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(Audio) Spark and sustain impact at scale

In this audio roundtable, IDinsight’s Krishna Ramesh sits down with Pascale de la Frégonnière, Strategic Advisor to the Board of Cartier Philanthropy, and Lonnie Hackett, President of Healthy Learners to discuss how data and evidence can support organizations as they scale in size to improve more lives. This talk offers insights from both the funder and implementer perspectives on pathways to scale up for global development organizations.

Full transcript of the interview:

Krishna: Welcome everyone to our audio round table. I am Krishna Ramesh from IDinsight, a research data analytics and advisory organization that works with partners in Africa and Asia to amplify their social impact with data and evidence. I’m joined today with Pascale De La Fregonniere Executive Director of Cartier Philanthropy and Lonnie Hackett, President, and Co-Founder of Healthy Learners.

This month IDinsight is focusing on organizations at every stage of scale-up and how data and evidence  can support them in their journeys. Today, we’ll hear from both sides of the equationthe funder perspective and the implementer perspectiveabout what this looks like in practice. As background, IDinsight is currently working with both organizations.

Welcome both of you, and thank you for joining us. Without further ado, Pascal. I’m wondering if you can start us off by introducing yourself and telling us a little bit more about your work at Cartier Philanthropy.

Pascale: Yes, thanks so much Krishna, pleasure to be with you today. Maybe I’ll start by saying that this year is the 10th anniversary of Cartier Philanthropy.

We’ve built our work around improving the lives of the most vulnerable women, children, and men who live in a low income countries. So far, we’ve invested some 100 million dollars and we are currently supporting over 50 partners working in 30 countries. So that’s where we are today. 10 years ago, we started from scratch.

I came to that job with a United Nations background, mostly with UNICEF. When I have worked at first in communication and then in donor relations and business development, for some of, I would say, the most critical humanitarian operations. I was in Somalia in 1993. I worked in Iraq in 1997 and then 2005 and also in Haiti, immediately after the 2010 earthquake.

So when Cartier asked me to set up their foundation, I have to say that I am particularly grateful for their commitment because they were both sincere and very serious in what they wanted to do. Sincere in the sense that the foundation is totally independent from the business. And we have never been used to push any commercial agenda or brand visibility.

And that, I think was extremely important for us to focus on what we needed to do and serious because they wanted someone with field experience and they fully supported our approach to work with organizations that have a solid track record of impact, and also the ambition to replicate and also scale their solutions so that we can actually benefit the largest number of people with what we do.

Krishna: Fantastic. Thank you so much. And we’re also reaching our 10 year mark at IDinsight, so, happy anniversary.

I’d love to hear from you next, Lonnie. Thanks for joining, and we’d love to have you introduce yourself and tell me a little bit about your role at Healthy Learners and the work that the organization has done to date.

Lonnie: Of course. And thank you so much for having me on this call as well. So Healthy Learners is a little bit younger. I co-founded healthy learners in 2014 2015 with Ignatius Belonga, who was a rather remarkable Zambianclinician.

He was a clinic director with the Ministry of Health at the time. And for us, the work that we do is to keep school children healthy. We’ve realized in Zambia, but also globally, that when it comes to health school-aged children tend to go critically overlooked, and as an age group, have the fewest touch points with the healthcare system. Because nearly all child health programs focused on the youngest kids, so under five, because that is a critical point for survival and development. But oftentimes, programs fail to reach school aged children. And even within governments, when you’re under five, you have the responsibility of the Ministry of Health – but once you become school aged, it says though, you become the responsibility of the Ministry of Education.

And as a result, school age children’s health needs often go overlooked. And this can have really devastating impacts, not just on their health, but on their physical, emotional, psychological development, and of course their learning and their future. And so, Ignatius and Ithis just for a little background on him, you know, if he were to tell his story he grew up in a village and where he experienced this firsthand. He oftentimes had challenges accessing healthcare, particularly as a child. Then as a clinic director, you know, he would see that oftentimes the clinic was filled with young children and their parents as well as adults, but very rarely school aged children. And then as a parent, he had seen some of the challenges of getting his own kids access to healthcare and the important role that the education system had.

And so to us, you know, we acted on a deceptively simple idea – that if kids aren’t accessing healthcare at clinics, let’s bring care to where kids already aretheir schools.  By turning to the folks that kids already trusted, and spent nearly every single day withtheir teachers.

