Hi Habiba, It is amazing what you have been able to build with the team at Spiro, and wishing you all the continued success, especially at this exciting moment as you have government interest and engagement.
I would be interested to learn more about how you are thinking about the scale strategy for Spiro. On the one hand, it appears that there is some level of demand from government as a potential doer at scale, and perhaps slightly less so as a payer at scale. On the flip side, it appears that we’re seeking funding to directly cover the costs of serving all of the proposed districts within Sindh.
Are you foreseeing this as a stepping stone to building a model that could scale directly through government engagement and support, where they may be actually willing to pay and do this intervention directly? Or do you feel like the most likely path to scale would be through directly providing this intervention support, both within Sindh and other districts in Pakistan, or perhaps in other locations around the world?
What are some of the key uncertainties or pieces of knowledge you would want to gather as an early-stage organization to make better determinations on what type of scale strategy would be appropriate?
Thank you Tony! These are really interesting and tough questions.
We certainly see a potential route for government as a doer and payer at scale.
Re payer: we’ve seen examples in Pakistan where he government outsource service provision in both education and health to NGOs - so NGOs deliver but government pays.
Re doer: when there is a strong community based health worker force it’s more possible to layer TB into what they do. There are some alternatives to consider e.g. Commcare Connect https://labs.connect.dimagi.com/ to essentially allow government staff to pick this up as gig work. But we haven’t looked into these a tonne yet.
I think the routes here are most promising in Punjab province and potentially other countries.
However, with the advent of the third wave of philanthropy the time pressure to handover to government as the payer at scale I think has lessened. I’m interested in your take on this too. It does seem possible to me that providing this intervention support directly in Sindh and elsewhere funded by philanthropy could be a more viable route than it has previously been. Right now I think that actually means viability of different funding sources is probably my biggest uncertainty to shed light on the best scaling strategy.
Hi Habiba, It is amazing what you have been able to build with the team at Spiro, and wishing you all the continued success, especially at this exciting moment as you have government interest and engagement.
I would be interested to learn more about how you are thinking about the scale strategy for Spiro. On the one hand, it appears that there is some level of demand from government as a potential doer at scale, and perhaps slightly less so as a payer at scale. On the flip side, it appears that we’re seeking funding to directly cover the costs of serving all of the proposed districts within Sindh.
Are you foreseeing this as a stepping stone to building a model that could scale directly through government engagement and support, where they may be actually willing to pay and do this intervention directly? Or do you feel like the most likely path to scale would be through directly providing this intervention support, both within Sindh and other districts in Pakistan, or perhaps in other locations around the world?
What are some of the key uncertainties or pieces of knowledge you would want to gather as an early-stage organization to make better determinations on what type of scale strategy would be appropriate?
Thank you Tony! These are really interesting and tough questions.
We certainly see a potential route for government as a doer and payer at scale. Re payer: we’ve seen examples in Pakistan where he government outsource service provision in both education and health to NGOs - so NGOs deliver but government pays. Re doer: when there is a strong community based health worker force it’s more possible to layer TB into what they do. There are some alternatives to consider e.g. Commcare Connect https://labs.connect.dimagi.com/ to essentially allow government staff to pick this up as gig work. But we haven’t looked into these a tonne yet. I think the routes here are most promising in Punjab province and potentially other countries.
However, with the advent of the third wave of philanthropy the time pressure to handover to government as the payer at scale I think has lessened. I’m interested in your take on this too. It does seem possible to me that providing this intervention support directly in Sindh and elsewhere funded by philanthropy could be a more viable route than it has previously been. Right now I think that actually means viability of different funding sources is probably my biggest uncertainty to shed light on the best scaling strategy.