Possible
Impact Rating

# Possible

Top Health Nonprofit

Impact: $5,900 saves the life of a child. Community Health Worker Intervention meets the benchmark for high cost-effectiveness. The nonprofit averts a disability-adjusted life year for less than the country's G.D.P. per capita. Note: The impact of this program may not be representative of the entire operation of Possible . Governance: Passes checks Mission Possible, a US-based non-profit, and Nyaya Health Nepal, a Nepal-based NGO, have partnered over the last decade to provide quality, accessible care to underserved communities in Nepal. Currently, we work in two districts in Nepal: Achham in the Far-West and Dolakha, which was devastated by the 2015 earthquakes. Our more than 350 staff provide integrated care from home to hospital to over 200,000 community members, provide over 150,000 hospital visits, and conduct over 8,000 surgical procedures annually. Cause Health Rated Program Community Health Worker Intervention Program Geography Nepal Headquarters New York, NY Website Donations processed by the nonprofit. Cause Health Rated Program Community Health Worker Intervention Program Geography Nepal Headquarters New York, NY Website Impact Calculator: I'd like to give$ 0

Impact Calculator:

#### Rated Program

###### Program

Community Health Worker Intervention

###### Activities

Community Health Workers deliver community-based care facilitated by mobile technology. Community Health Workers manage reproductive, maternal and child health, promote self-efficacy and social support, and make timely referrals for major causes of morbidity.

Community Health

###### Beneficiaries Served

People living in poverty
Children and youth
People with illnesses

###### Geography

Nepal

Outcomes: Changes in people's lives. They can be caused by a nonprofit.

Costs: The money spent by nonprofits and their partners and beneficiaries.

Impact: The cost to achieve an outcome.

Cost-effectiveness: A judgment as to whether the cost was "worth" the outcome.

#### Outcomes

###### Outcome Metric

A child's life saved.

To calculate impact, we estimate how many outcomes the nonprofit caused.

###### Data Source

Outcome data collected through a study which implemented Possible's CommCare system. The study included reproductive-aged women and children. The baseline (endline) measurements signify the start (end) of the intervention in a particular village cluster based on stepped-wise implementation.

###### Time Period of Data

July 1, 2015, to June 30, 2018

Ratings are based on data the nonprofit itself collects on its work. We use the most recent year with sufficient data. Typically, this data allows us to calculate direct changes in participants' lives, such as increased income.

###### Method for Attributing Outcomes

The counterfactual is estimated using the change in infant mortality in the far-western development region of Nepal from 2011 to 2016.

To determine causation, we take the outcomes we observe and subtract an estimate of the outcomes that would have happened even without the program.

#### Cost

###### Data Source

Cost data reported by Possible and data and assumptions about partner and beneficiary costs.

All monetary costs are counted, whether they are borne by a nonprofit service deliverer or by the nonprofit’s public and private partners.

#### Impact

###### Impact Statement

\$5,900 saves the life of a child.

We calculate impact, defined as the change in outcomes attributable to a program divided by the cost to achieve those outcomes.

#### Rating

###### Benchmark for Rating

Impact ratings of community health programs are based on the cost of a disability-adjusted life year (DALY) averted relative to the G.D.P. per capita of the country in which the program operates. Programs receive 5 stars if they avert a DALY for less than than the G.D.P. per capita, and 4 stars if they avert a DALY for less than three times G.D.P. per capita. If a nonprofit reports impact but doesn't meet the benchmark for cost-effectiveness, it earns 3 stars.

###### Determination

The nonprofit averts a disability-adjusted life year for less than the country's G.D.P. per capita.

#### Why We Could Be Wrong

We welcome your suggestions for improving our methodology. Our methodology section includes explanations of how we mitigate these issues.

• The outcome could oversimplify total impact. "A child's life saved" does not take into account the reduction in ill health and disability that the program caused.
• There could be multiple important outcomes not captured in our analysis.
• Possible may be spending additional money in order to serve harder-to-reach and/or particularly valuable populations.
• In the absence of better data, we assume uniform counterfactual rates for programs, at the risk of masking variation across nonprofits.
• Our estimates rely on data made public by Possible on its website, annual reports, financial statements and Form 990s.
• We only analyze programs that meet our criteria. As a result, this report may not fully reflect the impact of Possible .
• We do not assess what explains the nonprofit's cost-effectiveness.

We assign a rating to the nonprofit using the rubric:

• There are indications of governance or financial health issues at the nonprofit.

• After being given an opportunity, the nonprofit chose not to publish impact information.

We are not yet issuing this level of star rating.

• The rated program does not meet our benchmark for cost-effectiveness.

• The rated program is cost-effective.

• The rated program is highly cost-effective.

#### Nonprofit Comment

Not provided. This may be because we lacked contact information for Possible or it chose not to comment. If you are a representative of this nonprofit, contact us to review and comment on your rating.

Before publishing, we ask every nonprofit we can to review our work, offer corrections and provide a comment.

###### Analysis Details

Analysis conducted by ImpactMatters and published on November 22, 2019.

This rating is based on data reported by Possible using ImpactMatters' impact reporting platform. Using data from the platform, ImpactMatters analysts calculated impact and assigned a rating.

We welcome corrections. If you are interested in exploring applications of ImpactMatters data, contact us at partnerships@impactmatters.org.

#### Governance Check

Possible passes our governance check.

Conducted a financial audit

Overhead spending is reasonable (<35% of total spending)

Charity Navigator has not issued a fraud or mismanagement advisory

Possible itself has not reported any material diversions of assets

Possible itself has not reported any excess benefit transactions

Source: Possible Form 990 and Charity Navigator

#### How We Calculate Impact

This rating is based on ImpactMatters analysis of the impact of Community Health Worker Intervention relative to costs. Impact is the change in the social outcomes of people served by the program, net of the change that would have happened even without the program (the “counterfactual”); divided by cost. Learn more.

A guide to our process for analyzing nonprofits and assigning ratings.

Learn about best practices for reporting impact for different program types.

Our collected guidelines on how we analyze impact of nonprofit programs.

Rating is a complex exercise and we urge you to read our frequently asked questions for details of how and why we issue these ratings.