We let money follow evidence directly to the people doing work.


Our approach is focused on getting the people who do the work the visibility and resources they need to dramatically improve their systems. We believe that linking funding to individual performance data offers an unprecedented path for personal and systemic performance improvement.



The Problem:


the lack of transparency limits funding and keeps poor people from proven surgical interventions



Pay-for-Performance to the Point-of-Care


can dramatically increase accountability, transparency, and available funding


We piloted a new way to get funding to surgeons


As qualified surgeons submitted patient records, we paid out grants directly to them and gave them the flexibility to use the money at their discretion. We piloted this concept in Madagascar, Malawi, Mauritania and Zambia. This pilot program treated 752 women, exceeding all targets, driving quality and capacity-expansion, and delivering unprecedented cost-effectiveness in line with vaccines.


See the Results

Visibility improved performance and increased donor confidence


The pilot program shattered our paradigm in terms of understanding what causes fistula and how to best approach ending it. Surgeons were more interested in performance data than they were in funding. Funders found our traceable chain a more effective way to confirm impact. Pay-for-performance to the point-of-care creates a market for private care which increases access to facilities, improves quality and performance, and gives donors the confidence that their funds are effectively at work.


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A bridge to link resources with need


Performance-based incentives provided directly to the point of care are the bridge that links resources with need. By connecting funding flows directly to patient outcomes, we create a traceable chain of accountability that gives donors confidence in the impact of their funding.

Building a market for private care that serves the ultra poor


Direct funding to individuals creates a market for private care that increases utilization, improves access to quality care and stems the brain drain. Because the bulk of funds go to discretionary accounts for management use, this chain also yields resources to build broader health systems. Overall, the model delivers flexible resources and valuable data that our partners use to improve the quality of care they provide.

GOFER creates a net that improves systems


Our comprehensive data system creates a “net” that connects local medical practitioners and enables them to address needs in the most sustainable and scalable ways possible. The data validates safety and quality, reveals cost drivers, increases facility utilization, and provides insight into system needs.

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The possibility of collaboration on a scale unlike anything we’ve ever seen


Pushing decision-making authority and operational data to the people who drive patient care, both clinically and managerially, drives innovation. By leveraging technology to share and accelerate this innovation across the global network in real-time, we introduce the possibility of collaboration on a scale unlike anything we’ve seen before.