High-Impact Growth

What does it actually take for a country, government, or community to truly own a technology or an outcome? In this fast-paced and candid episode of High-Impact Growth, Dimagi CEO Jonathan Jackson and co-host Amie Vaccaro welcome back Nithya Ramanathan, CEO and co-founder of Nexleaf Analytics. Moving past polite sector rhetoric, Nithya and Jonathan break down why so many well-intentioned global health initiatives end up in "equipment graveyards" due to a broken "donor-to-hope" value chain. Grounded in her recent Stanford Social Innovation Review piece on country ownership, Nithya unpacks the three critical ingredients of true ownership—financial transaction, genuine control, and intrinsic pride—and advocates for a drastic shift: flipping the historical 80/20 investment split to focus heavily on human operational systems rather than chasing technical perfection. Featuring real-world insights from a recent cross-country ministry workshop on vaccine cold chains, this episode offers an honest look at the iterative dance between technology and policy. The conversation doesn't offer tidy answers, but it pushes the critical questions.

Related Resources:
https://ssir.org/articles/entry/scaling-global-health-innovations  Nithya Ramanathan, Nelima Otipa, and Hosea Kintu lay out a framework for moving from government partnership to country ownership in global health innovation. Referenced directly in the episode.
https://www.nexleaf.org/ A non-profit social enterprise co-founded by Nithya Ramanathan that uses data and technology to improve global health systems, particularly vaccine cold chains.
https://www.gavi.org/ A global health partnership that co-supported the multi-year vaccine cold chain and operational maintenance initiatives discussed in the episode.
Kevin Starr / Mulago Foundation Thought leader behind the concept of "Coke bottle philanthropy" cited by Nithya — the false notion that a single scalable solution can be handed to governments like a product off a shelf.
https://dimagi.com/commcare/ Dimagi’s SaaS product designed to support frontline workers and track community health outcomes at scale.

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Hosts: ⁠Jonathan Jackson⁠ and ⁠Amie Vaccaro

What happens when a health extension worker in rural Ethiopia faces a complex case and there's no doctor nearby? This episode goes beyond the AI hype cycle to explore a live, working answer: HEP Assist, a generative AI-powered call center built for Ethiopia's 40,000 health extension workers by Last Mile Health, IDinsight, and the Ethiopian Ministry of Health.
Abraham Zerihun, Ethiopia Country Director at Last Mile Health, and Sid Ravinutala, Chief Data Scientist at IDinsight, take us inside the real decisions — from choosing a RAG (Retrieval-Augmented Generation) architecture to stay within Ministry guidelines and reduce hallucinations, to creating a virtual assistant named Hawa to make interactions feel human rather than machine. They discuss the surprisingly nuanced cost model for AI at scale, the importance of government buy-in, and why evaluation should be built in from day one, not treated as an afterthought. With 6,500+ AI-supported consultations already completed and 53% of cases resolved at the community level, this isn't a pilot on paper — it's proof that AI can work at the last mile, in local languages, on high-stakes problems, right now.

Related Resources:
Last Mile Health – An organization dedicated to saving lives in the world's most remote communities, by partnering with governments to equip professional community health workers.
IDinsight – A global advisory, data analytics, and research organization that helps leaders maximize their social impact.
The Ethiopian Ministry of Health – The government body leading the digital transformation and AI integration within Ethiopia's national health system.
Data.org – A platform for partnerships to build the field of data science for social impact, which provided support for this initiative.
Clinton Health Access Initiative (CHAI) – A global health organization mentioned as a previous professional home for both guests
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Hosts: ⁠Jonathan Jackson⁠ and ⁠Amie Vaccaro

Imagine a country of 50 million people with only 50 psychiatrists. This staggering treatment gap is the reality in Uganda, but Pavel Reppo is proving that specialized experts aren’t the only ones who can provide life-changing care. As the Executive Director of Finemind and CEO of Matchbox Fund, Pavel brings a rare dual perspective to the conversation, bridging the worlds of grassroots mental health implementation and trust-based philanthropy.
In this episode, we dive into how Finemind upskills primary health workers—such as midwives and nurses—to deliver evidence-based mental health support at the point of care. Pavel explains why true impact must be measured by functional recovery—like children returning to school or improved household food security—rather than just clinical depression scores. We also explore the Matchbox Fund’s mission to rewrite the rules of funding by investing in overlooked local organizations and responding to outreach with dignity. This conversation offers a masterclass in ethical leadership, local ownership, and a radical definition of success: scale as the "reduction of the problem," not just the growth of an organization.

