Request for Application #2019-020

Digital Financial Services on Health Outcomes and Health Systems

Theory of Change for Digital Financial Services to Improve Health Outcomes

Executive summary: 

Tomorrow Global seeks to develop a theory of change for digital financial services to improve health outcomes. By drawing on the literature in health and development economics combined with operational expertise from other sectors, we will delineate the causal pathways through which these products can protect households against the financial risks from illness as well as the evidence base to support the model's underlying assumptions.

Consortium Team: 

 Tomorrow Global, LLC, is a woman-owned boutique policy research and advisory firm dedicated to reducing health disparities worldwide. We help clients use evidence to advance equity within and between regions, sustainability across administrations and generations, preparedness for systemic risks, resilience against unforeseen shocks, and governance as accountability. 
The project team would be led by economist Jessica Pickett, who brings a deep academic understanding of household demand for primary care in low- and middle-income countries. Her research focuses on the intersecting role of consumer information, provider quality, and out-of-pocket spending. Co-founder Alanna Shaikh brings expertise with USAID's health systems work, including developing theories of change to guide programmatic investments. As an independent consultant to the project, Michelle Kirby would bring operational expertise in digital financial services in the agricultural sector. We are open to joining an existing consortium with partners who have more direct experience implementing digital financial services for health, or could use a separate subaward to develop a complementary report.

Application Status: 
In Scope - withdraw


Thanks to the Digital Square team for resolving the upload error!

We note that in your application, you propose to be the “analytical bridge" between global research and country case studies. However, the purpose of this activity is to conduct the research and review to develop and synthesize the country-level evidence on implementation considerations. Will you be interested in and able to leverage technical expertise to conduct this research and produce learning from country examples?

We are absolutely interested in leveraging our technical expertise to conduct the country-level case studies directly, as well as to synthesize the evidence across multiple examples thereof (whether conducted by ourselves or our partners). Thanks for flagging that needs clarification in the final application! Unlike some of the other excellent proposals by larger organizations, though, Tomorrow Global lacks on-the-ground staff or field offices and so would both incur higher travel costs as well as lean more heavily on the local USAID representatives (or other consortium members) for logistics and introductions. Depending on Digital Square's priorities, we initially assumed that would likely put us at a comparative disadvantage for that portion of the work and so had hoped this analytical contribution would appeal to other applicants, e.g. as a supplement to their existing consortia. (On the last Q&A call we posed the idea of focusing on a narrower subset of the overall project and were told this would be an acceptable strategy.) On the other hand, our relative geographic neutrality means we are less biased toward any particular program. With that in mind, would you prefer that we significantly scale up the scope of our work rather than limiting ourselves to a complementary role?

A few more pieces of feedback to incorporate into your final application: How would you take responsibility for the entire ask within the RFA, in addition to the Theory of Change?