And we believe that by building strong relationships between schools, health facilities, and communities, and by combining traditional school health models with community health worker models, by training teachers as a new project of community health workers, that we can have a really significant impact on improving the health and wellbeing of school children.

And so, I won’t go too much into this, but this has been a really exciting couple of years for Healthy Learners. Uh, in the last two years, our model has been adopted as policy by both ministries of health and education. And last year we signed a memorandum of understanding with the Zambian government to begin scaling up nationally.

Krishna: Fantastic. Congratulations as well on the work that’s been done and it’s really exciting to hear more about it.

So at IDinsight, we’ve had the privilege of working with small, medium and large nonprofit organizations and social enterprises. And I think what we’ve seen is that data and evidence needs vary a lot, depending on current challenges and aspirations, as well as while organizations grow.

So for Healthy Learners. I think you just mentioned the scaling journey that has been undertaken and is continuing to be the case across the country. How did you know that you were ready for that expansion and what sort of factors fed into that and how did your use of data and evidence as an enabler adapt or evolve over time?

Lonnie: Yeah, that’s a great question. And I would say I would kind of put that into a few different buckets. On the one hand, I would say the catalysts or the impetus for our current scale-up was really driven by our partners. We had seen, you know, before COVID a high demand from the Ministries of Health and Education to scale our work.

But in particularly during COVID, the role that our model played to support schools to be more resilient, to stay open and to ensure that this age group continue to access health care was really critical. So it was the Ministry of education in particular that came to us, and they were willing to make really significant investments to scale the model.

And for us, we thought that was a really great opportunity to support them to really institutionalize school health within the government, and saw a great pathway both to scale, but also sustainability through the government. You know, for example, when the ministry, informed us that they were, moving towards starting a new department for school, health, and nutrition, putting personnel in place that would really be able to own this work. And so as an organization, we wanted to do everything we could to step up, to support them. And to your point how we knew we were ready I would say kind of two fold. One was looking at, how confident were we in our impact. And making sure our model was ready to be scaled at that point. And for us, the answer was yes.

In 2019, we were fortunate to partner early on with researchers from the Harvard School of Public Health to do an externally controlled evaluation looking at the impact of our program on health. We saw that we were significantly moving the needle on health status, reducing morbidity, improving health care utilization, health knowledge, and health behaviors. But also just through our internal data systems seeing that as we were scaling in Lusaka we sawthe fidelity and impact of our modelthe kind of day-to-day results that we were getting were quite consistent and positive. And then lastly, it was could we execute at a larger level? And did we have that senior team in place that we felt confident could take on that really significant challenge of moving beyond being in Lusaka?

So at this time, about a year and a half ago, we were covering a hundred schoolsabout 250,000 children and being asked by the government to scale up, to serve a million children over the next four years. And we felt we did. We have a very strong team in Lusaka, led of course by our Co-Founder Ignicious Bulongo, but also our Vice President AngelChela, Vice President Aadministration, Chal Mulapo, our Director of Partnerships, Catherine Samiselo, and the whole team. We felt like that leadership was there to help guide the organization during that critical time of growth.Obviously, we’ve had to do a lot of hiring since then, we’ve had to strengthen our systems and make sure that we areable to continue to maintain quality. And that’s something we’re still working on every week and is a priorities of ours.

But I think it was having those three buckets of strong, external support that was kind of the driving force for expansion. You know, real high confidence in the impact of our model and feeling that we had a strong team in place that was kind of those three ingredients that made us feel now is the right time.

Krishna: Yeah, that makes a lot of sense. And I’m curious about one of the important goals of Healthy Learners, and many other organizations, has been this point around scaling through government. And so I’m wondering if you can talk to me a little bit about what you had already in place in the form of the impact evaluation with performance, sort of understanding how your program is being implemented today through data, and how you think of that as you scale even further in partnership with government. What are the additional elements that become even more important because of that pathway that you are choosing to take?

Lonnie: As an organization, really, partnership with the governments in our DNA. Our co-founder was with the Ministry of Health. I often joke, but it’s true, our first office was a storeroom in a government facility. And the model was built hand in hand with our government partners, whether that was government teachers, government health workers, officials, and national officials.

I think early on, we were very mindful of building, (a) program that was affordable and designed in a way that could be effectively implemented by the government. But (b) also ensuring that their feedback around the way we are setting up our systems and thinking about data and impact was well aligned with both Ministries Health and Education. And so as we continue to scale, it’s been exciting to have ongoing conversations with both ministries about what type of data that they need to be able to manage the program, and to feel confident in their ability to have impact and a return on the investments that they’re making.

