefront of this, we’ve talked about this in previous episodes, but like that very rarely, if ever works, if it’s not anchored in, what is the value for money you’re creating? What is the value today? How’s that value growing tomorrow? Why should we keep the system running? Why should we keep this, platform up? And that’s another big mistake we see in how people are going about digital solutions and the current approach.

Amie Vaccaro: Yeah, so if I had to summarize, there’s kind of three main buckets here. The first is that we’re focusing too much on current constraints. We’re thinking too much about just extracting the data from the program, and we’re not necessarily using digital to redesign how services are offered and really prioritizing how the users are using that tool to support themselves and to have better jobs.

So that’s the first one. The second one, kind of thinking much about just today and about not realizing that you’re going to need to expand and elaborate and add services and add integrations and add new technologies over time on your program. So you’re kind of create these sort of digital applications that will lose value over time. And then of course the last one is just thinking too short term, right? Like, of course we have to start short term because that’s where the funding comes in, but we need to be able to plan for the longterm. And Jon, before we get into sort of the nitty gritty of like this Impact Delivery approach to tackling these challenges, I want to really just take some time and underscore, like, why does this matter so much?

Jonathan Jackson: Yeah, it’s what gets me up in the morning. You know, we as a global, like, community, society, whatever word you want to use, like, we’re facing mounting complex problems with climate change, with nutrition problems, with pandemics, with democracy, like, all sorts of things that require more and more successful public and private partnership, more and more successful technology deployments. We need more success, we need more value, we need more impact. And that’s the problem I see is right now, we’re just not able to achieve enough with the digital investments we’re making the need is so high and it’s growing and technology can do a lot to meet this moment and AI is a great example where there’s tons of downside to a lot of these technologies potentially as well, but there’s huge upside.

We need to be racing to figure out how to unlock the upside of some of these technologies that have already been proven very safe, like, you know, mobile technologies or digital health or telemedicine and that need is what gets me up in the morning because we are facing a world where we have decreasing health care provider satisfaction.

We have increasing food insecurity. We have increasing refugee crisis and conflict crisis. And we have lots of evidence that non-specialist providers, like community health care workers, can make huge impact with 10 to 1 ROIs. And Margaret Odera, who we had on a previous episode, speaks so eloquently about the potential of, you know, the community health workforce, agriculture extension agents can be incredibly effective. So many of these areas. If we can enable better jobs for this workforce, for these workforces, the sky’s the limit on, you know, how much value we can create. So  the problem is like, we’re,  not doing enough to be successful with our technology deployments currently. And we think there’s a better way.

Amie Vaccaro: And I think one of the things that really excites me about Dimagi is that, you know, this approach that we’re about to sort of outline for our audience here is really built on 20 years of experience. And Jon, you’ve been here those entire 20 years and this is an approach that I think we’re trying to introduce, but I think it also reflects the best practices of these leading organizations when they’re able to get it right. And so often we don’t get it right. So I want to hear from you a bit about what are some of the commonalities of some of the most successful digital transformation efforts that you’ve seen, Jon?

Jonathan Jackson: While I’m kind of saying in general, we’re not achieving enough, we’ve seen amazing partners, the government, private sector, non-profit for profit that have done great work and they’re kind of three elements that we distilled this down into, the first is really focused on creating better impact with technology. It’s not just about data collection. It’s not just about getting the administrative data you need. It’s really how is this technology going to create better impact in the services you’re providing. Whether that’s a provider facing tool that creates a better job, whether that’s a client facing tool that creates a better experience, but ultimately they’re looking at how that technology is creating a better impact. The second is that they’re not just focused on the impact in the current project they’re doing, they’re thinking about how they’re going to create more impact over time, right? So whether it’s through adding new vertical programs, whether adding new users, whether adding new use cases, they’re looking at the technologies they’re putting together, often multiple technologies and saying, okay, I understand what I’m doing in year one. But as we get to your two, as we get to your three, what’s our strategy and our vision for how we’re creating more and more impact with our technology investments. And the third is really about sustainability. They are thinking early on, ideally from day one, how is that combination of better impact and more impact going to lead to sustained impact? How am I getting sufficient value for money? How am I demonstrating sufficient value for money? You mentioned the project in Ethiopia, that’s been a multi year partnership with Dimagi, with JSI, with the government, with many other people supporting the vision that the government ultimately has. And constantly reevaluating, like, is what we’re about to go do next going to be sustainable? Is it going to help create even more value for money?

