Unorthodox Philanthropy identifies and supports compelling initiatives that have the potential to scale their impact using a finite amount of philanthropic capital. Each of our awardees represents a different hypothesis about how to create sustainable social change with finite philanthropic capital.
UP is pleased to announce awards to the following outstanding initiatives:
No Means No Worldwide (NMNW)
Scaling an Evidence-based Rape Prevention Program for Adolescent Boys and Girls The World Health Organization estimates that 1 in 3 women worldwide have experienced either physical or sexual violence from an intimate partner or non-partner in their lifetime. In the environments in which No Means No Worldwide (NMNW) operates -- extreme risk areas in East Africa -- it is estimated that 1 in 4 girls are raped every year. While there is increasing attention being paid to the issue of gender-based violence (GBV) globally, the majority of preventative efforts, such as awareness campaigns, educational sessions, or advocacy initiatives, do not successfully measure their impact on the incidence of rape and have unclear results.
NMNW has developed a rape prevention program called IMpower that trains adolescent girls and boys on how to prevent sexual assault. Five studies conducted by researchers from Stanford and Johns Hopkins University have shown that the IMpower program can cut the incidence of rape in half. The program has demonstrated benefits on other indicators, such as preventing pregnancy-related school dropouts (by 46%) and improving boys’ attitudes and behaviors toward women; for example, following participation in IMpower, 74% of male participants who witness a girl being physically or sexually assaulted successfully intervened to stop it. NMNW continues to collect impact data and is having a measurable effect in an area where few proven solutions exist.
The IMpower programs for girls and boys are low-cost and NMNW is scaling them by deploying a train-the-trainer model, whereby implementing partners are trained to deliver and resource the programs on an ongoing basis. IMpower is currently being delivered in Kenya and Malawi by implementation partner Ujamaa Africa, and NMNW is in discussions with BRAC to replicate the program in Uganda in 2019. NMNW has received numerous requests from potential partners in several other countries and will be building operational capacity to be able to meet this growing demand.
NMNW focuses on program replication and operating as a center of excellence that conducts research, advocacy, and training through partnerships to dramatically scale. NMNW hopes to generate further evidence that investing in effective rape prevention programs can provide significant cost savings and improved outcomes in the effort to reduce GBV worldwide -- and that ongoing program delivery by implementing partners could be financed by the cost savings of public resources being allocated to prevention rather than aftercare services. More broadly, NMNW seeks to change the underlying norms that enable the persistence and prevalence of GBV globally.
Developing Affordable Designs to Increase Household Ventilation and Improve Health in Dhaka, Bangladesh Respiratory disease kills approximately 1.3 million children per year. Descriptive studies in resource-limited settings find that natural ventilation via windows is associated with less respiratory disease transmission, yet more than one-third of the population of Bangladesh lives in dwellings that lack windows and are high in indoor air pollution. Current approaches to improve respiratory health in such settings have largely focused on reducing indoor air pollution through clean cookstove technology, which requires habitual behavior change.
This project takes a novel approach to the problem by developing affordable designs to increase household ventilation – the adoption of which requires new norm-setting and only limited behavior change. Given typical household roles, this approach to addressing unhealthy urban living environments may be particularly effective in reducing respiratory disease for women and young children.
As a collaboration between Dr. Stephen Luby of Stanford University and a team of academic experts and field researchers, this project brings together a group with diverse skills and backgrounds that can take a unique approach to an important research question. Building on findings from an initial pilot study supported by Stanford's Center for Innovation in Global Health, Dr. Luby and his team aim to conduct the first randomized controlled trial (RCT) evaluating the impact of improved household ventilation on the incidence of respiratory disease in Dhaka, Bangladesh. Before the RCT, the team will carry out a design phase to optimize the approach to ventilation and understand the market for windows and landlords’ willingness to pay. The project’s goal is not only to inform global health standards about the importance of ventilation for child health but also to demonstrate the financial incentives for landlords so that the intervention can scale through the private market without donor capital.
