Impact Review: Updates from Charity Entrepreneurship’s Incubated Organisations

By CE @ 2025-05-29T15:22 (+88)

Ambitious Impact’s Charity Entrepreneurship program has now been running for over 5 years, launching more than 50 charities across animal welfare, global development, mental health, education, and many other cause areas. We’re incredibly proud of the work of our founders and the organisations they have built, yet we take far too little time to celebrate their achievements.

In light of this, we’re delighted to share a collection of updates in this post from some of our charities, written by the organisations themselves. We’ve organised updates by rough cause area to make it easier for readers with specific interest areas to jump to the charities working in those spaces.

To pick a few of many highlights:

• To date, over 11,000 health workers in Nigeria have completed HealthLearn's course on basic, life-saving newborn care. Their recent evaluation suggests that the program is 24 times more cost-effective than the GiveWell benchmark of cash transfers.
• In its pilot year, Learning Alliance is reaching 50 schools, serving ~15,000 primary school students, with plans to reach 40,000 students in 2026
• Lafiya Nigeria has distributed 250,000 doses of Sayana Press to date, reaching over 130,000 women with high-quality, reliable family planning counselling and commodities.
• Vida Plena are working in Ecuador to scale community-based interpersonal group therapy in the country in partnership with the public health service, providing effective treatment for depression at half the cost of private therapy.

Read on to learn more about these and many other stories of incredible new organisations developing scalable, cost-effective solutions to pressing global problems.

Mental Health

Vida Plena (2022 Cohort)

The Problem

In 2021, Gallup ranked Ecuador among the 10 worst countries for mental health, and the situation has since deteriorated due to rising cartel violence. Despite this, only 0.04% of the national healthcare budget is allocated to mental health services. Depression now accounts for 8.3% of total YLD, one of the highest rates in the region.

The Solution

Vida Plena's work is founded in Group Interpersonal Therapy, the WHO's first-line recommendation for treating depression. Vida Plena is the first to implement in Latin America.

The Vida Plena approach is:

• Community-Based: We train and offer ongoing support to community leaders and local government staff to facilitate therapy groups
• Proven-Effective: Multiple RCTs have proven that this method works in improving mental health
• Human-Centered: Real people coming together in real time, to share and support one another in weekly meetings over the course of two months

Impact So Far

Psychotherapy improves the recipient’s wellbeing by 0.7 standard deviations (SDs), which decays over 3.4 years, and leads to a benefit of 2.69 (95% CI: 1.54, 6.45) WELLBYs.

When operating at scale, Vida Plena estimates the cost per participant for eight weeks of g-IPT therapy to be $130, which is half the cost of private therapy in Ecuador. Many of their participants would not have access to such services due to their remote locations and lack of affordable care.

Taking into account comprehensive cost-effectiveness evaluations of the Group Interpersonal Therapy model used by Vida Plena, with adjustments based on their cost per person, it is estimated that preventing one Disability-Adjusted Life Year (DALY) costs $1,232, while the cost per improved Well-Being-Adjusted Life Year (WELLBY) is $72.

Looking Ahead

2025 Objectives:

1. Scale treatment: from ≈700 individuals treated in 2024, to approximately 1,500 people in 2025.
2. Expand local government partnerships: Scale the 2024 pilot with the Quito Health Department from 10 to 30 outreach workers facilitating Vida Plena groups and train two additional government teams in other regions.
3. Learning and innovation in evidence-based mental health: Active research partnerships with the University of Toronto and Columbia University to test innovations in the g-IPT model, ensuring quality care during scaling.

Kaya Guides (2022 Cohort)

The Problem

Depression affects 62.5 million Indians annually with 200,000 dying from suicide, yet there are only 0.05 psychiatrists per 100,000 people. India is home to 43% of all depressed people in LMICs, making it a critical intervention point. The treatment gap is enormous—85% of Indians with depression receive no treatment whatsoever. Mental illnesses decrease productivity by about 1% of GDP, yet the Indian government spends less than $3 per depressed person.

