Our Recommendation
Living Goods is a high‑evidence, health‑systems partner with robust RCT evidence of large reductions in child and infant mortality and promising newer work on climate‑linked health resilience. For funders focused on cost‑effective, scalable primary health care in Africa, it is one of the strongest options available, and additional support could further scale government‑led models and deepen measurement on equity, costs, and long‑term outcomes.
Living Goods' Fierce Certification score is 120/100 based on our criteria:
✔ Has Ultimate Outcome Goals (50 pts)
✔ Measures Intermediate Outcomes (10 pts)
✔ Measures Ultimate Outcomes (15 pts)
✔ Shows Continual Learning & Adaptation (25 pts)
✔ Measures Intermediate Counterfactual (10 pts)
✔ Measures Ultimate Counterfactual (10 pts)
The Social Problem
Living Goods tackles high, preventable maternal and child mortality in low‑income communities with weak primary health systems. In many parts of Kenya, Uganda, and Burkina Faso, children still die from treatable diseases like malaria, pneumonia, and diarrhea, and pregnant women lack timely antenatal and postnatal care. Community health systems are under‑resourced, CHWs are inadequately supported, and data on what happens outside facilities are thin, leading to persistent gaps in coverage, quality, and equity.
The Solution
Living Goods’ solution is to strengthen government community health systems by supporting digitally empowered CHWs who deliver doorstep primary health care and link families to facilities when needed. It does this through three main modes: running “learning sites” that demonstrate gold‑standard community health, providing implementation support to governments (including digital tools, supervision models, and performance management), and offering technical assistance on policies and systems. CHWs supported by Living Goods diagnose and treat common childhood illnesses, promote maternal and newborn care, support immunization and family planning, and use mobile tools for decision‑support, data capture, and targeted outreach.
Key Outputs
- Scale of CHW support: Living Goods supports over 12,000 CHWs, providing training, supervision, and digital tools across Kenya, Uganda, and Burkina Faso.
- Population reached: its model delivers care to millions of people at a cost cited as under US$2 per person per year in some settings.
- Service delivery volumes: CHWs provide millions of home visits, diagnoses, treatments for childhood illnesses, pregnancy visits, and referrals each year, with RBF pilots showing they met or exceeded targets for several service indicators.
- Digital and data systems: Living Goods has deployed mobile apps and data platforms that generate high‑quality, real‑time programmatic data for governments and donors.
These outputs provide the operational backbone that makes their outcome and impact results plausible and scalable.
Key Intermediate Outcomes
- Improved coverage and timeliness of child health services: RCTs and program evaluations show significant increases in diagnosis and treatment of malaria, pneumonia, and diarrhea at the community level in Living Goods areas vs controls.
- Higher immunization and preventive coverage: digital tools and targeted outreach have driven high vaccination coverage in pilot sites, including examples where roughly 90% of children are vaccinated thanks to improved tracking and follow‑up.
- Better CHW performance and data quality: the RBF program in Uganda, evaluated by Oxford’s GO Lab, found measurable and sustained improvements in CHW productivity and programmatic data quality compared with earlier baselines.
These are backed by counterfactual evaluations, not merely before‑after changes, especially for CHW performance and service coverage metrics.
Key Ultimate Outcomes
- Child and infant mortality: a randomized controlled trial reported a 27% reduction in under‑5 mortality and a 33% reduction in infant mortality in Living Goods areas compared with control areas.
These results are causal, with robust counterfactual designs, giving Living Goods one of the strongest impact evidence bases among community health organizations.
- Climate‑resilient survival: a newer analysis in drought‑affected areas showed a 46% reduction in child mortality where Living Goods‑supported CHWs operated, suggesting that strong community health systems can buffer climate‑driven health shocks.
Continual Learning & Adaptation
Living Goods shows a strong learning posture:
- It has an explicit theory of change and a 2022–2026 strategic plan that reorients the organization from direct delivery to government‑led models, based on lessons from early growth.
- It created a Chief Program Officer role charged with revisiting the theory of change and optimizing high‑impact service delivery through program design, monitoring, research, evaluation, and learning.
- It runs learning sites to test and refine approaches, then uses insight from those sites, RBF pilots, and RCTs to adjust implementation support and policy advice.
Together, this suggests a full feedback loop where evidence, including counterfactual results, drives updates to strategy, partnerships, and operational models, rather than being an add‑on.
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