And for us, we’re in this interesting intersection where it’s not just one stakeholder, but it is these two different ministries. The Ministry of Health – they’re seeing the syndromic and epidemiological data coming to the program as having huge value to their surveillance systems. So it’s working with our tech partners, with groups like IDinsight and with obviously the Ministry of Health, to think of how we can best utilize all of that data coming through the program to support their systems.

And then on the education side, it’s all of the performance data, you know, what’s happening in the school, how well are teachers and schools performing? How can we integrate that into our district monitoring and evaluation and quality standards? How can we have that really cascade up then to the provincial and national level as well?

So making sure that our data’s tunes are really being integrated into those existing systems. So I think as we’ve begun to scale on the importance of that, but also the opportunity to do that has really increased.

Krishna: Yeah. That makes a lot of sense. Building within and building off those existing systems resonates a lot.

Pascale, I wanted to pivot slightly to the Cartier Philanthropy perspective. You support a lot of organizations that arealso at various stages of this journey to scale up, but with this objective of growing over time one of which is Healthy Learners. I’m curious to hear reflections from you on, over the course of that journey, how you’ve seen, from the funding perspective, data use and evidence changing as an organization grows, and then also sort of how your views and the organization’s views have evolved over the growth of Cartier Philanthropy as well,, with respect to how data and evidence is a central part of what you look for from grantees and from partners.

Pascale: I think we’re very lucky to have Healthy Learners and Lonnie with us today because it’s such a good example of how data and evidence can be used. And if you take the broader view, I think that and Lonnie explained –  if you can build evidence to demonstrate impact that potentially can lead to policy change and then to scale if you work with the government, of course. So for me, what’s really critical is not just in that data is needed to understand whether your assumptions are right, and if you’re doing the right thing, going in the right direction. But, basically data is needed to make the right decisions and inform those decisions.

But for organizations that are not as advanced in that development as Healthy Learners, I think what we want to see is organizations that have a very good understanding of whether the solution that they have is actually pertinent. Understand if your solution actually is providing the right answer to a problem that is well identified.

We need to understand whether and data can inform whether, your solution is actually effective. Is it cost-effective?How much are you spending to provide an effective service or product to a population? And then of course, we want to understand whether that solution is having impact. And also, the definition of impact also always needs to be clarified. And beyond impact then will come the potential for scale. And that potential for scale can lead to the sustainability of an intervention. So the real question is more about how do you measure impact? How do you actually demonstrate that people are better off with the intervention than if you had not been there.

Maybe what you need to focus on is not collecting too much data. And I think this is something that organizations think they have to do. You collect loads of data, but then you don’t really know what to do with that. So when it comes to data collection, I would say that probably that less is more, if you focus on the right indicators and understand very well what it is you’re trying to measure.

Say, in the education field, if you want to measure learning outcomes, what is it you’re going to look at? Is it literacy or numeracy gains? And this is what you should really define very well. Then what is the source of the data that you’re going to look at? Maybe it’s the exams that are going to be held in the school system. Then you want to know how the data is going to be collected. And once you have all that, you have a clear indicator that can help you do your analysis as to whether you’re going in the right direction or not. And I’m saying this before you actually consider doing an RCTor grading tool, you know, a more expensive and time-consuming type of impact measurement. And this is something that organizations can do on their own. They need to just set the right systems and be very thoughtful about what to measure and how to do that so that it is actually verifiable, and then of course very useful.

Krishna: Yeah, thank you. That resonates a lot. And I think that the point of less is more and taking a little bit of a stepas early on as possible within that organizational journey to interrogate this question of what are the pathways to impact and how are we look into achieve that. I think in various different organizations that we’ve worked with, we found that to be a very important step.

Cartier philanthropy works across sectors and across a range of organizations. I’m wondering if you can talk a little bit about how you see your role in supporting organizations within that process and what you look to do as a funder in helping think through and take that journey, particularly in sort of supporting organizations through the process of scale.

Pascale: Well, what we’re trying to do first of all, is to listen very much to what they’re doing. We consider that they’re the experts. So on that basis, what we need to do is really listen and try to understand how the model that they’ve set in place, you know how that model can then be replicated and taken to scale. And for us, it’s mostly asking questions, understanding where the funding is going to come from, impact is very much about delivery and execution of the offer of a service.

