Noora Health

Todd Manwaring

on May 17, 2026

• 12 min read

Family Care Companions

Impact score: 100

Noora Health - Fierce Philanthropy Research Report

Date: March 21, 2026 Methodology: Todd Manwaring's Social Impact Evaluation Framework Organization: Noora Health

1. Social Problem: Inadequate family caregiver training

2. Population: Patients recovering from surgery, childbirth, or illness and their family members; healthcare workers in low- and middle-income countries

3. Location: India, Bangladesh, Indonesia, Nepal (primary); potential for global expansion

PROMPT 2 -- Top 20 Negative Consequences

#	Negative Consequence
1	High rates of post-surgical complications
2	Elevated hospital readmission rates
3	Increased newborn mortality and morbidity
4	Poor maternal health outcomes post-delivery
5	Preventable healthcare complications at home
6	Inadequate post-discharge care knowledge
7	Low treatment adherence by caregivers
8	Lack of recognition of family caregivers in healthcare systems
9	Caregiver anxiety and psychological distress
10	Limited health knowledge among family members
11	Poor infection prevention practices at home
12	Ineffective nutritional care during recovery
13	Missed warning signs of complications
14	Delayed care-seeking behavior
15	Inadequate understanding of medical instructions
16	Healthcare worker burnout from lack of family support
17	Inefficient use of healthcare system resources
18	Limited caregiver confidence in caregiving ability
19	Preventable mortality from avoidable conditions
20	Health inequity for patients in under-resourced settings

PROMPT 3 -- Intermediary vs Ultimate Outcome Classification

#	Negative Consequence	Classification
15	Inadequate understanding of medical instructions	Intermediary
13	Missed warning signs of complications	Intermediary
10	Limited health knowledge among family members	Intermediary
18	Limited caregiver confidence in caregiving ability	Intermediary
8	Lack of recognition of family caregivers in healthcare systems	Intermediary
7	Low treatment adherence by caregivers	Intermediary
12	Ineffective nutritional care during recovery	Intermediary
11	Poor infection prevention practices at home	Intermediary
14	Delayed care-seeking behavior	Intermediary
9	Caregiver anxiety and psychological distress	Intermediary
1	High rates of post-surgical complications	Ultimate
2	Elevated hospital readmission rates	Ultimate
3	Increased newborn mortality and morbidity	Ultimate
4	Poor maternal health outcomes post-delivery	Ultimate
5	Preventable healthcare complications at home	Ultimate
6	Inadequate post-discharge care knowledge	Ultimate
16	Healthcare worker burnout from lack of family support	Ultimate
17	Inefficient use of healthcare system resources	Ultimate
19	Preventable mortality from avoidable conditions	Ultimate
20	Health inequity for patients in under-resourced settings	Ultimate

PROMPT 4 -- Positive Results Shared by Organization

#	Negative Consequence	Classification	Positive Results
15	Inadequate understanding of medical instructions	Intermediary	Yes.

Dry cord care increased by 4% and skin-to-skin care by 78%

following the intervention, indicating improved comprehension and practice of medical instructions.

Skin-to-skin care rose from 4.8% to 9.2% between the control and intervention groups, corresponding to a 78% odds increase when adjusted.

Outpatient visits increased by 27% (RR=1.27, 95% CI 1.10 to 1.46) in the CCP group

, suggesting improved health-seeking behavior when warning signs are recognized. However, direct measurement of warning sign recognition is not explicitly reported. | | 10 | Limited health knowledge among family members | Intermediary | Yes.

Results of a 188 patient-caregiver dyad study suggest significant associations between participation in the Care Companion Program (CCP) and increased health knowledge, with complications reduced from 34.4% to 14.5% between the control and intervention groups, corresponding to a 71% odds reduction when adjusted.

| | 18 | Limited caregiver confidence in caregiving ability | Intermediary | Yes.

Measures show improved confidence in practicing behaviors at home.