Scaling A School-Based Adolescent Program to Address Gender-Biased Sex Selection in India Despite two decades of rapid economic growth and social transformation, outcomes for women in India are considerably worse than those for men. Educational attainment, age of marriage, and labor force participation are all lower. Of significant concern is gender-biased sex selection – which can occur before or after birth. In the Indian state of Haryana, there are alarming estimates of 830 girls per 1,000 boys. Despite calls for action from the government, little progress has been made to address deep-rooted attitudes and norms that lead to these disparities.
Breakthrough, a human rights NGO in the US and India, aims to change awareness, attitudes, and ultimately behaviors that limit outcomes for women, particularly by targeting gender-biased sex selection. The Breakthrough program uses a powerful curriculum and “train the trainer” model that empowers teachers to facilitate classroom discussions with adolescents in government secondary schools to change perceptions and reset expectations around gender roles. The program includes a partnership with the Government of Haryana, which has allowed Breakthrough to carry out its intervention in 150 secondary schools, and J-PAL, which is conducting an RCT to evaluate results. Few RCTs exist in the area of adolescent gender programs. If the results of this RCT are positive, the program will build the evidence base and leverage a low-cost pathway through government schools to rapidly scale the approach in Haryana, with the potential for other states across India to adopt it as well.
A New Model of Justice to Reduce Mass Incarceration in the United States Over 2 million people are behind bars in the US today – an incarceration rate that is five times its historical level and at least seven times that of other advanced democracies. This trend is not only expensive, but also largely ineffective in improving public safety or promoting rehabilitation. Re-entry is a particularly problematic component of the criminal justice system; the abrupt transition makes unreasonable psychological and social demands on freed prisoners. The challenge shows itself through extraordinarily high mortality rates and recidivism statistics in the weeks and months following release. Halfway houses, pre-release centers, and work-release programs have all attempted to address this re-entry challenge, but can make only a modest contribution due to the budgetary, land-use, and political barriers associated with expanding brick-and-mortar re-entry facilities.
The Graduated Reintegration model will build a reentry facility without the facility. Graduated Reintegration will implement an innovative and scalable alternative to incarceration by placing prisoners in scattered site apartments that offer a graduated and incremental pathway to re-entry. In a controlled, humane, and rehabilitative environment, case officers will possess the monitoring capacity and adjudication speed required for swift, certain, and fair supervision – a model that has proven enormously effective for parolees and probationers – and freedoms will be gradually introduced as an incentive for sustained compliance and specific accomplishments. Graduated Reintegration will enable residents to successfully transition through “baby steps” from a prisoner to a free person with a job, apartment, savings, and an experience of success in playing by the rules.
The need for criminal justice reform has been recognized as an urgent national priority by a diverse array of voices across the political spectrum. Today represents a unique opportunity to tap this political will in order to test new models like never before. If the Graduated Reintegration pilot proves successful in one jurisdiction, others around the country will follow and, eventually, this model can administer justice to hundreds of thousands of offenders and defendants at a lower cost, with greater rehabilitative potential, and with lower risk to public safety.
National Scale-up of a Radio and Television Campaign for Maternal, Newborn, and Child Survival in Mozambique Billions of dollars have been spent on global health, but millions of people still die each year from largely preventable causes like malaria, pneumonia, and diarrhea. Simple, proven practices can prevent many of these deaths, but there is a gap in the adoption of such healthy behaviors like exclusive breastfeeding, handwashing, and the use of insecticide-treated bednets. Development Media International (DMI) seeks to address this gap by designing, implementing, and evaluating mass media campaigns to encourage healthy changes in behavior. Mass media has the potential to be one of the least expensive, easiest to deliver, and highest ROI health interventions available.
DMI will test if a national media campaign at scale is the most cost-effective approach to improving maternal, newborn and child survival. DMI will raise awareness about simple life-saving solutions through a comprehensive radio and TV campaign in Mozambique, where 84,000 children die every year before their fifth birthday. DMI’s campaign will not only save lives in Mozambique but could also influence how donors and governments spend their development dollars, potentially saving millions of lives at a fraction of the cost of other interventions.