So who can do that as well as your organization can? And I think that they need to pay attention with the organizations that we work with, that there is no confusion about the growth of the organization and this scaling of the impact. And I think sometimes this is where asking the right questions and challenging organizations as to identifying exactly what they’re trying to do and for what purpose, I think it’d be very helpful.

Krishna: Thanks for that. Lonnie, I’m keen to hear you tell us a little bit about sort of your journey on this front. I think Pascal mentioned these points around both thinking through the impact pathways of the program, conducting the sort of more rigorous impact evaluations and then sort of monitoring the program over time. We’d love to hear at the earliest stages, did you go through that process? How did you think about designing the program optimally? I imagine there were many sort of phases of what does the program look like? How do we need to adjust it? And that sort of continuing into this, the scaling with government. But I’m curious if you could talk a little bit more about that earlier phase as you were refining how your intervention was going to be designed and how you went about that and what the key factors that sort of fed into that process worked for you.

Lonnie: Yeah, that’s a great question. And I would say early on, I think there were two driving forces in shaping our program. One was very local, and that was working with our, partners with teachers and with health workers and parents and students to deeply understand what their challenges are.Trying to unpack those to find out what are those primary barriers that are impeding school children’s ability to access healthcare. Understanding that from a kid’s perspective, the school’s perspective and the community and health facilities perspective as well. I think that local and proximal lens was really important in designing an impactful program.

But at the same time, we wanted to make sure that we’re taking more of a global view as well of what are the existing best practices. School health is a field that goes back to the 1980s, whether that was initially deworming, school-based health education. How can we learn from those that came before us as well? What were the driving forces of those programs towards impact? And also looking at other community health worker organizations and programs, whether that was Partners in Health or Last Mile Health or Muso, but seeing the amazing work they were doing and the best practices they were discovering in community health, and thinking, how can we build a model that taps into that as well? So I think those early days, it was a lot of learning from others and learning from our partners and then just iterating and just constantly testing. How can we operationalize these kind of core, best practices effectively within a school setting.

And I think that’s where making sure that we had data coming in and out on a regular basis was really critical. And so whether that was through the program, to be able to find out how well is the program implementing. I think, you know, as far as like the core concept behind what we do training teachers as community health workers we were very confident they could do the work. If you can train lay community members, certainly you could train a professional teacher. The big question is, can teachers manage the work though? Can this really integrate into the school’s day-to-day setting? And that was having kind of constant feedback from schools, whether that was attendance on meetings, making sure that we are training the right number of teachers to avoid any displacement effects, or what their normal schoolwork would be. So I think that was both quantitative data coming in as far as from the program, but also qualitative, having lots of discussions to find out how they’re managing this new program.

And we did fairly early on partner with academic researchers to do an evaluation. And so I think once we had the general structure of our model together, it was working internally, but also with partners to really understand our theory of change what are those core assumptions within our theory of change that we believe are necessary to drive the impact that we want to see in improving the health of school children? And back in 2016, we partnered with researchers to do a small controlled evaluation around that. And that was important for us. To kind of really rigorously evaluate those assumptions before we began scaling in any meaningful way in Lusaka or now beyond Lusaka.

Krishna: Yeah. Thanks for that. I think that makes a lot of sense, particularly I think the point around learning from others in terms of building off of what has already been done and, and sort of trying to identify where and how that can be contextualized within this environment and then sort of taking it from there.

Pascale, I want to come to you to talk a little bit more about sort of the funding landscape and in a more general sense. So there’s plenty of funding organizations looking to support early stage non-profits and organizations like Healthy Learners, as you say, that are a little bit further along on the road to scale, you talked a little bit about what sort of Cartier philanthropy’s approach is, in the sense of sort of providing the support. But I’m curious in a slightly more macro sense, to hear thoughts on what you think funders often do, right, in terms of both identifying these organizations and enabling that scaling process, as well as where you feel that there’s room to continue to improve and learn as portfolios grow, as organizations and funders and support more organizations and they grow within their portfolio.

