2025 Mid-Year Update: GiveWell grant, expansion plans

Written By Guest User

At Taimaka, we are expanding our program with the goal of treating over 34,000 cases annually by 2027! 

We recently received a three-year grant from GiveWell that will fund the majority of our expansion. We’re excited to provide life-saving care to thousands of children with acute malnutrition, many of whom wouldn’t have received treatment otherwise. 

This grant from GiveWell is transformative for us because it gives us the stability to plan on a multi-year timescale for the first time. We’ve already started to put this to use, hiring a number of new staff members to help facilitate our scale-up while ensuring we maintain or even improve program quality. 

GiveWell estimates that the cost-effectiveness of our program is around their funding bar based on their estimates of how many lives we save and the life-improving benefits of our program. We’re working with them to collect additional data that will help address uncertainties about the cost-effectiveness of our program. 

We are fortunately not directly impacted by the USAID funding cuts. However, there are many life-saving programs, including other malnutrition treatment programs, that have been shuttered or destabilized. At the end of this post, we added a few resources on USAID.

Below are more details on our plans for the next few years, wins, updates, and challenges. Feel free to skim if you’re short on time! 

Our plans for 2025 - 2027

  • We plan to treat over 72,000 cases over the next three years, saving an estimated 1,519 - 4,237 lives! GiveWell’s grant will fund ~55,000 of those cases, and we’re currently fundraising to treat an additional 17,000+ cases of acute malnutrition and conduct our program improvement work. Our goals are to treat 14,120 cases from April 2025 to March 2026, 24,160 cases from April 2026 to March 2027, and 34,160 cases from April 2027 to March 2028. We just opened four facilities and plan to open 2-3 new facilities in the next few months. 

  • We will collect additional data in partnership with GiveWell to inform our understanding of the cost-effectiveness of our program. We’re working with GiveWell to plan data collection projects on the prevalence of malnutrition in the areas we serve, coverage (uptake of malnutrition treatment services), patients coming from outside our catchment areas, counterfactual mortality, and the potential impact of our program on the provision of other health services. This information will be useful not just to better understand our program, but to improve GiveWell’s modeling of malnutrition treatment more generally.

  • We will continue to improve our program. We’ve hired a Program Improvement Associate (and plan to hire another) to help drive this work. This includes piloting larger innovations, like we’ve done in the past, including enhanced discharge criteria to prevent relapse and improved care for children under 6 months old, along with more granular work to improve our day-to-day service delivery, like giving our program officers more tools to address nonresponse in our patient population. As always, our goal is to run the most cost-effective malnutrition treatment program in the world, through continual refinement of our services.  

Other wins/updates 

  • The Happier Lives Institute (HLI) has recommended Taimaka as a Promising Charity for improving happiness and wellbeing! As a Promising Charity, we are likely a highly cost-effective way to improve wellbeing. While Taimaka’s focus is saving lives, we are excited about our potential impact on this outcome as well. HLI’s evaluation of Taimaka is based on studies of the wellbeing effects of related nutrition interventions and our low cost per child treated. Read more about their research on Taimaka here. 

  • We are working with the Oxygen Access Project to provide medical oxygen therapy for patients in our inpatient treatment facilities and other hospital wards across Gombe State. Low oxygen saturation is a significant risk factor for mortality, and 5-10% of pediatric patients in Gombe suffer from low oxygen saturation, often due to pneumonia. The Oxygen Access Project is a new charity, incubated by Ambitious Impact, working to provide oxygen therapy in hospitals in Nigeria. Taimaka is helping OAP get started in Nigeria, serving as a fiscal sponsor and providing shared resources and contacts in Gombe. This is similar to work we did with HealthLearn and we’re eager to help launch highly impactful efforts in Nigeria and Gombe where we can. If you’d like to learn more, you can reach out to leonie@oxygenaccessproject.org. 

  • We have expanded our leadership team to prepare for growth! In addition to our program improvement hires, we have hired an Operations Manager and a Program Optimization and Data Lead to manage our budget, human resources, and monitoring and evaluation systems. 

Challenges 

  • Our monitoring and evaluation systems caught instances of data fabrication late last year. In our investigations, we found that one of our managers was berating staff for submitting children as non-response and tacitly encouraging data fabrication. We’ve terminated this staff member, underscored the importance of data accuracy with our staff, and increased our cadence of data backchecks. We’ve also expanded our efforts to verify beneficiaries through facial matching. We’ll be writing a post-mortem about this in the next few months that we’ll send in our next update. 

  • This data fabrication masked a larger issue with nonresponse in our program. A nonresponder is a child who is still malnourished under one of our three standard measures of acute malnutrition (mid-upper-arm circumference, weight-for-height z-score, and absence of oedema/swelling) after 12 weeks in our program. After correcting for these fabrications, our non-response rate over the last 9 months stands at ~12.5%. Our goal is to decrease this rate to 5-6%, and one of our core program focuses right now is to improve response rates. We’ve rolled out a few updates to how our program officers track nonresponse to encourage earlier intervention when a child is falling behind their expected recovery trajectory. We’re also working on new tools to help the most at-risk cases, like improved counseling and supplementary feeding. We’re cautiously optimistic that we’re starting to make progress, as the trend lines are pointing in the direction we want them to, but we expect this to be an ongoing battle for a while. You can keep up to date with our progress by tracking our live program data here. 

Updates on specific studies and pilots we’ve been running: 

  • Relapse: We’re currently running a study on the sustained effect of acute malnutrition treatment to better understand the drivers of relapse after treatment and help us find ways to prevent relapse. We have enrolled more than 1,800 children in our relapse study so far. 

    • Building on this work, we have just launched an RCT of enhanced discharge criteria, where we hold children in the program longer before we consider them recovered (requiring a MUAC of >13 and a WFH z-score of >= -1.5) to test whether this can create a protective buffer that prevents future relapse.

  • Predictive Modeling: With the help of a number of great volunteers, we have built several machine learning models to predict the probabilities patients will die, default, or nonrespond during treatment, with the aim of targeting care to these children to prevent these outcomes. We’re currently in the process of building these into our supervision workflows, and are excited to see whether they are helpful for our program officers overseeing facilities.

  • ORS and Zinc: We just wrapped up a pilot of distributing ORS and zinc copacks to children at risk of diarrheal disease through the mass MUAC screenings we carry out to screen for cases of acute malnutrition. We think this is an exciting possible add-on that uses a pre-existing distribution channel to prevent even more deaths. We’re currently analyzing our data from this pilot to make sure that ORS and zinc were distributed with appropriate instructions and that caregivers understood how to use it before we integrate it permanently into our programming.

  • Caregiver mental health: Our study assessing whether integrated maternal mental healthcare improves CMAM outcomes is ongoing. We are continuing to enroll caregivers in our RCT arm of this study, though more slowly than expected because we predicted 30-40% of mothers would have at least mildly depressive symptoms, but in reality it’s been about 20%.

Resources on USAID 

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