The Solution

Kaya Guides delivers the WHO's Step-by-Step program in Hindi via WhatsApp, combining videos teaching self-help techniques, and weekly 15-minute calls with lay counsellors over 8 weeks. Self-help with light-touch human support reduces depression as effectively as face-to-face psychotherapy at a fraction of the cost. They are the world's first NGO implementer of Step-by-Step, which showed moderate to large effects on depression in three RCTs. Unlike most mental health resources in India, which are in English, their Hindi delivery reaches poorer, more rural populations.

Impact So Far

Participants experience an average 5-point PHQ-9 reduction in depression scores, mirroring the WHO's RCT results. In 2024, 40% of participants saw a treatment response (reduction of ≥50% in PHQ-9 score) and 25% achieved remission. At ~$140 per beneficiary, they achieved a cost-effectiveness of 6 WELLBYs (well-being years) per $1,000 spent, which is already 0.7× more cost-effective than direct cash transfers. To date, they've treated 1,145 participants at a current rate of 80 participants per month.

Looking Ahead

By the end of 2026, Kaya Guides aims to scale from 700 to 15,000 participants helped per year while maintaining their impact on depression. They plan to lower cost per participant from $140 to $25 over this period, improving their cost-effectiveness to 45 WELLBYs per $1,000 (~5× cash transfers). This put them on track to lower costs to ~$6 per beneficiary by 2030, which could make them about 5× as cost-effective as StrongMinds, the top psychotherapy charity by cost-effectiveness.

Maternal Health

Access to Medicines Initiative (2024 Cohort)

The Problem

Nearly 30% of pregnancies in Nigeria are unintended. 6 in 10 women of reproductive age in Nigeria have an unmet need for contraception, and fulfilling these needs could avert nearly 11,000 maternal deaths per year.

While many women want to access contraceptives, health facilities run out often, with up to 85% of public health facilities reporting running out of at least one contraceptive method. This undermines trust in the health system and severely limits access for women — especially those unable to afford private healthcare — who want to prevent or delay their next pregnancy.

The Solution

Access to Medicines Initiative (AMI) partners with local authorities to increase contraceptive availability in public facilities by improving data visibility, filling procurement gaps, and strengthening distribution.

Their work ensures that when women seek contraception, it’s actually available — maximizing the impact of existing investments in demand generation, provider training, and facility staffing. By supporting a cost-effective mix of methods tailored to local demand, AMI helps ensure women can consistently access the contraceptives that meet their needs.

Impact So Far

In their first year, AMI partnered with 137 public health facilities across two Nigerian states, training staff to use a mobile-based reporting system to improve data visibility and gain a deeper understanding of how the supply chain functions. AMI provided additional contraceptives to 43 facilities to fill gaps in supply, aiming to cover two months of consumption with each delivery.

Based on their pilot results, AMI estimates their work has provided over 1,100 Couple Years of Protection (CYP).

Looking Ahead

In their second year, AMI plans to expand to over 500 public health facilities, reaching up to 50,000 women with free contraceptives. AMI estimates this will generate 22,000 counterfactual Couple Years of Protection at a cost of $13 per CYP, well below the bar of $26 GiveWell identifies as meeting their cost-effectiveness threshold in Nigeria.

Access to Medicines Initiative is also supporting Katsina state, Nigeria to pass legislation enabling local procurement of contraceptives, complementing existing federal supply. Additionally, AMI are piloting low-cost commodity marking and tracking systems to streamline monitoring and evaluation, reduce overhead, improve scalability, and strengthen accountability.

In the long term, AMI estimates that their work could reach a cost-effectiveness of as much as 55x direct cash transfers.

NOVAH (No Violence At Home) (2024 Cohort)

The Problem

Intimate partner violence (IPV) affects 1 in 4 women globally. Each year, 230 million women endure abuse from intimate partners, contributing to an estimated 7 million healthy years of life lost—likely a conservative figure. Despite the scale and severity, progress remains slow in low- and middle-income countries, with just a 0.2% annual decline in IPV prevalence over the past two decades.