Pascale: That’s an interesting question. But I would say, maybe there’s no right or wrong. It’s more knowing about where we can, as a foundation, be most useful to help the organizations on the ground achieve their mission. And, I think it’s really understood that philanthropy is very much meant to take risks, and foundations, it’s true, don’t have to justify what they do to anybody. So I think that this is great, that you can actually de-risk, maybe, some intervention with philanthropic money and we should definitely do that. So as you rightly said, many funders want to innovate and support, maybe the new cool idea. Well, frankly speaking, this is not us. I think this is not what we do. This is not what we’re good at. So we fund at a larger stage because we require evidence that a solution works and we want to support the replication and the scaling phases. And we come in with larger grants, which I think is useful. Also we fund multi-year and we’re funding more with unrestricted grants. So I think that if you look around and I know you mentioned that looking at the best practices from others, and I think there are plenty of great ideas out there. Just like the Healthy Learners idea and that model that need to go to scale. So I think there’s lots of money needed to actually take to scale the great ideas that have proven to work already.

And also, if you consider as a team, you know, in our foundation, we want to stay lean, and the idea for us wouldn’t be to be using as much energy and time to support very small grants to more organizations. We don’t want to do that. We think we can provide larger grants, keep a lean team and actually support what works so that we can take it to the largest number of people who need those services and deserve it as a right, very often. The right to health, the right to educationAnd this is exactly what we want to support. It’s also a matter, I think, of our priority being the fact that we don’t want our name to be anywhere. We don’t have an ego as to whether we have invented or supported the coolest idea around. It doesn’t matter.

We work extremely well with many other foundations that are actually putting in the effort and the money to actually support startups. And we’re coming later on and we are very complimentary. So I think in our field, we can work extremely well together each of us understanding where they can have a role to play to actually take those solutions to the largest number of people.

Krishna: You mentioned this point around sort of collaboration between organizations and between funding partners as well in terms of sort of supporting organizations at different stages over their journey to scale. I’m curious if you have any thoughts on, or advice that you would give to organizations that are scaling based upon what you’ve seen,based upon the partners that you’ve worked with, on how to put their best foot forward. And what’s the focus on them. You’ve worked with plenty of organizations so far as you’ve mentioned within this, having reached to somewhat more established size, but continuing to grow. And I’m curious your thoughts on sort of what trends stand out in terms of organizations that are best placed to do this and where the biggest enablers are of success, but then also where the biggest challenges are within that journey.

Pascale: I think in that journey, what’s interesting is, and a problem sometimes, is what funders want to see. And I think for organizations that are beyond the stage of R&D and are really on the path to replicating and maybe starting to think about scale is sometimes being pushed to grow too fast, maybe to scale too fast and go to new countries too fast. And, that could definitely be a problem, and this is where we, I mean, all of us from both sides have to be very responsible as to what is the right way to go. And I’m a bit curious to hear from Lonnie whether he’s had that type of pressure from funders to actually go to new countries because he’s made such strides in working with the government and to have the government actually own his model now. So I think this is definitely something that I would want to, you know, say word of caution about growing too fast and going to too many countries too fast.

But when it comes to collaboration, I think there’s a great deal of great organizations that are talking a lot to one another. And I think there’s so much information and knowledge around that I think we can save so much time and energy by actually not starting from scratch when others have tried different things. And this is where also, I think we need toI know we hear that a lot but cultivate also the sharing of our failures, sharing that stuff that doesn’t work. And I think this is such a service for everybody when that can happen. And, we’ve done it early on when we’ve, you know, had to do an evaluation of a collaboration we actually funded in Haiti. And when the University of Tufts did the evaluation, they realized that it was just not working. And they said, can we use that evaluation to go to a conference and show why it didn’t work and what failed? And we thought, yeah, absolutely. We need to do that. We need to actually use that to help the sector just not repeat the same mistakes. So, yeah, these are two things that I think would be important to bear in mind.

Krishna: Yeah, that’s fantastic. Uh, Lonnie, do you want to jump in on that point with respect to the scaling quite quickly, and I don’t mean to put you on the spot, but also very interested to hear your thoughts around this point of how do you learn from what didn’t go well, and how much, how important is that within this process of iteration? As much as what has been done well within the organization and outside.

Lonnie: Yeah, no, I’m happy to talk a little bit about our experience in those two areas. As far as kind of finding that right pace for scale, I think for everyone, when you deeply care about the cause that you’re working on, and you’re seeing a solution in a model that’s having a significant impact, you want to get that to as many individuals and beneficiaries as possible. So I think there’s that internal drive. And externally, I think, you know, the problems that we’re addressing are huge problems. And foundations, similarly, have a desire to see that reach as, as as many folks as possible. And for us, I think communication has been critical in understanding our strategy and where we want to go. And not just in the next year or two years or three years, but where do we see ourselves in five years or 10 years? And for us, from the beginning, we always looked at Zambia as a model for how to address this problem and improve the health and wellbeing of school children that could be replicated to other countries.