In two states, the Care Companion Program was recognized by the Indian ministry of health as a replicable and innovative practice in public health.

Additionally,

WHO and Noora Health signed a three-year Memorandum of Understanding (MoU) to enhance global support for family caregivers during the 78th World Health Assembly in Geneva in May 2025.

Over a four year period, the organization trained more than 163,646 caregivers in COVID-19 response

Dry cord care improved by 4% (RR=1.04, 95% CI 1.02 to 1.06) in the post-intervention group as compared with preintervention group.

Outpatient visits increased by 27% (RR=1.27, 95% CI 1.10 to 1.46),

The program is proven to reduce anxiety for family caregivers,

71% reduction in 30-day post-surgical complications in cardiac care patients.

Complications reduced from 34.4% to 14.5% between the control and intervention groups in a 188-person cardiac surgery study, corresponding to a 71% odds reduction when adjusted.

| | 2 | Elevated hospital readmission rates | Ultimate | Yes.

Newborn readmissions reduced by 56% (RR=0.44, 95% CI 0.31 to 0.61)

in the postintervention group.

A 54% reduction in readmissions for maternal and newborn care, and in the cardiac space, about a 23% reduction

A study published in PLOS Global Public Health showed an 18% reduction in newborn mortality risk for families attending Care Companion Program sessions, saving 9.2 babies per 1,000 live births.

18% reduction in neonatal mortality.

| | 4 | Poor maternal health outcomes post-delivery | Ultimate | Yes.

Mother complications reduced by 12% (RR=0.88, 95% CI 0.79 to 0.97)

Newborn complications reduced by 16% (RR=0.84, 95% CI 0.76 to 0.91)

skin-to-skin care by 78% (RR=1.78, 95% CI 1.37 to 2.27)

hospital staff borrowed Noora's communication model for health campaigns,

The organization works in partnership with healthcare systems to embed CCP as a tool that supports better care delivery without being dependent on Noora Health delivering care day-to-day,

Noora Health's program has been shown to reduce cardiac surgery complications by 71% and neonatal mortality by 18%.

The organization has built strong partnerships with state governments of Andhra Pradesh, Goa, Haryana, Himachal Pradesh, Karnataka, Madhya Pradesh, Maharashtra, Odisha, and Punjab in India, as well as the national government in Bangladesh

, reaching underresourced public health systems, but equity outcome metrics are not directly reported. |

PROMPT 5 -- Counterfactual Results

#	Negative Consequence	Classification	Positive Results	Counterfactual Results
15	Inadequate understanding of medical instructions	Intermediary	Yes. Dry cord care increased by 4% and skin-to-skin care by 78%	Partial.

Study compared intervention group to preintervention group with 95% confidence intervals reported (RR=1.78, 95% CI 1.37 to 2.27 for skin-to-skin care),

but design appears to be pre-post rather than controlled trial.

Organization commits to measuring through quasi-experimental and pre-post studies by condition area,

The study of 7,900 new mothers compared behavior change with 95% CIs (RR=1.27, 95% CI 1.10 to 1.46),

Study of 188 patient-caregiver dyads with adjusted confidence intervals reported (71% odds reduction),

Improvement in dry cord care (RR=1.04, 95% CI 1.02 to 1.06)

Outpatient visits increased by 27% (RR=1.27, 95% CI 1.10 to 1.46)

Study of 188 patient-caregiver dyads showed complications reduced from 34.4% to 14.5% between control and intervention groups, corresponding to a 71% odds reduction when adjusted.

Newborn readmissions reduced by 56% (RR=0.44, 95% CI 0.31 to 0.61) in a 7,900-person study.

Study interim findings showed 54% reduction in newborn readmissions among those who received training,

Published study in PLOS Global Public Health showing an 18% reduction in newborn mortality risk for families attending Care Companion Program sessions.

