Community Health Outcomes Fund - Instiglio

Community Health Outcomes Fund

Community Health
Outcomes Fund

The exploration of establishing the Community Health Outcomes Fund (CHOF) is a joint venture between UBS Optimus Foundation, The Global Fund, and GiveWell. The goal of the fund is to improve health outcomes for underserved communities with high disease burden in sub-Saharan Africa. Instiglio developed the fund’s strategy, by establishing the metrics definitions and assessment, including potential measurement tools, and creating risk analysis and mitigation strategies.


Kenya and Zambia



Type of Project

RBF Design or Implementation




project description

The Fund aims to operate as a vehicle for the discovery and scaling of impact intervention that can improve health outcomes in a cost-effective way. To achieve this goal, the fund pools resources from several outcome payers and disburses them towards results-oriented service providers, conditional on their achievement of health outcomes closely related to mortality.

The Fund aims to:

  • Reach underserved communities with a high disease burden
  • Focus on outcomes closely related to mortality
  • Discover and scale impactful cost-effective health interventions

Instiglio developed the strategic plan for the Community Health Outcomes Fund development (mission, vision, value propositions, and objectives) and led the definition of the technical parameters of the Fund.  These parameters include a

  • Framework for the discovery and prioritization of funding opportunities
  • A strategy to promote the Fund’s sustainability and its integration with the local health systems
  • The Fund’s preliminary payment metrics
  • The payment functions
  • A framework to set the price per outcome

Along with this process, Instiglio also mapped more than 130 potential health service providers across sub-Saharan Africa and engaged with several of them to integrate their input in the design of the Fund.

We also designed a framework that allowed us to identify and preselect two countries in sub-Saharan Africa and explore their potential and suitability to host the first round of transactions of the Fund. As a result of this process, Instiglio developed two in-depth country reports assessing the readiness and value-add of the Community Health Outcomes Fund (CHOF) in Zambia and Kenya. The analysis considered:

The country’s disease burden

  • Under-five mortality
  • Malaria
  • HIV
  • Tuberculosis
  • Maternal and infant health
  • Nutrition

The potential to bring-in additional funding

  • Development assistance
  • Domestic resources

The pool of potential service providers that could deliver the desired outcomes in a cost-effective way

The buy-in of the national governments

Concurrently, Instiglio engaged several bilateral and multilateral agencies and philanthropic organizations to gauge their interest in participating as potential outcomes funders within the CHOF.

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