So I think those three core elements. Better impact, more impact, and sustained impact. Those are the three elements that we think we’ve seen be successful in our two decades of working in. Those are the three key pillars of the approach we’re advocating for with Impact Delivery.

Amie Vaccaro: Great. So we’ve got better impact, more impact, sustained impact. I want to dig in on each of these and hear from you, Jon what are some examples? Like, how have you seen this playing out in practicality? I think for a lot of our listeners, that might sound like really nice and well. And of course we want more impact, better impact. But what could that actually look like in practice?

Jonathan Jackson: Yeah, and I think this is key because on the one hand you can be like, you’re just talking about motherhood and apple pie. Like, of course everybody wants more impact, more value for money. The argument of Impact Delivery is you really can be getting better impact, more impact, and sustained impact for the same amount you’re already spending.

We don’t think there’s some magical pot of money coming in with, like, the right horizontal strategy to unlock all this amazing work we need to do as a digital community. Yes, sometimes that might happen. We might get lucky with the perfect project design with a patient funder and a multi year time horizon.

But for the most part, Impact Delivery is about accepting the constraints as they are today, which means really cyclical funding spikes and valleys and a lot of challenges and how this comes and so with better impact as an example When we go to collect data and we’re adding to provider burden there are so many different ways we can (A) decrease that administrative burden by extracting the data from systems they’re already using and when we’re introducing new systems creating a more streamlined user experience for the provider, getting more data out of the system in the context of doing their job.

And for our listeners, you probably have a lot of internal IT systems, which you do your job and then you have to go put into another system how you did your job. And that second step is all a quote on quote waste of time from your perspective. Now your boss needs it or your company needs it, but you did your job over here on the left, and then you moved over here on the right and like entered the fact that you did your job.

And it’s about combining those two steps and saying how can technology help you do your job, and then as exhaust from that process for free from the end users perspective, we have the data we need to send upstream into the administrative system or into the data system. That’s an example of how we get better impact, that’s a better job for the provider, that’s going to be a better experience for the client. And you’re probably getting higher quality data back through that because it’s embedded into the context of the job as opposed to a second step after the fact. And the example we have with our platform, CommCare when you’re doing things like behavior change communication, you’re playing videos in the household between the provider and the client, or you’re doing real time decision support between the provider and the client, or you’re helping them triage which household to go visit next. These all happen, and it acts as a job aid to the CHW, and you don’t have a second step of saying, I want to go to that household, it’s already embedded in your workflow, so you don’t have these steps you’re taking just to report back on how you did your job. You’re just doing your job and the data is flowing back in real time, you know to the people that need to see it. That’s, that’s an example of better impact.

Amie Vaccaro: Yeah, that’s so great. And I can picture it, right? Like, it’s almost like if, for example, we have a tool called Clockify to measure, you know, the hours worked. It’s like, what if Clockify was just running? It could tell already when I was working and when I was not. And it was just in the background, but it actually added value to my experience and wasn’t this like next step.

Jonathan Jackson: And I think  Clockify is one example of how you log time, but also, you know, for a lot of our team that listens to this podcast, like you use our internal Salesforce system, like how much value does that add to your direct job, as opposed to my ability to get the insights I need as the CEO of the company. And so in the dream world, all of that experience within Salesforce is actually helpful as opposed to being viewed as like a data entry necessity. So it drives our forecasts and pipeline projections. So that’s the dream and when we think about that, it’s hard we were coming up with this new category of Impact Delivery, we believe deeply in it and it’s still a big struggle for us internally with our own tools. So I’m not claiming this is easy by any stretch, but we have to try because A, achieving this is so much better than the current state and B, it’s going to create way more value for money for a, you know, global community that has limited resources and we have to figure out how to make money go much further.

Amie Vaccaro: We do hear a lot of positive feedback on using CommCare, right? Because this has been at the core of our approach since day one of like, how can we actually, be really mindful of the job of the user and enhancing that. So, with that, I want to move to the second pillar, which is more impact. And, same question what’s a kind of tangible example of what this looks like in practice, and how might it play out, for example, in a tool like CommCare?