The Solution

NOVAH produces radio dramas that help couples adopt healthier relationship habits to prevent IPV. This edutainment approach—educational messages embedded in engaging content—has proven effective in areas like family planning and sexual health (e.g. DMI, PMC). When broadcast via mass media, it offers high cost-effectiveness. New evidence (e.g. IPA Best Bets review) shows it can also reduce IPV.

Impact So Far

In its first year, NOVAH reached an estimated 30,000 active listeners in rural Rwanda. In a qualitative evaluation, 90% of listeners reported significant improvements in their relationship, and 85% reported better communication. Scaling to Rwanda’s largest radio station could allow NOVAH to reach 1.1M active listeners and prevent IPV in one couple for every 29 dollars spent (which could translate to 100$ per DALY protected).

Looking Ahead

NOVAH plans to improve and expand its radio drama and aims to reach 120,000 active listeners in the next 12 months. A rigorous quantitative evaluation will be conducted to measure its impact on IPV more precisely. The team is also preparing to scale up in a different country.

Lafiya Nigeria (2023 Cohort)

The Problem

In Nigeria, 1 in 4 women want to use contraception but do not have access. Low contraceptive uptake leads to unintended pregnancies, threatening women’s agency and health. The maternal mortality rate in Nigeria is alarmingly high, with a 1 in 22 lifetime risk of death from pregnancy-related causes. Contributing factors include:

• Short-spaced births
• Unsafe abortions
• Teen pregnancies
• Obstetric fistula
• Postpartum depression

In Nigeria, one in four women want to use contraception but do not have access to it. Low contraceptive uptake means that more women get pregnant unintentionally, taking away their agency over their bodies and futures. Unintended pregnancies are also a threat to women’s health. The lifetime risk of a Nigerian woman dying during pregnancy, childbirth, postpartum or post-abortion is 1 in 22, in contrast to the lifetime risk in developed countries estimated at 1 in 4900, this is exacerbated by short-spaced births, unsafe abortions, and births by mothers under 19 years old. Other issues contributing to the DALY burden around giving birth are fistula and postpartum depression.

The Solution

Lafiya focuses on last-mile distribution in ultra-rural areas in northern Nigeria. They upskill health workers and distribute Sayana Press, a 3-month self-injectable contraceptive. If they want, women can receive 3 doses to take home, so they can self-manage their reproductive health for an entire year. This way, Lafiya reaches women who previously did not have access to family planning. 43% of Lafiya's users are first-time ever users of contraception.

Impact So Far

Lafiya has distributed 250,000 doses of Sayana Press to date, reaching over 130,000 women with high-quality, reliable family planning counselling and commodities. Based on modelling by Rethink Priorities, they may have saved 602 lives and averted 48,000 DALYs in 2024. Depending on their scale, their intervention is modelled to be between 11-53x cash transfers.

Looking Ahead

In the next year, Lafiya aims to get their model ready to be tested through an RCT. Next to strategically scaling their operations to other regions, they want to focus on signing cost-sharing agreements with the government, where the state governments incrementally increase their own commodity procurement and training financing, eventually executing the model at scale.

Education

Learning Alliance (2024 Cohort)

The Problem

In Sub-Saharan Africa, most children attend primary school, but 86% of 5th graders cannot read and comprehend a simple paragraph. This lack of foundational reading skills prevents students from learning more complex concepts and passing primary school completion exams, creating a lifelong drag on their educational and livelihoods prospects, and a drag on economic growth, as the foundational learning crisis is so widespread. Governments have made huge investments to build schools, pay teachers, and enroll students, but they have provided very little training or appropriate materials to help teachers be effective at teaching foundational literacy skills.

The Solution

Learning Alliance delivers an intervention called Structured Pedagogy, which is a highly cost-effective, evidence-based approach to improving foundational learning. It includes 3 elements:

1. Simple, daily lesson plans aligned to the science of how children learn to read;
2. Training for teachers on using the lesson plans; and
3. Ongoing coaching visits to provide teachers with advice and encouragement.

Learning Alliance aims to scale an exceptionally cost-effective version of this intervention through an emphasis on rapid, tech-enabled feedback loops for excellent execution and program iteration, and highly skilled coaches who build strong relationships with teachers to achieve high levels of teacher program adoption.

