Facing the COVID-19 pandemic has forced Living Goods to stretch and grow in unforeseen ways, and to truly live our organizational values. We had to take smart risks, embrace radical collaboration, and quickly learn and adapt to an ever-changing context and countless unknowns. Most importantly, we have worked to ensure we always put families first, drive measurable impact across households and health systems, and prevent needless illness and death for lack of life-saving services.   

After quickly putting into place the COVID-19 response plan we outlined in Q1, we have already gathered a wealth of learnings and are reassessing and refining all aspects of service delivery. While it will take more time to fully evaluate the insights we’ve gleaned just in the past few months—and it’s hard to attribute success to one initiative when several changes have been made simultaneously—we thought we’d share a few of our high-level learnings now.  

Free Medicine Distribution 

Living Goods started distributing free essential medicines from April 2020 to reduce preventable deaths in the face of increased facility strain and economic hardship. We believe free medicines have played a key role in increasing the number of U5 children receiving treatment for common childhood illnesses. Qualitative feedback indicates that free medicine has been very helpful for communities, given challenges with transport to reach health facilities, stock-outs of essential medicines, or facilities that weren’t operational at all due to HR constraints or lack of PPE. It may be challenging reacclimating communities to pay for treatments again if we change our approach during a later phase of COVID-19.  

Revised incentive structure  

We adjusted our CHW incentive structure to ensure they remain motivated and supported amidst the crisis, knowing they were facing the loss of jobs and earnings, and the cessation of earnings from  health product sales, which we ceased in the communities where that was taking place. This new formulation has generally increased overall earnings per CHW by 25%, compared to Q1, although earnings have also increased thanks to improved performance. Compensation is now 50% fixed and 50% based on meeting a minimum threshold of health activities each week. Because of the pandemic, Living Goods had to pause an experiment we were doing to determine the optimum amount and structure of compensation. However, there’s anecdotal feedback from the field suggesting high motivation among CHWs as a result of this new incentive structure, with most now hitting the earning target of $20 a month. 

E-Learning

We’re testing the use of e-learning platforms to enable continuous capacity improvement for staff and CHWs in the absence of physical trainings. The reception to these systems has been quite positive, but we believe there’s opportunity to iterate further to simplify content and improve user experience on the platform. Challenges we’re working to resolve include the resource-intensive need to ship phones to branches to install applications that cannot be done virtually, the content is lengthy, and poor phone connectivity and obsolete phone technologies sometimes struggle to support the app.  

Remote supervision 

To support the wellbeing of staff, CHWs, and communities during this phase of COVID-19, we implemented remote supervision to ensure continuous support to CHWs in the absence of physical visits. We provided supervisors with airtime and data bundles to facilitate regular phone check-ins with the CHWs they support. We have found remote supervision to be an enabler of sustained CHW supervision rates, which we believe is having a positive impact on our core KPIs. Supervision costs have also declined considerably, though there have been challenges with ensuring teams receive timely credits and data reloads to effectively do their jobs in contexts with very expensive data rates, and some activities cannot be easily monitored remotely. A big surprise is that some supervisors have reported feeling more efficient in their work and better able to deep dive into performance management issues remotely, so we will be deep diving into these insights to see how we leverage this even after the emergency is over.