Jonathan Jackson: Yeah, and this is something that I think we’re really proud of within CommCare though it’s by no means unique to the CommCare platform but we’ve always had this vision of understanding a lot of program funding is vertical and it may only service a part of what somebody’s job is or a part of what somebody’s client experience is and for technology to really be successful, it’s got to eventually meet the whole need of that job function or of that client experience. And so early on, we had really focused on how do we build exactly what we’re asked to build right now, but then know that the program is going to change in the future, right? Even if you just stick within your vertical program, that’s going to have changing requirements. And if your software can’t adapt to meet the needs of those changing requirements, it’s going to decay, people are going to start to really dislike it. I love the podcast we just recorded, a couple of weeks ago, Amie with MHP Salud and they’ve been using CommCare for over 10 years. And I remarked I don’t know of any internal tool I’ve ever used for over 10 years that I didn’t hate by the time I was done using it.

And so more impact is really about recognizing you’re going to have to adapt the current program you’re building, but also add new programs to it. And so if we look at things like maternal and child health, you may start with just a screening and searching for high risk pregnant mothers. But then you to refer them to other clinics and those clinics don’t want to use your software just to accept a referral. How else are you going to add value to the clinic and then that maternal and child health, the pregnancy is going to turn into a newborn and to an under five child And how are you going to help support vaccines and these things? So as you think about growing the program over time that’s kind of expanding within the normal job description of a worker but beyond that you then need to integrate with other data systems you need to incorporate digital diagnostics and other areas. So all of that, I think, comes into more impact and it’s really easy to say of course, plan for doing all that stuff. You have to do it and you have to design your systems to not cost any more money as you’re moving down that path, right? That’s the key. And one of the ways that we built it, again, this is not unique to just Dimagi software or the CommCare platform, but by taking that platform approach, by having to be configurable, by having to be able to support lots of different user types, lots of different workflows and, and referrals and case management, that’s where you start to be able to incorporate the complex realities of the real world, supporting multiple organizations, multiple governments, and doing it in such a way that you’re keeping the cost down while you’re expanding the value that you’re providing.


Amie Vaccaro: and

I think one of the obvious recent examples is COVID, right? So, countries, organizations that already had this kind of strong foundation in place were able to quickly roll out new content, new modules, new ways to support their staff to, address the issue of COVID, right. Which required a whole new sense of protocols and learning.

Jonathan Jackson: And with a platform like CommCare, they were able to do it with their own skills they’d already built on that first program they’re running. So they were able to meet together and rapidly draw that out, get that to the same users. They could add COVID screening and other knowledge based awareness into the application all on their own, all very quickly.

And that’s part of the value that you can create if you design your systems to handle that use case. So many different health IT products, but also other sectors. They’re doing this in the context where you can change the software. But it’s this huge requirements process, this big waterfall implementation, it’s not nearly responsive enough. You know, we’ve designed to CommCare. Again, I keep talking about CommCare but this applies to other tech platforms too, but you can ship this stuff overnight. And so when you’re talking about more impact in the context of really uncertain conditions, whether that’s environmental or conflict or pandemic, you need to be able to move this stuff overnight. You need to be able to change the application.

Amie Vaccaro: I think this also ties into something we’ve talked about a little bit in a few episodes around intersectionality, where a lot of these different health systems and programs. They intersect at the level of the human, right? The human has all kinds of challenges and needs, right? And so why should digital be sort of siloed to one approach or another?

Jonathan Jackson: Absolutely, yeah.

Amie Vaccaro: All right. So let’s move on to sustained impact. And I think in a recent conversation we had with Dr. Dixon Chibanda, the CEO at Friendship Bench, he talked about how, you know, one of the ways he’s thinking about sustainability long term for his program is transferring it over to the government. And to be able to do that, he wants to be able to speak to how His program, which really focuses on mental health, ties into and integrates with broader health outcomes, right? So you really want to be able to see that full picture and having tools that allow you to track that.

What are some concrete examples of how this shows up in practice and how organizations can think about achieving sustained impact?