Impact So Far

In its pilot year, Learning Alliance is reaching 50 schools, serving ~15,000 primary school students. Learning Alliance anticipates measuring its impact on reading outcomes by early 2026.

Based on the impact of similar programs, Learning Alliance projects a pilot cost-effectiveness of $37.24 USD per 1 standard deviation increase in reading scores; with cost-effectiveness improving to $8.74 by 2030 as the program scales. This would put Learning Alliance among the most cost-effective learning programs in the world.

Looking Ahead

Learning Alliance expects to complete its initial pilot in Dec 2025 and will likely scale to serve 30-40,000 students in 2026 in Uganda. They will use 2026 to test additional improvements to the program model, as well as exploring opportunities to scale even more rapidly through national government partnerships, partnerships with teacher training colleges, and tech-enabled scaling.

Early Child Health

Taimaka (2024 Cohort)

The Problem

Acute malnutrition is the leading cause of death in under-five children globally. Over 20 years ago, public health practitioners developed a highly effective model for treating pediatric malnutrition – but it’s far too expensive. The complexity and high costs of existing treatment options ($251+ per child), mean that more than 75% of children go untreated.

In Nigeria alone, more than two million children suffer from severe acute malnutrition every year, with 1.5 million+ of them receiving no treatment, resulting in 192,000 preventable deaths annually.

The Solution

Taimaka’s reimagined model cuts the average cost to treat a child to <$100, a 60% reduction from traditional methods. They do that by leveraging digital tools, community health workers (CHWs), and cutting-edge public health research.

Impact So Far

Taimaka has treated more than 12,000 cases of acute malnutrition. They estimate it costs $1,500 - $4,500 to save a life in their program.

Looking Ahead

Taimaka received a grant from GiveWell to support the expansion of their malnutrition treatment program! With this grant, Taimaka plans to treat over 33,000 cases of acute malnutrition in the next two years.

Taimaka also plans to pilot new program improvements and collect additional data to improve their understanding of the cost-effectiveness of their program.

HealthLearn (2023 Cohort)

The Problem

Every year, millions of preventable deaths occur in low- and middle-income countries due to gaps in frontline health workers’ knowledge and clinical skills. This is particularly true for newborn care, where simple practices (such as delayed cord clamping and promoting immediate skin-to-skin contact between the mother and baby) dramatically reduce mortality, but these practices are underutilized, with adherence rates well below 50% in some settings.

The Solution

HealthLearn addresses this critical gap at scale by training health workers in Nigeria and Uganda with engaging, mobile-optimized, case-based online courses. HealthLearn is distinct from many other digital health solutions (for example, data collection tools, chatbots, or clinical decision support apps) because their intervention is specifically designed to deliver in-service professional development to facility-based health workers who are using their own devices.

Impact So Far

To date, over 11,000 health workers in Nigeria have completed HealthLearn's course on basic, life-saving newborn care. Their recent evaluation suggests that the program is 24 times more cost-effective than the GiveWell benchmark of cash transfers, even after applying conservative discounts. The program is becoming even more cost-effective as HealthLearn scales up.

Looking Ahead

In the next year, HealthLearn plans to train more than 25,000 health workers in newborn care, improve their monitoring and evaluation to address key uncertainties, expand to at least one new country, and offer a new course in Nigeria focused on high-impact interventions to improve child health. They are fundraising now to support these critical activities.

Spiro (2023 Cohort)

The Problem

Tuberculosis is the world’s most deadly infectious disease, killing 3,400 people every day. It spreads through the air, so people living in the same house as someone with TB are at high risk of catching it. There is a cheap medicine called TB preventive therapy (“TPT”) that reduces the risk of developing TB disease by 60%. But most people are not getting access to this potentially lifesaving treatment - in Pakistan only 3% of eligible contacts received TPT.

The Solution

We are expanding TB contact tracing programs in Pakistan, demonstrating a delivery model that can achieve high TPT coverage. Our community based model for under 5s removes barriers to care - we go to their homes, connect them with a doctor over the phone, and deliver TPT medicine on the spot - rather than expecting caregivers to take a day off work and travel to a hospital to get their child screened. We also improve services at the hospital to support over 5 year olds getting screened too.