That would only happen if we got it right in Zambia. If we worked with the government, alongside the government and really had that government ownership and integration. But we understood that that was going to take time. And so particularly for the first four or five years of the organization’s life, it was ensuring that we had government buy-in,policies, core integration with their administrative structures in a way that would facilitate much larger scale within the country, which we’re currently experiencing. But a lot of the growth we have now is because of that foundation that we laid, between 2014, 15 and 2020. So it was whether that’s evidence of impact but also just deepening that relationship with the government. And from time to time, it’s not an uncommon question to get asked whether, you know, we want to expand to another country because, you know, we do believe that our model is quite replicable. And while that’s something that long-term we are very interested in, we’re mindful that we need to first get it right in Zambia. And we’ve made a ton of progress, but we have a lot of work left to go as well. And I think, when we’ve been successful in communicating that strategy, our partners have been incredibly supportive and understanding that you’re right!”. You know, if you want to have the most impact, you know, the aggregate impact over the next 10 years, really focusing on Zambia for now is the best way to do that. So I think internally having that real clear kind of vision, and then just constantly communicating that has been quite helpful.

To the second question about like learning from what hasn’t worked I feel like we constantly are doing that and iterating and you know, sometimes on really small kind of components of the program, testing out different ways to refine our referral systems or the way that health education is incorporated in school timetables. What we love about our work is every single school that we partner with becomes a little R&D hub. Our schools will, you know, test out,kind of independently of us, new ways of implementing the program, new nuances, that work well for them. And I feel like we’re in a great position with our government partners to identify when schools have really discovered something that works or something that doesn’t work, and then in a place to kind of in a more structured way, take those best practices and test them and incorporate them more broadly across the schools in the program. And so I think our core values as an organization are humble, hungry, smart” and a big part of humility is being open and willing and in fact, eager to identify when something’s not working and then working with our partners to come up with ways to improvethat. A lot of our project, Krishna, that we do with IDinsight, was about as we scale, how do we continue to get that feedback from our partners? How do we know when they’re having challenges or things aren’t working on the ground, but not just downstream where we’re seeing an actual negative implications on the program and output, but further upstream when it’s just, you know, teachers are realizing that I’m struggling in implementing these activities or we’re feeling these pain points in the program. When you’re small, it’s easy. It’s organic. You’re in the same room with your partners on a regular basis. But as we’ve scaled, how do we ensure that we still have that communication? So we can also identify when something’s not working and when our partners see something’s not working. And I think that’s where the project we did to create a more kind of a more structured feedback system where all of our teachers on a regular basisthree, four times a year, are able to provide our organization with what’s working, what’s not working,what we’re doing well, what we could do better, where we’re failing. I think that has been extraordinarily helpful in maintaining quality as we’ve scaled.

Krishna: Yeah, that’s fantastic. Thank you for that I think that point around sort of setting up the foundational systemsin advance of anticipating the problems is a really important one, I think, for any organization. We’ve seen this even within IDinsight, for example, in terms of, as the organization grows, how do we go from that phase of being small, being involved across the board, into having an organization that has a system set up to facilitate growing beyond that.

I’m keen to look forward a little bit now. I think Pascale, you mentioned Cartier Philanthropy is at it’s 10 year mark, and has been in sort of an evolution in the process and in how you support organizations, how you think about sort of providing the support and also the sort of way in which you work in partnership with other funders. And Lonnie, on your state as well, Healthy Learners, is at what seems like a really, really exciting inflection point in the sense of,scaling in general, but then also particularly scaling through government and really taking this model and implementing this model in a way that’s sustainable.

So Pascale starting with you, I’d love to hear you talk a little bit about the future, sort of how you see the focus of Cartier Philanthropy going forward, the areas that are most exciting to you and as an organization, and also sort of how you think about what you’ve learned over the course of the last 10 years, and how you want to implement some of those lessons when you’re thinking about supporting other organizations, including more grantees and continuing to support organizations as they grow and scale their impact.