Jonathan Jackson: Yeah, sustained impact. This is probably, you know, for many people in the digital health ecosystem ourselves included in a lot of our projects, we’re still searching for the answers here, right? And that’s why I think this Impact Delivery approach is so critical for all of us to be taking. You know, we don’t want Dimagi being the only ones taking an Impact Delivery approach.

We want everybody doing this. And when we think about sustained impact, we’re talking about how to really think about value for money. You know, if it cost a million dollars to deploy CommCare for a national scale community health program. How are we demonstrating that value for money? So we got better impact, we got more impact, but it cost a million dollars.

We, as a community, need to articulate what is the value for money we got out of that project and how do we sustain that over time. And not only that, but whatever that value is today, how’s it going to be higher tomorrow? How do we make sure that we’re deploying technology in such a way that we can add more and more value over time for the same cost, whether that’s a recurring cost or a one time cost. And that’s something that we’re really excited about working with the global community on because it’s such a hard problem. We don’t have all the answers, but we do know that doing very diligent alignment with all the stakeholders, whether it’s the government who’s running the program or local partners, how are we designing success together? How are we defining success in year one? How are we defining year three, year five and beyond? And so it’s not just about what does the pilot look like or what does scale up look like? But it’s about constantly having that idea of like, let’s plan for success. The system is still around in three years.

We clearly can’t be just doing this one vertical program with this platform in three years. So what is the roadmap going to look like? Who’s going to be able to authorize? Expanding into additional use cases. How are we going to argue about the improved impact we can make or the two for one, or the three for one, or the 10 for one in the investment we have. All that comes together in how we want everybody thinking about sustained impact, how we’re trying to think about sustained impact with our partners.

Amie Vaccaro: Yeah. And I would build on that too just thinking about choosing a partner that’s going to be around for the long term, right? I think one of the things I believe we heard from one of our ministry of health officials that came on the podcast is a lot of times, digital vendors come in and they behave like vendors where they want to come in, deploy their thing and then show success and call it a day and kind of check the box and move on. And then it leaves the country with, you know, dozens and dozens of different apps that are all standalone and kind of thinking in that short term way. So both approaching a partner as a long term partner and also ensuring that that technology that they’re going to be offering you has a long term approach and has been around for a long time and is going to be around for a long time and is being really invested in.

Jonathan Jackson: Yeah, definitely great point. And one of our mantras as a company and one of our sub-points in our values is be a partner, not a vendor. And there are moments when the use case is so clear. And the solution is so clear, a vendor relationship makes perfect sense you have a widget, I want the widget, I just need a vendor.

But for a lot of what the digital health space is doing and other digital sectors, the problems you’re attempting to solve are very complex. And so acting as a vendor in those cases may not create significant value for money and may not lead to the ability to sustain that impact. And so I definitely agree with you. I mean, I think one of the core mantras we have and why we have it is act as a partner, not a vendor, because we think that’s how you create sustained impact. That’s how you make sure you maintain that better impact and more impact.

Amie Vaccaro: Absolutely. So we’ve talked a lot about technology, and I think it’s really clear that Impact Delivery isn’t just about technology, right? Technology is one piece of the puzzle, but I think there’s also a lot to be said for setting up the right processes, making sure you’ve got the right people in place. So I want to hear a little bit from you, Jon, on each of these. So what are some of the processes that need to be in place to really get the most value from your investment in digital and to really sustain and deliver more impact over time?

Jonathan Jackson: So we’re really excited about the playbook that you’re creating, Amie, along with partners of ours and our team. But we have this diagram that shows funding going up and down, but impacts going consistently up into the right. And I think one of the processes we have to understand is like funding challenges. While we should never stop fighting to improve them and make it easier for smart funding decisions to get made, we have to recognize like these boom and bust cycles of vertical funding, like kind of just are the reality of the world we’re living in right now. And so one of the processes we have to plan for is how are you going to create permanently increasing value while going through those boom and bust cycles? And so from a process standpoint, that’s about building capacity to leverage the platform. That’s about having the ability to still create lots of value at low maintenance costs. for those bust periods. That’s about being able to mobilize quickly when there is funding to create lots of new applications, lots of new value, and then have that ability to sustain through those areas. So that’s one process area. A second process that’s critical to think about is the governance around Impact Delivery. You know, so often we have these great technologies, whether it’s CommCare or other platforms, and somebody has to have a vision for how am I getting more impact, better impact, and sustaining this over time.