Impact So Far

We ran a 3 month pilot in late 2024 screening 89% of under 5s (short write up, detailed analysis). Since the pilot, the program has continued and we have now screened over 1000 people for TB.

Looking only at program costs, our pilot cost $20 per person evaluated for TB which compares favourable to the $35 per child screened implementer costs modelled by GiveWell for a similar program they have funded.

Our own cost-effectiveness model, again for program costs alone (not including any overheads), models the intervention at less than $3,000 per life saved or 17 times as valuable as direct cash transfer (when including all modelled mortality, morbidity and economic effects).

Looking Ahead

We are planning larger programs in the biggest two provinces - Punjab and Sindh (where USAID has recently withdrawn). We aim to work with the government to help shape the next 3-year strategic plan for household contact screening which will inform the next Global Fund grant. We will also take opportunities to support other NGOs to adopt our model and may expand to a second country.

Healthy Futures Global (2023 Cohort)

The Problem

Syphilis infection can pass from mother to child during pregnancy, with devastating consequences. This is a large problem in public health - syphilis is the second leading cause of stillbirth in the world. Thankfully, it's very straightforward to deal with - rapid finger-prick tests can diagnose syphilis for about $1 and within 15 minutes. Once a pregnant woman is diagnosed with syphilis, a single injection of penicillin protects her and prevents mother-to-child transmission.

The Solution

Healthy Futures Global helps governments make syphilis testing and treatment a part of their normal pregnancy care. They call it the one-stop-shop: wherever pregnant women go for their first antenatal check-up, they should get finger-prick testing for syphilis, and they should be treated straight away if they need it. Healthy Futures gives technical assistance to governments, to roll-out syphilis care at scale. This approach is very cost-effective, because they make use of existing government systems that are already reaching millions of pregnant women.

Impact So Far

Healthy Futures' pilot was very successful, boosting syphilis testing rates from 14% to over 96%, and saving 4 newborns' lives. These results were enough to convince the Philippines Department of Health to roll-out antenatal syphilis care across the country, starting this year. Their work in the Philippines is on track to save a life for less than $4,200, with cost-effectiveness of $140 per DALY.

Looking Ahead

Healthy Futures will continue to support the Philippines in rolling-out syphilis testing across the country. Meanwhile, they are looking to expand into their next country in mid-2025.

Health Policy

Concentric Policies (2023 Cohort)

The Problem

Tobacco and alcohol use kills more than 10 million people combined per year globally–15% of all deaths. 86% of premature deaths from Noncommunicable diseases occur in LMICs.

The Solution

Concentric Policies helps governments adopt and implement WHO 'Best Buys' for noncommunicable diseases by engaging government stakeholders, connecting policymakers with technical experts, producing contextually tailored evidence, and mobilizing civil society.

Impact So Far

In 2024, Concentric Policies helped stop an executive order in Liberia that would have decreased alcohol and tobacco tax rates. From only the change for alcohol products, Concentric estimates its work to prevent the Executive Order had a cost-effectiveness of $192/DALY.

Looking Ahead

Concentric Policies hopes to support national tobacco control policy adoption and implementation in Liberia; complete a municipal policy pilot in Liberia and expand municipal-level work in another country; provide assistance for the implementation of health taxes and the development of tobacco control policy in Guinea-Bissau.

Research

CEARCH (2022 Cohort)

The Problem

New highly cost-effective cause areas remain unidentified and unfunded, which is a potential loss in impact.

The Solution

Additional research and grantmaking to find new ideas (that are more cost-effective than the counterfactual, typically GiveWell in GHD) and then moving both EA and non-EA money towards these new high-impact ideas.

Impact So Far

The nature of our work is very meta and speculative, but our own assessment suggests that our research and grantmaking has an effective giving multiplier of >=10x GiveWell, while CE's previous assessment of such "exploratory altruism" work is that it is 8x GiveWell.

