Episode notes:

• Follow Abigail and Ash on LinkedIn

• Learn more about the GE Healthcare Foundation

• Get more information from the WHO on the maternal mortality crisis

• Learn about the racial disparities in maternal health outcomes

• Dig into the data that shows most pregnancy-related deaths in the US are preventable

• Check out the Lwala Community Alliance 

• Read about Kenya’s adoption of the O-POCUS guidelines to enhance maternal health

• Dig into the history behind many Kenyans’ mistrust of the formal health system 

• Read about the disparities in maternal health across Kenya’s 47 counties

• Learn more about MacKenzie Scott’s philanthropy

Transcript:

This transcript was automatically generated.

GE Healthcare, the company, was built on scientific breakthroughs such as the technology behind the X-ray machine and the CT scanner.

As important as those breakthroughs are as diagnostic tools, the GE Healthcare team knows that public health is a collective goal.

It's going to take more than one company to help communities get the technology, education, and access they need.

With that in mind, last year GE Healthcare launched the GE Healthcare Foundation, a charitable organization dedicated to funding nonprofits that make healthcare more accessible, personal, human, and flexible.

Today, I get a behind the scenes look at the inner workings of the GE Healthcare Foundation from two different perspectives: the foundation team and one of their grant partners.

It's a unique glimpse at what it takes to make a corporate foundation successful right from the start.

Welcome to Impact Audio. I am Sam Kaplan, vice president of social impact at Submittable. Today, I'm joined by two guests, Abigail Effenay Osweiler, president of the GE Healthcare Foundation, and Ash Rogers, co CEO of Lewala Community Alliance, one of the foundation's first grantees.

They shed some light on what it takes to launch a corporate foundation and how decisions along the way shape the grantee experience and affect program outcomes.

First, here's Abigail giving us some behind the scenes of how GE Healthcare set out a vision for their foundation.

So after GE Healthcare, separated in twenty twenty three, I would say that funding a charitable foundation was an early priority for the leadership team. Advancing health equity has been a priority for GE Healthcare, and the GE Healthcare Foundation is really just building off the company's legacy in delivering care, or access to care to make a difference in the lives of those in underserved communities.

As important as it is to have the initial drive to make a difference, it's essential for a new foundation to get clear about what exactly they're aiming to achieve.

I will say in the beginning, we we have been really committed in creating positive impacts. So we we recognize that it is critical to have a strategically focused mission. So really being focused and intentional was really a priority for us. As you may know, GE Healthcare's business really spans across, several therapeutic areas.

And the company, you know, serves about a hundred and sixty countries. So choosing a focus was really no small challenge, as you can imagine. And, I will say that throughout, most of twenty twenty three, we did an extensive landscape analysis, really looking at at the needs and the areas where we could really leverage expertise in the assets that we have. It was a question of where to start, not should we start this this initiative. And we ultimately, decided we would begin at the beginning where GE Healthcare's technology first comes into a patient's life even before birth.

As the GE Healthcare Foundation team zeroed in on a cause that fit their mission, they also looked outward to identify what outcomes they could influence and what communities were most needed of support. In particular, they honed in on maternal health.

We know that maternal health statistics are grim around the world, even in the US as recently as twenty twenty.

One woman died every two minutes from causes related to pregnancy or childbirth.

And if you look at black women, there are three, you know, to four times more likely to die from pregnancy related complications than than white woman. Also, we know that many, if not most, of these patients, deaths are are preventable.

And, you know, we've also looked at, you know, the CDC work, which estimates that over sixty percent of maternal deaths could be avoided with proper care and timely interventions that, you know, that's a huge potential of improvement.

That is why, honestly, we're investing in the training and development of primary care providers, including midwives, to really help this agenda.

In choosing maternal health as their focus, the foundation leans into the reputation of GE Healthcare, the corporation.

This kind of alignment, especially for a new foundation, can be incredibly powerful. It allows you to build on the trust that you've already established as an organization.

The team spent months really evaluating the needs in the care pathways, whether it was cardiology, oncology, or neurology. Right? All areas where GE Healthcare has expertise in. And when we looked at where we could focus the foundations first programs, we drew upon strength of the company's expertise and legacy in really maternal and infant care, which is a big part of where we've played as an as an organization.

For more than thirty years, I mean, GE Healthcare has offered really a portfolio of solutions that help meet the the needs of providers of maternal and infant care. And I would say that it has also built a trusted reputation among providers of care to moms and infants.

For corporate foundations, relationships with nonprofits are a key component of the work. The GE Healthcare Foundation team invested time into identifying community organizations that truly fit their goals.

Our team did extensive research to really understand which sort of nonprofits were working in the spaces where we wanna participate, in what geographic, regions they worked, who their funders were, what their programs, what their KPIs were, and more. We met with them to discuss their goals and expansion plans for the future and really evaluated whether their projects were a good fit with our resources because resources matter. It's not like we have endless resources.

And then we we then issued, an RFP and evaluated their specific proposals and budgets, make sure that it fitted in where we were trying to to go as an organization.

Choosing the right nonprofit partners means finding organizations with a similar mission. But beyond that, it also means finding partners that complement a foundation's identity.

