The Success Story of the Outcomes for Change Fund
By Jean Emmanuel Desmornes
Against the backdrop of civil unrest, a quiet transformation is underway. A coalition of funders, investors and implementing partners are seeking to improve how aid is delivered in Haiti—a sector that spends nearly US$1 billion annually. Their aim is to bring accountability, value for money and locally driven solutions to address the country’s greatest development challenges.
Inaugurated by IDB Lab in 2022, this transformative initiative is known as the Outcomes for Change Fund, or “OCF,” as the first outcomes fund in a fragile island state. Envisioned as a mechanism to scale effective development strategies, the OCF was structured by IDB Lab to pool funding, expertise and learning to support meaningful change across multiple sectors, including sanitation, health, agriculture, education and employment. To date, the OCF has launched three pilot projects that are already delivering results and changing lives, showing the value and feasibility of the outcomes-based model for fragile contexts.
Key to the Fund’s success, the OCF pays for outcomes instead of activities. Called “outcomes-based financing” (OBF), this approach seeks to deliver greater value for money—compared to traditional grant financing—by aligning incentives around the agreed outcomes and giving implementing partners greater flexibility to adjust their activities to changing conditions on the ground and achieve maximum impact. Results are independently verified, allowing funders to only pay for what works. In challenging contexts especially, this type of contract provides critical flexibility so that high-impact organizations can build track record and attract increasing amounts of funding while providing funders with a pipeline of high quality and shovel-ready projects to confidently support.
The first OCF pilot is scaling climate-resilient sanitation. In October 2022, Vitol Foundation joined IDB Lab to launch a lifesaving intervention that delivers safely managed sanitation to vulnerable families in Haiti’s northern cities. Implemented by local NGO, SOIL, Paying for Sanitation Success is setting benchmark costs for container-based sanitation (CBS)—a composting toilet that is often the only viable solution for specific neighborhoods, as climate-driven flooding and a high-water table make latrines unsafe. This provides one of the few safely managed sanitation services in Haiti, over 70% of the population lacks access to improved sanitation.[1]
Since its launch, Paying for Sanitation Success has enabled SOIL to achieve considerable efficiency gains over past performance, increasing its monthly installations from 51 households to 134. SOIL has successfully increased access to improved sanitation in target communities by over 25%, surpassing the ambitious targets set at the beginning of the project.
As of May 2025, IDB Lab and partners are finalizing preparations for the scale-up phase, slated to launch in the coming months. Efforts to secure additional funding from both public and private actors are well advanced, with strong interest from several stakeholders. This next phase will build on the benchmark costs established during the pilot, incorporate strategies to achieve economies of scale, and aims to double SOIL’s subscriber base to over 8,000 households—laying the groundwork for a sustainable, climate-resilient sanitation system that supports Haiti’s national goal of ending open defecation.
The OCF is also growing access to lifesaving maternal healthcare for rural Haitian mothers and their infants by paying programs that can successfully increase uptake of antenatal and postnatal services. Joined again by Vitol Foundation, IDB Lab selected Care2Communities (C2C) to implement Last Mile Health to deliver reliable primary health care to vulnerable Haitians in partnership with Haiti’s Ministry of Health. C2C’s low-cost, high-quality public-private partnership model will set a standard for additional future partners across Haiti to achieve universal access to maternal and newborn health services.
The cumulative outcomes of the project to date have exceeded the targets. Through October 2024, over 1000 children have completed their vaccinations, over 250 mothers have given birth in a skilled facility, and over 900 mothers have completed at least four antenatal visits exceeding the goal of over 20%. Among other efficiencies, C2C has seen its staff take greater responsibility for their work and increased performance since adopting an outcomes-based model, which is leading to better outcomes that ultimately benefit local community. The Last Mile Health pilot will be wrapping up its 1st phase of the program in 2025 and is currently looking to secure additional funding for phase two from public and private funders.
In July 2024, the W.K. Kellogg Foundation joined IDB Lab to confront Haiti’s looming food crisis by scaling sustainable and climate resilient smallholder farming across Haiti’s Central Plateau. Seed to Market is led by Acceso and implemented by the Haiti Food Systems Alliance, including the first large-scale test of low-cost soil testing and sustainable farming practices. This project is increasing farmer productivity and income and scale the use of sustainable farming practices by providing quality inputs to 1,000 rural farmers in the Central Plateau and providing training so inputs are used correctly, secure buyer agreements for the expected harvest with Food for the Poor and other buyers, roll out agroforestry practices and basic regenerative practices for all participating farms.
Looking to the future, IDB Lab seeks partners to build on these early successes and scale these first pilots into sustainable businesses with public funding. All the launched pilots, have specific goals for growth, job creation, economies of scale and cost recovery over the coming years and IDB Lab is in talks to launch additional projects in education and employment. To learn more and join the conversation, visit us here. If you’re interested in partnering with us, as a funder, investor, or implementing organization, please contact [email protected].