Project: Eye Health Social Impact Guarantee
State of development: Current
Stage of development: Scoping
Stage notes: Vision Catalyst Fund is working with Tri-Sector Associates to conduct a market mapping and issue identification exercise. This exercise will tentatively be completed in March before we move into the feasibility study stage
Type of instrument — Impact Bond: No; Outcomes Fund: No; Social Impact Incentives (SIINC): No; Social Impact Guarantee: Yes; Payment-by-results (no pre-financing): No; Technical Assistance and Market-building program: No; Other: 
Part of a larger outcomes-based financing program: No 
Expected launch date: Q2 - 2023
Total expected project development time: 12-24 months
Expected length of project (years): 2
Project design process began: Q4-2021
Rationale for using outcome-based finance: - Guarantees Upfront Funders the target outcomes that they desire. In the event that these outcomes are not achieved, the guarantee will be called, and they will get some of their funding back.
- Incentivises service providers to focus on delivering outcomes and move away from outputs. 
- Mobilises new sources of funding by providing a guarantee to non-traditional funders of eye health to incentivize the funding of vision-related interventions; the guarantee can be tied to outcomes that are of importance to non-traditional funders (e.g. education or livelihood outcomes)
- Catalyses an inflow of more upfront funding if applied at scale, as the same dollar can be used to guarantee different projects. By developing a portfolio of SIGs, one can create significant leverage by using the same dollar to provide SIGs to multiple projects. 
- Encourages strong performance management through the set-up of formal governance structure and rigorous evaluation practices among service providers so that service providers can continue to build evidence-based interventions..
Key challenges to launch: Funding flowing into the eye health space does not reflect the value that good eye health can bring to society. There is a need to educate stakeholders on the Social Impact guarantee, a new outcomes-based contracting model.
Role of the domestic government — Outcomes funder: No; Service provider: No; Member of project committee: No; No formal role: No; Other: TBD
Service providers identified and selected — Request-for-proposals: No; Direct contracting by outcome funder/investor/intermediary: No; Provider-led deal development: No; Other: 
Feasibility study: No
Proposed financing instruments — Debt: No; Equity: No; Guarantee: Yes; Grant: No; Other: Upfront funding would be structured as a grant, but the funder can purchase a guarantee which gets called if outcomes are not met
Technical assistance grant: Yes — Vision Catalyst Fund has provided a technical assistance grant to Tri-Sector to initiate the development of the project
Estimated maximum potential outcome payment: 3600000 USD
Social/developmental challenge: More than a billion people in the world have poor vision. The solutions are already available for 90% of them through cost-effective solutions like glasses and cataract surgery. Low- and middle-income countries are home to 90% of visually impaired persons. Women and girls experience the majority of vision loss and are less likely to receive care. There is an estimated $410 billion annual global cost of productivity losses associated with vision loss. The World Health Organization estimates it would take $24.7 billion to close the gap for unaddressed refractive errors and cataracts globally.
Poor vision is a major public health problem in Vietnam for school-going children. Over 3 million school children have a visual impairment, and they face challenges in accessing high quality services and assistive technologies. In Vietnam, prevalence of uncorrected refractive error among urban school children aged 6–15 years is 25–40%, which is one of the highest in the world. Of those who have uncorrected refractive error, only 33% of them have access to a pair of spectacles, which 60% of the time is likely an incorrect prescription. Key drivers included the lack of consideration of eye health in prior school health policy frameworks, the lack of guidelines for implementing vision screening during annual school health check-ups for children, poor awareness of the importance of eye health among teachers, and the lack of training resources for school nurses and teachers to provide eye health services and referrals. School eye health is now an important priority for the government. In February 2022, the Government of Vietnam announced the objective of implementing the National School Eye Health Guideline across all schools in Vietnam. 
Expected intervention model: The intervention will work to strengthen the rollout of the Vietnamese Government's National School Eye Care guidelines. Activities will include school-based screening, diagnosis, referral, and treatment interventions, along with educational communications campaigns to facilitate preventative eye care. The programme is taking a systems strengthening approach including capacity building, health system integration and development of new processes. 
Policy sectors — Employment and private sector development: No; Education: No; Social protection: No; Criminal justice: No; Health: Yes; Agriculture: No; Environment and climate change: No; Water, Sanitation and Hygiene: No; Energy: No; Humanitarian: No; Early Childhood Education: ; Other: 
Secondary SDG goals: 3
Target population: The primary target population is school children from 6–15 years old, prioritising economically disadvantaged and ethnic minority communities.
Targeted number of unique service users or beneficiaries: TBD (dependent on the intervention which we are still developing)
Unit type of targeted beneficiaries: Individual
Country income classification of beneficiaries — Low-income: No; Lower-middle-income: Yes; Upper-middle-income: No; High-income: No
Notes: Data for this pipeline project was last updated in April 2022
Delivery location: Nepal, and others, Cambodia, Vietnam, Bangladesh, Indonesia