For the GE Healthcare Foundation, the best partners were nonprofits that had already established themselves.

Look, because we're we're a new foundation, right, with a small staff, it was really important to work with organizations that were proven, had a a track record of delivering results, and really maintained trusted relationships in their communities. We sought organizations that had capable staffs with experiences working through their corporate foundations.

We also were interested in working in geographic areas where GE Healthcare has personnel who could really maintain in person relationships with the grantees working working locally.

Within the partnerships between corporate foundations and nonprofits, trust is essential. As the GE Healthcare Foundation team builds relationships, they do so with an understanding that they're resourcing work that was in process well before they arrived. And the role isn't to dictate, but to provide support for nonprofits to scale their solutions.

Your grantees are the true experts on the ground, so trust that. You gotta trust your grantees.

However, be active in finding ways to help them scale solutions. I think that's the ultimate piece You've talked about, you know, even with local government officials, how that can drive scale and and and impact for for those communities. I think any way that you as a foundation can help create those levels of scale scalability, will be quite important.

Most nonprofits don't have the infrastructure and reach that their corporate partners do, so there's an opportunity for foundations to provide support beyond the funding. For Abigail and her team, that often looks like connecting their nonprofit partners to a broader network of funders.

So our our team has regular calls with our grantees throughout the year to discuss what they are working on, what they need, how they can can best be helped. That might mean an introduction to, healthier projects or or making connections successful projects, but really drive meaningful change, which requires really true collaboration. Right? We we know we cannot do it all based on the the pool of funding that we have, but we also know that there are other, collaborators that are willing to partner with us and our grantees to maybe amplify the work that we're doing and take it to another level. And so, we we we try to do that for them.

For a new foundation, it's important to build an impact measurement strategy that tracks short term progress toward long term goals. Although the GE Healthcare Foundation aims to decrease maternal mortality, they know in the short term that's not a reasonable measure of success for their programs.

So their focus in the near term is increasing access to care.

I think it'll take more time, but, you know, in the first year, we're we're really trying to see how we can help increase access to maternal and infant care for those in in need. We're also seeking to really, you know, accomplish several different ways, whether it's including, you know, pool of health care workers trained and performing critical maternal scans, whether it's conducting research to remove biases with AI. So we're we're doing things that will help. Eventually, I think we'll be able to measure those things. But I I I would say most importantly, collaboratively, you know, really defining measurable outcomes tailored to pretty much each initiatives. You know, the the metrics that will come out of that will be able to inform us and make better decisions and where we invest in the future. But I wouldn't say we have that data today to do that, but we will get there, eventually.

For Abigail, there is a very personal component to the work she leads at the GE Healthcare Foundation. And I think there's such power in having a personal connection to a cause and really understanding what's at stake.

I come from very far. So originally from Cameroon, West West Africa.

I always go back, I've shared this story before, to growing up in Cameroon and spending time in a small town called Lukumba, in Cameroon where my grandparents lived. And there was a a young woman who was pregnant and, left the the town to go give birth in a neighboring town, and, unfortunately, she never came back.

I will say, fast forward to me moving to the United States and being pregnant with my first child. And I'll be very frank. I I was actually scared and and wondered. And as I remember that story, because it was something that really stuck to me if I would've experienced the same faith. Right?

But I was very fortunate. I did not. I was fortunate to be in America, and be able to get the best care that I could at the time and had a healthy baby. So, look, I know not, so many people are fortunate to have that. And so for me, it hits a little personal that this work is a great cause, and one, just being a mom that I can relate to, no mother either losing their child or not having the right care for themselves in these times of giving birth or childbirth.

When the GE Healthcare team looked for organizations whose work aligned with their mission of reducing maternal mortality, the Lewala Community Alliance was a clear fit. Lewala is a Kenyan based organization focused on improving health through systems change.

We spoke with Ash Rogers, co CEO of Lewala Community Alliance, to learn about the grant making process from their vantage and what the foundation's support has meant for their work.

GE Healthcare Foundation, is is really just recently launched, and Lewala feels really excited and proud to be one of these inaugural grantees of this new foundation. And their vision is really about reducing maternal and child mortality, improving maternal and child health outcomes globally, and Lewala is working with them to try to solve that challenge in Kenya.

I really love that GE Healthcare Foundation has taken a holistic systems level view of the challenge, and that fits well with Lewala's community led health model. So we're working together to think about what are some of the barriers that mothers face to receiving high quality care. And so the grant supports that work that we're doing in community organizing with community health workers, and it zeros in on one of these skills and technologies that's missing at the health facility level. So the WHO recommends that every woman receive at least one ultrasound screening during her pregnancy. And the reason for that is that you can, identify high risk conditions. You can make better predictions about birth timing. You can look at fetal size and position.

All of these things help to improve the care that a team's able to provide to a mother during her pregnancy and during labor.

And yet less than five percent of Kenyan women are receiving an obstetric ultrasound. So there's a big gap in what best practice is and what is the current standard of care. And technology is not the barrier. There are many low cost, high quality mobile ultrasound, machines on the market. And great companies like, GE Healthcare, but many others are innovating additional technology in that space that we know we're gonna increasingly come to the market. But the gap is that right now, we don't have enough stenographers to be able to actually use those machines and take those readings.