Risks of mother complications reduced by 12% (RR=0.88, 95% CI 0.79 to 0.97)

Newborn complications reduced by 16% (RR=0.84, 95% CI 0.76 to 0.91)

with 95% CI and adjusted analysis, suggesting quasi-experimental design. | | 6 | Inadequate post-discharge care knowledge | Ultimate | Yes. Improvements in care practices with confidence intervals | Partial. Multiple outcomes reported with 95% CIs and adjusted analysis

(4,984-person study with adjusted odds increases/reductions)

Cardiac surgery study (188 dyads) with control and intervention group comparison showing 71% adjusted odds reduction.

PLOS Global Public Health study showed 18% reduction in newborn mortality risk,

comparing program participants to comparison group. | | 20 | Health inequity for patients in under-resourced settings | Ultimate | Partial. Partnership with public systems in multiple states mentioned | No counterfactual results. No comparative equity analysis or matched facility comparison provided. |

SUMMARY REPORT

Section 1 -- Our Recommendation

Noora Health demonstrates strong commitment to improving health outcomes through family caregiver training. The organization has published multiple quasi-experimental and pre-post studies showing substantial impacts on both intermediate outcomes (knowledge, confidence, behaviors) and ultimate outcomes (readmissions, complications, mortality). However, the evidence base, while promising, relies primarily on quasi-experimental designs rather than gold-standard randomized controlled trials. The organization is actively measuring outcomes across multiple condition areas and has achieved recognition from governmental health ministries and WHO. The organization shows early evidence of learning and adaptation through curriculum refinement and expansion into new condition areas. To strengthen Fierce Philanthropy's confidence in this organization, more rigorous randomized controlled trials and stronger counterfactual evidence would be valuable, particularly for maternal and neonatal outcomes where they claim largest impact.

Fierce Philanthropy Checklist:

a. Understands the Social Issue
b. Has Intermediate Outcome Goals
c. Has Ultimate Outcome Goals
d. Measures these Intermediate & Ultimate Outcomes
e. Measures Intermediate Counterfactuals
f. Measures Ultimate Counterfactuals
g. Evidence of Continual Learning & Adaptation

There is a power imbalance in the global healthcare system where those who care most for patients — their loved ones — are left out of patient healing. Families and their patients often leave healthcare facilities anxious, confused, and ill-equipped to care for their loved ones, leading to preventable complications and, in some cases, death.

In India and Bangladesh, physicians spend less than 2.5 minutes in India and less than one minute in Bangladesh to convey important care instructions to patients.

Caregivers often lack the information, medication, best practices, and hygiene they need to care for their loved ones. This leads to poor outcomes in maternal and neonatal health, health complications, high readmission rates, and suboptimal use of health system resources.

In South Asia alone, nearly 1.5 million children under five die every year from causes that could be averted through health practices actionable at home.

Section 3 -- The Solution

Noora Health's core innovation is the Care Companion Program (CCP), which trains family caregivers and patients with skills they need to care for themselves and their loved ones. Noora Health delivers fit-for-purpose, high-quality, accessible training for post-surgery, post-delivery, and general recovery and care.

The program works in four steps: (1) First, Noora Health partners with state and national healthcare systems to implement CCP in their facilities; (2) They train "Master Trainers," three to four health providers at each facility who become local champions of CCP; (3) Noora supports healthcare staff to train family caregivers, providing condition-specific, skills-based sessions as they wait in facility wards, halls or waiting rooms; (4) Finally, they reinforce caregiver behavior with remote engagement services, supplementing sessions with reminders, educational content and live chat support, typically through WhatsApp.

The program has been adapted for several major medical conditions, including maternal and newborn care, cardiology and cardiac surgery, oncology care, general medical and surgical care, tuberculosis and COVID-19.

Section 4 -- Key Outputs

Since 2014, Noora Health has equipped over 30 million family caregivers and patients across Bangladesh, India, Indonesia, and Nepal through its innovative training programmes.

