Dimagi's mission to revolutionise the world's public health data

CommCare is supporting community nutrition educators in Madhya Pradesh, India. Photograph: Dimagi

The software social enterprise’s COO, Carter Powers, explains how their tech improves service delivery in low-resource communities

How did Dimagi get started?

In 2002, three Massachusetts Institute of Technology (MIT) students started Dimagi out of MIT’s Media Lab. At the time, the field of public health informatics was rapidly growing, but it was still a challenge for small companies to obtain digitised public health data in low-resource settings. When our current CEO Jonathan Jackson took over Dimagi’s operations as the only full-time employee, he focused Dimagi’s mission on creating technology solutions that produce actionable health data in a developing world context.

Today, we’ve stayed true to that original mission, while also expanding into other sectors beyond health. We’re now a 120-person software company that builds technology designed to support frontline workers’ ability to deliver high-value services in areas including community healthcare, agriculture and microfinance. Our primary technology platform, CommCare, is equipping hundreds of organisations with quality mobile applications to support service delivery in underserved areas.

Dimagi joined Business Call to Action in 2011 - how does the company compare today?

Since 2011, Dimagi has grown significantly both as a company and in the impact we deliver. Our team has grown from 25 people in two offices to 120 people spanning five offices worldwide — in Boston, Dakar, Cape Town, New Delhi, and Antigua. In 2011, CommCare was active in six countries; now it is active in over 60.

One big reason for this growth is that our industry has grown significantly too. In 2011, there was less certainty around the impact mobile phones could have on improving healthcare delivery in low-resource settings. Since then, research has demonstrated that appropriate technology solutions can drive positive impact in healthcare delivery. Our growing evidence base has shown us similar results, and has been a motivating factor for us to continue with our work.

What have been your setbacks along the way?

CommCare being used in Cambodia to support and train local entrepreneurs on how to distribute affordable clean drinking water to their communities. Photograph: Dimagi

When running an inclusive business, it can sometimes feel like you are faced with twice the number of challenges because your bottom line is not just about profit — it is about impact as well.

The aid industry in general is challenging because funding mechanisms are volatile. Incentives may not remain in place, and a project can change overnight if a new political administration comes in. Managing priorities and misaligned goals is part of our job when working with multiple partners on a project.

We also learned the hard way that you cannot say yes to everything. When we started off, we rewardedpeople for being able to wear many hats. However, we learned that if you want to lock in a sustainable business model, you have to create space for people to specialise in a particular role.

How are you scaling the business?

One key reason that our growth has been possible is that we invested in making CommCare a more accessible and user-friendly software product. In 2011, all mobile applications built with CommCare required implementation support from Dimagi staff. Now, over 60% of active CommCare applications are built without any support from our staff. Instead, these users are logging onto CommCare and building their own mobile applications — the majority without any kind of programming background. We describe our software-as-a-service (SAAS) customers as “self-starters.”

The increase in self-starters is a testament to our users’ ability to scale their own impact, without having to rely on Dimagi’s support. It also shows that building an inclusive business model starts with building inclusive software. The company has intentionally prioritised building software that is open source, free, supports multiple languages, and is designed for non-technical users. Outside of the software, we also developed extensive support tools and toolkits.

Partnering with governments is necessary to achieve scale and we are gaining more opportunities to work directly with them. In India, we are scaling a project across eight Indian states to strengthen service delivery of healthcare for women and children. This project is expected to cover tens of thousands of health workers, and reach millions of people.

Working with governments has also changed the way that we run Dimagi. Four years ago, our implementation team members were each managing several small projects with 10 to 20 users. Now it is common to have 10 people on our implementation team each working on the same national project.

What drives you?

In one word: paper. What drives us is walking into health clinics and seeing enormous paper stacks of important patient records just sitting there. For all of that paper, you know there are patients that could be and deserve to be receiving better care. Until all health systems are digitised everywhere, we are going to continue working on closing that gap.

How do you intend to grow over the next five years?

We are interested in continuing to see growth in our SAAS customers. We also realise that continuing to work with governments is key for increasing our impact and our software’s scale.

We’re excited about seeing a rapid growth in technologists who are building solutions for low-resource settings. In universities, you are seeing new technology for international development courses across graduate programmes, including in public health, business, medical schools, and more. For the past few years, Dimagi has worked with universities which are teaching students about how to use digital solutions like CommCare to support their research, fieldwork, and future careers. Over the past year, 10 American universities including Boston University’s School of Public Health used our components in their classrooms, including a free course we put together.

Content on this page is provided by Business Call to Action, and originally appeared on the The Guardian Business and the Sustainable Development Goals Hub