Pascale: That’s a huge question, Krishna. And we are actually right now with you in a little bit, the past 10 years in looking at all those lessons learned. So that would be the case much more later on, but if I can just quickly summarize the journey we’ve been on. It’s been very much about understanding our responsibility in the field and also being accountable. And if we have a clear mission to improve the lives of the most vulnerable communities, how do we do that and how can we be accountable? And for us, it’s been very much that shift we had very early on when we understood that funding projects for three years and then moving on to the next project and a new country and was not leading anywhere, in the end. And Lonnie is such a good example of how, you know, when he’s talking about his strategy and also challenging his theory of change all the time. This is very much what we thought we should fund. And this is where with long-term funding, and this is the case with Healthy Learners and many of our partners we’vefunded Educate Girls for the past eight years – and we’re going to continue to do that because we keep seeing change and we keep funding that scaling phase.

So that first was very important. That was a big and important step forward in our funding strategy as well. And our board was extremely supportive. So that really gives us a lot of flexibility, as well, and the idea is not to, to bring in new partners all the time that we do, but it’s just staying the course when we see progress, when we continue to see incredible potential for scale. And I think that’s pretty much where we are going? What are we adding? And what is new? What we’re doing is trying to see as well beyond the funding that we provide our grantees, how can we provide additional services that they may need?

And the fact that we’ve partnered with you IDinsight to provide these consulting services to our partners has been extremely useful and very much appreciated. So we want to do that. We’re starting to go in another area, which is more in the area of behavior change. How can we support our partners, identify some roadblocks that they’ve had intochanging those behaviors, which are very complex and difficult. So if they can get help in identifying what they’re not doing properly, what they could do differently to actually then get to that change of behavior that is going to help towards impact. I think this is exactly what we want to do as well. So we’re looking at different ways. And again, we have great support from our board. It is very ambitious as well, so, in the next, I don’t know, maybe 10 years, that’s what we should look at. It is to see the scale that we can help our partners achieve. And I think that’s exactly, it’s not so much impact that we have as a foundation, but it’s more about, how can we foster the type of impact at the largest scale possible that we actually want to see?

Krishna: Fantastic. And I love that message of iteration on a foundation of consistency.

Lonnie, coming to you, curious to hear your thoughts, what is most exciting for you at this juncture as Healthy Learners in terms of what are the areas you’re sort of looking to double down on? What are the challenges you anticipate going forward? We’d love to hear you talk a little bit about the future of whatever time horizon makes moresense.

Lonnie: So, last year in 2021, we signed an agreement and developed a national scale-up plan with the Zambian government. And that will run us through the next three years. So certainly as an organization, I’d say that’s our primary focus at the moment and what that entails, what that looks like – there’s really two arms to it.

So, for us to make sure that we’re growing, not just to reach more studentswhich ultimately is our goal but in a way that’s really strategic to have a multiplier effect. And so we wanted to leverage the scale up to build capacity in the government and to institutionalize the work further in the government. And so working with them, we developed this nationwide rollout, but really focusing on the provincial capital district. We saw the introduction of a new Department for School Health as a really seminal development in our relationship with the government where now, here’s this department that can really own and sustain and scale the work that we’re building together.

But, you know, as a fledgling department, we really wanted to do what we could to make sure this department is receiving the support that it needed to be scaled across the country and to really get off the ground. And so, the best way to do that was to target these provincial centers because that’s where the provincial health and education offices are. So we’re able to a reach large number of children, but at the same time, we’re co -implementing with the provincial and district offices. And so we’re able to work with their staff to build their capacity, their understanding of how to implement school health programs. So we’re able to provide technical support and direct implementation together. And for us, that was really important. We also believed it was important to have a national footprint to continue to generate demand. What we’ve seen as everywhere the program gets implemented,  the response from the community is very overwhelming. Whether that’s from the traditional leaders, the chiefs, the parent teacher committees, the community itself, and believe that having as broad of a footprint as possible, that is going to be really important to create the political will as well, to support this program, to be sustained as a project, as a government program that will be here for decades. And so certainly a lot of our staff are focused on, on that area at the moment.

But the second arm of our scale-up is a randomized control trial that will happen across four additional districts in the Copperbelt province of Zambia. And as an organization, we feel that we have an obligation to not just evaluate our impact once, but to constantly both through our internal programs and systems, but also from time to time through more externally rigorous evaluations to be constantly evaluating our impact and those assumptions that we’re making within our theory of change. Particularly as we’re scaling to new parts of the country, both urban and rural settings, we saw that as a great opportunity to partner with researchers again, to evaluate how our impact is continuing to evolve.

