Why ongoing assessment of top charities leads to more impact: HKI’s vitamin A supplementation program

Charities must meet rigorous requirements to make our list of top charities. However, a common misconception about our work is that our assessment process ends with the naming of a top charity. Not so! We continually examine our top charities—in fact, four staff members are devoted to ongoing assessment of our top charities. We collect information to update our assessment of our top charities’ track records and to evaluate the effectiveness of their spending plans.
Continuous assessment is critical because we direct donations to our top charities on an ongoing basis. Donors can make a gift anytime throughout the year, and we want to ensure their support is directed to the charity or charities that will best use it. We formally assess where funds can be best used each quarter when we allocate “Grants to recommended charities at GiveWell’s discretion” (discretionary funds).
We allocate discretionary funds based on our understanding of charities’ spending plans and their estimated cost-effectiveness. This is heavily informed by our understanding of the cost-effectiveness of the charities’ past work and track record to date. Although our understanding of charities’ spending plans is a key part of our allocation decision, we don’t restrict discretionary funds to a particular purpose within the program we recommend. Organizations may reallocate GiveWell-directed funding as new information becomes available.
This post will highlight how this combination of continual assessment and flexible funding leads to positive outcomes by sharing the recent example of our work with Helen Keller International (HKI)’s vitamin A supplementation (VAS) program, one of GiveWell’s top charities.
HKI’s vitamin A supplementation program
In late 2019, we allocated discretionary funding from GiveWell donors to HKI to support VAS campaigns in Bauchi State, Nigeria, from 2020 to 2022. VAS campaigns target preschool-aged children and are most impactful in areas with high rates of vitamin A deficiency. The World Health Organization recommends that children in these areas receive vitamin A supplements two to three times per year.[1] We recommend HKI’s VAS program because we believe that VAS reduces children’s mortality from infectious disease.[2]
HKI told us in July 2019 that VAS campaigns were ongoing in Bauchi State but that a 2018 government survey found very low coverage rates there. At the time of the survey, only 30% of individuals targeted for VAS in Bauchi State received it. HKI proposed

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