Developing a High-Quality Advisory Service for 100 Million Farmers using New Technology Tools Smallholder farms support more than two billion people worldwide, but many rely on agricultural practices which may be inefficient and environmentally unsustainable. Research suggests that even small changes in agricultural practices can often substantially increase productivity and profits while also improving environmental sustainability. While governments around the world invest heavily in large-scale agriculture extension programs, advice frequently does not reach poor farmers, and when it does, it may not be tailored to local agro-climatic conditions. In developed countries, precision agriculture – which includes new technologies such as soil, yield, and climate sensors – is transforming agricultural production. A brand new initiative, Precision Agriculture for Development (PAD), will use new technologies to bring customized agricultural information to over 100 million farmers in the developing world.
PAD’s service is an intelligent platform that provides individualized recommendations based on theory and data. It will give farmers advice for their particular farm through mobile phones, enabling farmers to improve production. Technological advances in environmental monitoring, weather forecasting, satellite imagery, remote sensing, and machine learning will allow PAD to deliver precise agricultural advice. PAD’s technology will not just deliver information to but also gather information from farmers to ensure the advice continuously improves. Once PAD develops its technology platform and delivery model, the initiative will explore sustainable funding pathways, from partnerships with government extension programs to collaboration in value chains with anchor buyers.
RCT OF A REFORMULATED READY-TO-USE THERAPEUTIC FOOD (RUTF)
Ensuring Cognitive Recovery for Malnourished Children Ready-to-Use Therapeutic Food (RUTF) revolutionized the treatment of severe acute malnutrition for children and has saved millions of lives over the past decade. While RUTF has been proven effective in improving children’s physical recovery, the same investigators who were involved in the early development of RUTF have recently demonstrated that lipids in the current standard RUTF can actually lead to a reduction in the fatty acids necessary to revitalize neural tissue for brain development. These investigators now believe the existing RUTF formula – made from peanuts, palm oil, and milk powder – is not only inadequate to improve neurocognitive development in children but may actually compromise brain growth due to excessive omega 6 fatty acids.
A small study has demonstrated that with a slight adjustment in the formula to incorporate newly available non-GMO high-oleic peanuts, RUTF can support physical growth and provide the fatty acids necessary for growth of brain cell structure. Africare (formerly the Accordia Global Health Foundation) and its collaborators will lead a randomized control trial (RCT) with 3,700 children through the Institute for Child Wellness in Malawi to learn whether these findings are extended to mental and behavioral development. If the RCT is successful, standard global management of malnutrition will be transformed to enhance brain development while also providing lifesaving physical nourishment to the roughly 3 million children per year who receive RUTF.
Treating Depression at Scale in Africa through Self-Perpetuating, Community-Based Interpersonal Therapy Groups Depression affects 350 million people worldwide. Women suffer the burden of depression at twice the rate of men, and the effects on women and their families are often severe and far-reaching. Improving mental health for women can significantly improve child and family health, income generation and livelihoods, and other key indicators of health and wellbeing. But despite the large and growing need, mental health services are largely neglected and under-funded. The problem is particularly acute in developing countries, where rates of depression can be several times higher than in the US and Europe. StrongMinds seeks to reduce depression among African women by expanding access to proven mental health services.
StrongMinds will build a self-perpetuating, community-based system (akin to Alcoholics Anonymous) to help women reduce their current depressive symptoms and prevent future depressive episodes. StrongMinds uses the proven, simple, and cost-efficient model of group interpersonal psychotherapy, which has been shown to reduce depressive symptoms in 92% of participants in previous studies. In the group therapy program, trained community facilitators lead 12 to 16 weeks of talk therapy sessions with groups of women. StrongMinds has just completed its first pilot in Uganda and preliminary results show that many of the therapy groups have continued to meet on a voluntary, regular basis even without a facilitator formally involved. As they continue to refine the peer support group model, StrongMinds hopes to harness this natural momentum to demonstrate an effective, replicable, sustainable model for treating depression at scale.