And that really requires kind of like a product owner mindset. So I’ve bought CommCare, I’ve bought these other platforms, I’m deploying them like who’s setting the long term agenda, who’s setting the long term vision and roadmap for what’s getting built onto these over time. And so Impact Delivery really requires somebody in the ecosystem playing that product owner and that governance role to make sure we’re unlocking more value over money. And then the third process, which is often unfortunately overlooked is  coming from a foundation of provider first, client first, security first, but getting these basic blocking and tackling elements. done so they don’t get in the way of the project a year or two in. You know, security, data security, this is a growing huge issue within the industry, within the ecosystem.

We need to set up the rules up front so we don’t get two years into a project and then we like, need to kind of redefine how the system was supposed to be architected in the first place. getting all that kind of up front so that we have an enterprise class foundation that we’re building our Impact Delivery vision on top of is critical..

When I talk about being provider first and client first, I mean really bringing in those voices from day one. So many times it’s about what administrative data do I need? You know, how do I get that data extracted from the program? And so that’s a process question, like what is the definition of success going to look like for deploying this to a provider? What is the definition of success for a client? How do we get all of that up front from a process standpoint so we know we’re moving towards that Impact Delivery vision? So those are three tips I’d have. I mean, there’s a lot more that we’ll be talking about and putting into the playbook, but those are three key areas.

Amie Vaccaro: Yeah. and I think I would I would add to that. Maybe this is in the bucket of governance, but really having strong communication and really driving alignment and buy in across stakeholders, I think, is really important from from day one, and that’s an ongoing process. So that takes us to the last piece, which is the people, right?

People are essential to this. Can you tell me a little bit about how organizations should be thinking about making sure they’ve got the right people in place with the right level of authority to be able to bring an Impact Delivery approach to life?

Jonathan Jackson: You know, we talked about that product owner being a key role and that typically needs to be on the end owner of the services that’s being enabled or of the the program that’s being delivered, but  any team member who’s in the constellation can play that role on behalf of the the organization another key area for people is everybody should have an expectation of Impact Delivery meaning everybody should have an expectation that the solution is going to make the provider’s job better, that the client’s going to have a better experience, that we’re getting more impact and better impact and sustained impact. And so for all the people on the project having that mindset of hey, we’re expecting more we don’t just want the traditional data system, data collection system for the price that we’re paying. We want more, we want Impact Delivery. And another area for Impact Delivery design for teams is after you’ve had that first successful project launch, it really is a different skillset to scale what you’ve already built and then to be building the new thing. So as we think about more,better and sustained, they are kind of three different skillsets, right? And you want to think about your team structure to start to more explicitly call out the separation of those things after you’ve had the successful launch of the initial program. Because then you’ve got to be thinking about who’s running and scaling program one? Who’s bringing program two online? Who’s going after program three? Who’s creating the value proposition and talking to the ministers? Talking to the directors? Talking to the legislator? Talking to the executives? About the value we’re creating, about how it’s not just the value we’re creating today, which is great.

But think about the value we’re going to have in three years, right? Think about the value we’re going to have in five years. So that’s another key thing on the team side. And then it’s not just us behaving like a partner, not a vendor. It’s all of the ecosystem treating each other together in a partnership, right? These are hard projects. They’re hard jobs. They’re complex, requirements change. There’s never enough money to go around. And so to achieve Impact Delivery requires a lot of empathy for everybody’s role on the project and all working together to unlock this.

Amie Vaccaro: Yeah, absolutely I think you know, we heard from MHP Salud how they’ve set up an entire CommCare team within the organization that’s in charge of kind of looking at this over time and just making sure that it’s continually improving we also heard from Dr. Girma in Ethiopia around how just the important role of partners and enabling the work that they’ve been able to do and unfold over the last decade or so.

I also love what you said Jon around mindset, right? Of just expecting more. And I think like if I had to boil down this approach to sort of one sentence, it’s sort of like we need to be expecting more from digital like and demanding more and raising the bar on what’s possible. And that part of that’s a mindset.