And so we’re working currently with Faculty of Melinda School of Economics, Swiss  Tropical Public Health Institute, the University of Zambia and the University of Virginia to plan a fairly large scale randomized controlled trial across 90 schools. And we’ll have around 12,000 students. That will start in 2023. It’ll run for about three years, but we can also look at the longitudinal impact on education outcomes. And we see that as critical, if not for our scale up in Zambiabecause we’ve already had so much progress with, with the government in terms of policy and adoption. But particularly as we think larger, as we think of how can we make sure that we’re supporting the Zambian government to get the evidence they need to attract funding from other bilateral and multilateral groups, but also to make sure we have the necessary evidence that is going to be important to take the idea and the model we built in Zambia and help to expand to other countries as well.

So kind of looping back to your earlier question of how do we kind of balance that kind of demand and drive to scale potentially to other countries versus, you know, making sure you’re growing sustainably and methodically, I think for us, we very much have that ambition and we see the work we’re doing now is really catalytic for that in the future.

Krishna: Incredibly exciting. Well, this has been a fantastic conversation, with two organizations that are doing hugelyimportant work from different sides of the coin, but very clearly value aligned within that process. And it’s been great to just share these reflections around scale, around growing and enhancing the impact that both of your organizations have as well as sort of where and how evidence plugs into that.

I think there’s definitely some takeaways for me in terms of, from the implementing organization perspective, I think the importance over the course of that journey of taking a step back, continuing to think critically about impact pathways, about the theory of change, about the sort of channels through which a program is going to generate thatimpact, continuing to sort of quantitatively assess the impact and generate the evidence that’s necessary to understand that. And then sort of as growing, setting that foundation to provide the data grounding, to facilitate measuring and, enhancing that impact going forward and really the idea that, while, that needs to be built, it needs to be both sort of lean and as sustainable as possible.

And then I think from the funder perspective, the importance of being a supporter of sort of that level of consistency and support, but then continued thought partnership with respect to getting organizations to think critically about the work that they’re doing, the programs that they’re implementing and the evidence that they’re generating. And I think this sort of foundational element of collaboration across the board with respect to ensuring that we’re not starting from scratch, we’re building on what others have already done that we’re sharing both successes and also challenges and failures with other organizations that are facing very similar challenges over the course of time.

And then also that sort of organizations coming together to support each other, to support implementing organizations through the stages of the journey and vice versa. So, very, very grateful for both of your time. I want to invite you both in case you have anything to close us out on. Pascal maybe, to start with you and then, Lonnie, any closing thoughts.

Pascale: Thanks. That was a very good summary of that conversation, Krishna, thank you. What I want to say is that, I want to remind funders about the accountability that we need to impose on ourselves because there’s nothing in the sector that pushes us to actually provide the right type of support to organizations. So be there. And maybe veryquickly to touch upon the, the technical assistance that, uh, Lonnie very rightly mentioned. And this is yet, I think an area that needs to, um, provide a lot of information and knowledge that we can share across the board because it’s complex, it’s difficult, but we have to make it work.

Krishna: Fantastic.

Lonnie: Yeah, just couldn’t agree more Krishna with your summary and Pascal about the importance of accountability as organizations, not just accountability to our funders, but accountability to our partners and to those that we serve. You know, ultimately we get into this line of business because we deeply care about a problem and we want to do what we can to have a meaningful impact there.

And data is the only way that we can know whether or not we’re truly accountable and making progress. And lastly, we’d like to thank both of you, Cartier for being such transformational partner to Healthy Learners, over the past three years now. And tremendously excited to just recentlyI think I can say thisa new partnership for the next three years, which is so critical to our scale up in the work we’re doing with the Zambian government.

And Krishna to your team and the support that you’ve done and helping to strengthen our internal systems and the way that we’re monitoring and evaluating our program, and using our data as we scale, has been really critical to our team to ensure that we’re maintaining that quality as we continue to grow. So as Healthy Learners, I speak for our team where we’re just very grateful for both of you.

Pascale: Thank you Lonnie, very much. So proud of the work you’re doing. Thank you, Krishna. It’s been a pleasure working with you.

Krishna: Fantastic. Thank you so much. Really appreciated this conversation. Thank you.