As of Q3 2025, Noora Health has trained 30,200+ healthcare workers and 43 million+ caregivers and patients across 12,800+ partner facilities.

Every day, Noora Health supports health systems in training more than 45,000 caregivers and patients across thousands of facilities throughout India, Bangladesh, Indonesia, and Nepal.

The organization employs 201-500 staff members and is headquartered in San Francisco, California, with primary operations in India, Bangladesh, and Indonesia.

Section 5 -- Key Intermediate Outcomes

Noora Health demonstrates substantial improvements in intermediate outcomes related to caregiver knowledge, confidence, and health behaviors:

Dry cord care increased by 4% and skin-to-skin care by 78%

following the intervention.

Outpatient visits increased by 27% (RR=1.27, 95% CI 1.10 to 1.46),

indicating improved health-seeking behaviors. The organization reports measuring caregiver confidence and knowledge improvements but provides limited specific quantitative data for these measures beyond the behavioral practice improvements.

Counterfactual Evidence on Intermediate Outcomes:

The organization commits to measuring outcomes through quasi-experimental and pre-post studies by condition area.

The reported intermediate outcome improvements appear to come from quasi-experimental designs with comparison groups, as evidenced by the 95% confidence intervals reported, though full study methodology details are not universally transparent in publicly available materials.

Section 6 -- Key Ultimate Outcomes

Noora Health demonstrates robust improvements in ultimate health outcomes:

Cardiac Surgery:

A study of 188 patient-caregiver dyads showed complications reduced from 34.4% to 14.5% between control and intervention groups, corresponding to a 71% odds reduction when adjusted.

Maternal and Newborn Health:

In a multi-state study, newborn complications reduced by 16% (RR=0.84, 95% CI 0.76 to 0.91), mother complications by 12% (RR=0.88, 95% CI 0.79 to 0.97) and newborn readmissions by 56% (RR=0.44, 95% CI 0.31 to 0.61).

Mortality:

A study published in PLOS Global Public Health showed an 18% reduction in newborn mortality risk for families attending Care Companion Program sessions, saving 9.2 babies per 1,000 live births.

Counterfactual Evidence on Ultimate Outcomes:

The organization's studies found greater changes in complications and readmissions than changes in newborn and maternal care practices. The apparent difference in effect may be because different care practices have varying influence on complication risk.

The reported ultimate outcomes appear to come from quasi-experimental designs with comparison groups, with 95% confidence intervals and adjusted analysis reported. However, the organization has not published full-scale randomized controlled trials; rather, it relies on quasi-experimental designs with control/comparison groups.

Section 7 -- Continual Learning & Adaptation

Evidence fuels everything the organization does. As they look to the future, they are doubling down to make their approach even more data-driven and rigorous.

The organization monitors reach and program quality, and evaluates behavior and health outcomes for patients, caregivers, and health systems. They are committed to measuring through quasi-experimental and pre-post studies by condition area and conduct ongoing, high-quality research to understand the impact of their approach on health outcomes, refine their programs and services, and build evidence for health-systems change.

The organization is planning a cluster randomized study with two stages: a pilot evaluation across 30 public health facilities, followed by a large-scale RCT across 140 public health facilities in India,

focusing on maternal and neonatal health outcomes. This represents movement toward higher-quality counterfactual evidence.

Evidence of adaptation includes:

Expansion of condition areas to include maternal and newborn care

Recognition of TB family care model by India's Prime Minister as one of five key initiatives to end TB in India by 2025, with the organization contributing to national guidelines,

and

publication of qualitative research in PLOS Global Health highlighting program perceptions and a PLOS Global Public Health study on mortality reduction.

The organization has expanded into new countries (Indonesia in 2021, Nepal in 2024) and adapted curricula for new conditions based on evidence findings.

Report prepared using Todd Manwaring's Social Impact Evaluation Framework for Fierce Philanthropy.

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