Jonathan Jackson: You can disagree with us a little bit on this, but I think we’re just, we can get more value for the amount of money we’re spending. Like this isn’t about, of course we advocate for more money coming into the industry. But, we already can be doing more today with the money we’re spending. And we should all be expecting more. More value for money, more impact, better jobs. All of these things are possible with the money that’s going in today already.

Amie Vaccaro: So last question for you, Jonathan, if you’re an organization listening to this. And you’re like, wow, this is making a lot of sense. What are some tips for kind of getting started on this Impact Delivery journey?

Jonathan Jackson: So great question. And we’re building a community around this. So the first one is, you know, email us at the pod and we’re happy to connect you into some discussion groups we’re having, we don’t have all the answers, you know, we just want to say that up front, but we’re going to be releasing a playbook soon to share case studies of organizations who we think embody Impact Delivery and have proven success stories of how they’ve done it. And I think starting with, you can change your mindset today, which is like expect more out of your current partnerships, out of your current vendors, expect to deliver more if you are a vendor, and that’s really what we’re doing. But if I could have one wish list, it’s our, it’s our top strategic priority for Dimagi it’s part of our High Impact Growth strategy, it’s part of Impact Delivery. It’s make sure we’re creating better jobs, right? As we design technology, making sure we create better jobs that gets us better data, that gets us more impact, that positions us to add new programs into the system. So I think that’s one immediate thing I would take.

And you just referenced MHP Salud in a podcast that we have like one of the key things they do is listen to their users and constantly redesign how they’re deploying CommCare based on user feedback, based on what’s working and what’s not working and having that voice of the provider, having that user in mind as we go forward, I think is as a critical part of Impact Delivery.

Thank you so much for listening. I’ll share my top three takeaways, which aligned to the three pillars of Impact Delivery this different approach to technology in global health and development. That will allow us to get more value from existing resources. First, we need to deliver better impact by creating better jobs for users and therefore better outcomes. Digital programs to often focus only on capturing data for administrative reporting. Creating a burden on providers and clients,

but digital solutions can and must be designed to also improve and deepen the impact delivered by frontline providers. Second, we need to deliver more impact by setting up digital to support multiple programs. User types and integrations at scale. Digital solutions are often created with a focus on one specific project or program. But this can leave you with dozens of standalone applications, each fading in value over time . By taking an Impact Delivery approach, we intentionally plan to support more impact. With no or limited additional cost.

Third. We need to deliver sustained impact

by articulating the value for money over time, including a plan for improving on it, as well as working with longterm technology partners on a robust platform. When programs invest in digital solutions, they often utilize time limited funding with specific demands. But without being able to support the unpredictable emerging needs of the future. The solutions fit for your programs may be short-lived. Becoming a burden as the program changes. Sustaining impact over time requires being prepared to meet the emerging needs of tomorrow.

And finally I’ll reiterate that Impact Delivery is not just about technology. Getting the tech right. Is important, but you also need to ensure you’ve got the right processes and people in place to really bring this to life. And the next episode we’ll hear from MHP Salud on their real life Impact Delivery story.

One that we referenced a few times today.

That’s our show, please like rate, review, subscribe, and share this episode. If you found it useful, it really helps us grow our impact. This Impact Delivery approach is new, and we want to hear your reactions, your questions and your comments. So please write to us at This show is executive produced by myself. Danielle Sheldon is our producer. Sarah Strauss is our editor and cover art is by Sud

Meet The Hosts

Amie Vaccaro

Senior Director, Global Marketing, Dimagi

Amie leads the team responsible for defining Dimagi’s brand strategy and driving awareness and demand for its offerings. She is passionate about bringing together creativity, empathy and technology to help people thrive. Amie joins Dimagi with over 15 years of experience including 10 years in B2B technology product marketing bringing innovative, impactful products to market.

Jonathan Jackson

Co-Founder & CEO, Dimagi

Jonathan Jackson is the Co-Founder and Chief Executive Officer of Dimagi. As the CEO of Dimagi, Jonathan oversees a team of global employees who are supporting digital solutions in the vast majority of countries with globally-recognized partners. He has led Dimagi to become a leading, scaling social enterprise and creator of the world’s most widely used and powerful data collection platform, CommCare.



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