Related Resources:
High-Impact Growth episode featuring Vikram Patel - https://sites.dimagi.com/high-impact-growth-podcast/reimagining-mental-health 
High-Impact Growth episode featuring Kevin Starr - https://dimagi.com/podcast/funders-power-to-change-the-system/
Finemind - https://afinemind.org/about/
Matchboxfund - https://matchboxfund.org/
Sangath - https://www.sangath.in/
Spring Impact - https://www.springimpact.org/
A WHO-developed psychological intervention for people in communities affected by adversity - https://www.who.int/publications/i/item/9789241506816 

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Hosts: ⁠Jonathan Jackson⁠ and ⁠Amie Vaccaro

As traditional funding sources shift, many nonprofits are asking a hard question: can individual giving become a meaningful and sustainable revenue stream? In this episode of High-Impact Growth, Amie Vaccaro and Jonathan Jackson sit down with Javan Van Gronigen, founder of Donate.ly, to unpack what it truly takes to make that transition work.
Drawing from more than a decade in digital fundraising, Javan shares why storytelling—not technology—is the most critical asset nonprofits have, and why so many organizations struggle by committing “random acts of marketing.” The conversation explores how to move from one-to-one fundraising toward scalable, one-to-many models without burning limited budgets, and how testing small bets is essential before going all-in.
The group also digs into the evolving role of AI in fundraising—from speeding up content creation and data analysis to raising new ethical questions about authenticity and trust. Whether you’re testing individual giving for the first time or rethinking your entire fundraising strategy, this episode offers a grounded, honest roadmap for navigating a more crowded and uncertain funding landscape.
Related Resources:
https://www.fiftyandfifty.org/services/engagement-os 
https://www.donately.com/
https://www.charitywater.org/
https://invisiblechildren.com/ 

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If you enjoy this show, please leave us a 5-Star Review and share your favorite episodes with friends. 

Hosts: ⁠Jonathan Jackson⁠ and ⁠Amie Vaccaro

AI is moving fast in global health and development, but good intentions alone don’t guarantee good outcomes. In this episode of High-Impact Growth, we sit down with Genevieve Smith, Founding Director of the Responsible AI Initiative at UC Berkeley’s AI Research Lab, to unpack what it really means to build and deploy AI responsibly in contexts that matter most.
Drawing on a decade of experience in international development and cutting-edge research on AI bias, Genevieve explains why labeling a project “AI for good” isn’t enough. She introduces five critical lenses –  fairness, privacy, security, transparency, and accountability – that program managers and product leaders must apply to avoid reinforcing existing inequalities or creating new risks.
The conversation explores real-world examples, from AI-driven credit assessments that unintentionally disadvantage women, to the challenges of deploying generative AI in low-resource and multilingual settings. Genevieve also shares emerging alternatives, like data cooperatives, that give communities governance over how their data is used, shifting power toward trust, agency, and long-term impact.
This episode offers practical insights for anyone navigating the hype, pressure, and promise of AI in development, and looking to get it right.
Responsible AI Initiative – UC Berkeley AI Research Lab – A multidisciplinary initiative advancing research and practice around responsible, trustworthy AI.
Mitigating Bias in Artificial Intelligence - A playbook for business leaders who build & use AI to unlock value responsibly & equitably
UC Berkeley AI Research (BAIR) – A leading AI research lab focused on advancing the science and real-world impact of artificial intelligence.
Fairness, Accountability, and Transparency (FAccT) Conference – A major interdisciplinary conference on ethical and responsible AI systems.
UN Women – An organization referenced in Genevieve’s background, focused on gender equality and women’s empowerment globally.
International Center for Research on Women (ICRW) – A research organization mentioned in the episode, specializing in gender, equity, and inclusive development.
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If you enjoy this show, please leave us a 5-Star Review and share your favorite episodes with friends. 
Hosts: ⁠Jonathan Jackson⁠ and ⁠Amie Vaccaro