Testing a Digital Platform and Incentives to Deliver Child Health Care

Nigeria's health system does not sufficiently reach children under five with essential preventative services. Lack of reach is largely due to a shortage of healthcare workers and poor health infrastructure, including the absence of a unified system to track the coordination and delivery of health services outside of health facilities, which are often provided by a variety of local organizations. To encourage frontline workers to reach children in high-need areas, Dimagi has developed Connect. Through Connect, which is built on Dimagi's CommCare, locally led healthcare organizations fulfill pay-per-service delivery contracts to help frontline workers rapidly learn, deliver, and be paid for verified high-impact services. Connect improves the efficiency of tracking and verifying high-impact health interventions, such as Vitamin A supplementation and oral rehydration salts (ORS) to treat diarrhoeal dehydration, which have been found to significantly reduce child mortality. For each visit, the organizations receive a payment to cover the frontline worker's training, compensation, and supplies. These payments are designed to incentivize frontline workers to provide basic healthcare services to children who are difficult to reach, increasing service area coverage at relatively low cost. This funding will enable Dimagi to refine how Connect supports child health campaigns and conduct a randomized controlled trial (RCT) to evaluate whether it is more cost effective than the status quo in delivering Vitamin A and ORS to children under five in northern Nigeria, where GiveWell funded a large operational pilot facilitating 400,000 child health visits in 2025. If proven effective in diverse Nigerian contexts, Dimagi estimates the Connect platform has the potential to scale widely through replication with locally led organizations across LMICs to provide millions of preventative healthcare visits annually, with the ultimate aim of averting thousands of child deaths. The RCT will provide insight into the efficacy and cost-effectiveness of Connect, generating valuable lessons in how to increase access and coverage of essential child health services globally.