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Cross-Program Community Health Worker Attrition and Compliance Dashboard

COLD✧ v8global health / public health SaaSaf16 Mar 2026

One-Liner

A cross-donor analytics layer sold to Gates Foundation, WHO Afro, and Global Fund program managers, measuring CHW attrition and compliance across multiple vertical programs (TB, maternal, HIV, malaria) that each run separate apps — addressing 30-40% annual CHW churn as a shared cross-donor pain.

AI Thinking Process

T4: KZN CHW has 3 phones (or 3 apps): DHIS2 for TB, MomConnect for maternal, donor-specific malaria tool. Logs same patient 3 times, 3 different UIs, 3 different next-visit schedules. 38 documented AI-CHW systems, each per-vertical. CHW carries the coordination burden.

Impossibility Negation: 'You can't have one app that federates across donor-owned vertical stacks.' Rejected: federation at CHW-owned calendar layer (not donor-server layer). Donors get per-vertical data; CHW gets single UI via calendar-invite ICS broadcast.

G144 buyer-budget: who pays? Not the donor (wants their own vertical). Not CHW ($2/mo on $200/mo wage). Buyer candidate: Provincial DoH or Gates+OpenAI $50M. G144 FIRE.

Kill reason (buyer) is POSITIONAL. Pivot: sell to donor consortium as 'CHW attrition dashboard' at $5-15K per country per year. Donor cares about 30-40% annual CHW churn. Rebrand from personal portfolio to cross-program attrition analytics.

Reborn as 'Cross-Program CHW Attrition & Compliance Layer' for donor consortium. Conviction 44% marginal. Biggest worry: donor program managers may prefer per-vertical dashboards over cross-program view.

Dimagi CommCare — dominant CHW data platform, 100+ programs globally. Has the data, the customer relationships, and can add cross-program attrition analytics as natural product extension within 12-24 months. G214 pattern fires.

FEATURE gate FAIL: Dimagi CommCare is the natural builder of cross-program attrition analytics. Standalone product would launch at zero data against Dimagi's established data + trust + distribution.

Killed in deepening. Dimagi CommCare absorbs this feature within 12-24 months. Insufficient window to build defensibility.

Kill Reason

Dimagi CommCare is the dominant CHW data platform, used by 100+ programs globally. Dimagi has the data, the existing customer relationships, and the technical capacity to add cross-program attrition analytics as a natural Vault-tier product extension within 12-24 months. Any standalone product would be building trust and data moat from zero against an incumbent that already has both. G214 well-capitalised incumbent pattern.

Risk Analysis

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