Looking Ahead

For 2025, CEARCH is largely focused on solving our main bottleneck of money moved, and in particular we are spending more time doing outreach to both EA donors and non-EA donors (particularly traditional Asian philanthropists and family offices).

Animal Welfare

Shrimp Welfare Project (2021 Cohort)

The Problem

Over 440 billion shrimps are farmed annually — over five times the total number of all farmed land animals — yet their welfare remains drastically under-addressed. These animals often suffer from extreme conditions such as inhumane slaughter, overcrowding, poor water quality, and painful practices like eyestalk ablation. Despite the scale and severity of their suffering, very few organizations address shrimp welfare directly through advocacy, policy, and research. This creates a unique opportunity to make a large-scale impact cost-effectively.

The Solution

Shrimp Welfare Project focuses on cost-effective, scalable interventions across four workstreams: Corporate Engagement, Farmer Support, Research & Policy, and Precision Aquaculture. Its flagship Humane Slaughter Initiative provides shrimp stunners to producers, removing financial and logistical barriers, and catalyzing commitments from major retailers. Unlike traditional top-down campaigns, Shrimp Welfare Project also directly engages smallholder farmers via its Sustainable Shrimp Farmers of India (SSFI) program to improve chronic conditions such as sludge buildup and high stocking densities.

Impact So Far

To date, Shrimp Welfare Project has signed agreements with 17 producers, reaching approximately 3.3 billion shrimps in expectation per year through the Humane Slaughter Initiative. Seven major retailers, including Tesco and Sainsbury’s, have committed to electrical stunning across their supply chains. The organization estimates a cost-effectiveness of over 1,500 shrimps helped per dollar through stunning, and about 3,300 shrimps per dollar through the SSFI sludge removal program. These interventions are one-off or recurring with minimal ongoing cost, enabling lasting welfare improvements per dollar spent.

Looking Ahead

Over the next two years, Shrimp Welfare Project plans to significantly scale both the Humane Slaughter Initiative and the SSFI program. They aim to increase the number of stunners deployed (projecting a cumulative total of 27 by 2026), including lifting a previous limit of one stunner per producer. In India, SSFI plans to expand sludge removal from 100 to 300–500 acres in 2025 and move toward financial self-sufficiency by testing paid service models. Research & Policy work will support certifier reforms and push for the adoption of the Shrimp Welfare Index by retailers and regulatory bodies. They also plan to develop welfare outcome metrics for Precision Aquaculture and pilot them with Recirculating Aquaculture System (RAS) farms by 2026.

FarmKind (2024 Cohort)

Impact So Far

$85k raised for effective farm animal charities in the 8 months the platform has been live to date.

Fish Welfare Initiative (2019 Cohort)

The Problem

Roughly 100 billion fishes are alive on farms at any given point. Because humans face little incentive to treat them well, these animals often live lives of significant suffering—caused by poor water quality, overcrowding, disease, and the denial of their ability to express their natural behaviors. Very little work to date has been done to understand and improve the conditions of these animals. Learn more

The Solution

Fish Welfare Initiative (FWI) works primarily in India, and works to help these animals in two high-level ways:

1. Research and Development to identify and validate new welfare interventions. Learn more
2. Our farm program, which implements stocking density caps and water quality improvements on the ~170 farms currently enrolled. Learn more

We also run a more nascent program in China.

Impact So Far

We estimate to have improved the lives of 2.9M fishes to date, primarily via water quality improvements made by our farm program in India.

Most of our resources currently go into R&D, not impact-generating programs. So to understand cost-effectiveness, you can divide our most recent year's impact by our most recent year's program budget. This yields a program-specific cost-effectiveness of 10 fishes helped per dollar spent (though note this is different to per dollar donated, as it is program-specific and unrestricted donations also support R&D). Learn more

Looking Ahead

Our main focus for the 2025–2026 year period is to develop new welfare interventions that hit our minimum thresholds for cost-effectiveness, scalability, and evidence-base.

To do this, we are concurrently developing and/or testing the following interventions:

• Water quality monitoring via satellite imagery
• Feed fortification
• Pre-slaughter stunning
• and a few more

Learn more