And some estimates say that it would take it would take Kenya approximately two decades to produce the number of stenographers that we currently need for our current need. And so the women can't wait that long. We have pregnant women who, need care now. And so, really, we're envisioning with the Kenyan government what can we do to make obstetric ultrasound more accessible.

And so the Kenyan government has come up with new task sharing guidelines to allow stenographers to oversee other health practitioners in being able to do initial screenings and then to escalate those more complicated cases to higher skilled technicians. And so those new guidelines, Lewala has been participating in, and they have just been launched this year. And so in this partnership with GE Healthcare Foundation, we will be implementing a pilot of those new guidelines providing, in in in the course of doing that, we'll be training, over fifty health workers on using, obstetric ultrasound.

That'll be across twenty eight government health facilities, and it'll come with a study that helps us learn, but more importantly, helps the government learn what the efficacy of those guidelines are and be able to glean some implementation insights so that as government works to roll them out nationally, they can do so in a way that really increases, quality to obstetric ultrasound services. And really, the vision is that every pregnant woman in Kenya would be able to have access to an obstetrical ultrasound.

A big part of what makes Lewala's work successful is that they understand the culture and historical context of the challenges community members face.

Founded by two brothers who grew up in the area, the organization has built a strong reputation and earned trust in the community.

That reputation is one of the big reasons Lewala is such a great grant partner for the GE Healthcare Foundation. Because Lewala has those community connections needed to make real progress on the ground.

Ash shares a bit about what this history looks like.

So when the organization was first founded in two thousand and seven, That was really the height of the HIV pandemic.

It was a time when there were was very little access to health facilities, and to to treatment really of any kind.

And, also, one in which the region that we're working is one that has been historically under resourced, has been outside of political power, and has seen, fewer investments in its health system.

And that relationship that that has happened in many communities in Kenya, and it has really broken down trust between communities in the formal health system where people feel through a lot of, a lot of direct experience that perhaps the health system is not going to provide services to them.

If they travel long distances to get to a health facility, They might be faced with financial barriers to actually receive care. There may not be a health worker there. There may not be the drugs that they need to save their life. And so people have really, really pulled away from the health system.

And in two thousand and ten, Kenya had a new constitution that brought in decentralization and devolved a lot of power into county governments. And so now you had more localized leadership that had real economic power, as well as authority to be able to deliver health services, particularly as within the mandate of county governments. And that brought the health system a lot closer to people. And you also saw at a similar time, greater investment in health infrastructure and health services and greater commitment from the Kenyan government towards universal health coverage and making health care more accessible to people.

And McGorry County where Lewala has been founded certainly experienced that and saw an increase in health services.

At the same time, Lewala felt it was really important to meet that those increased investments with change within the population of people really feeling like they could own their health system. They could participate in their health system and be part of improving health outcomes. And so that is really the idea around Loala's community led health model. We start by organizing communities to participate in their local health facility, in their subcounty and county level government processes to launch their own health initiatives.

And then we pay, train, supervise, and digitally empower community health workers to provide care to their neighbors and to link them with government health facilities. And then we support government health facilities to improve the quality of care that they're providing.

And from that model, we're seeing real improvements in health outcomes. We're seeing, big increases in antenatal care visits. In skilled delivery, we're at nearly a hundred percent skilled delivery. We're seeing, two point eight times increase in the percent of women who are using modern contraceptive methods. We're seeing decreases in, under five mortality, decreases in infant mortality.

And so we know something is working. People are more likely to seek care, and the care that they receive is improving in quality.

Lewala understands how their community's history shapes individuals' current views and practices. As the organization crafts its programs and goals, it does so with this understanding top of mind. So for Ash and her team, building trust within the community is a top priority.

It's essential first because the diagnosis of the problem is not just that the health services aren't there. That's part of the problem, and it's important to improve the quality and access to health services. But it's also that people have been taught by the system itself not to seek care, that it's gonna waste your time, that you're not gonna get the care that you need, that you need to find it some other place. And so rebuilding trust, rebuilding the relationship between communities and the formal health system is really fundamental to solving the challenge.

The other is that just government health facilities, a nurse, a doctor, they can't be everywhere. And so you need community members to be able to support each other and to be able to get resources, testing treatment, diagnosis prevention at the last mile. And that's really what a community health worker can provide as well as and this really comes to the root of the the program that we're working on with GE Healthcare Foundation.

You have a a human resource challenge of the we just do not have the number of skilled providers that are required to provide the care that this rapidly growing population needs.

And so you need to be able to task share, to shift tasks that maybe a medical officer might do or a a doctor might do, that a that a nurse might do, to be able to share those tasks as appropriate with community health workers so that there's care that's accessible to every home and that not every condition requires that a client come into a health facility.

As part of their work, Lewala collaborates directly with the Kenyan Ministry of Health. This relationship allows Lewala the traction they need to influence policies and potentially scale solutions.

The guidelines Lualoa has helped craft around health screenings and how providers share tasks are one of the early outputs of this partnership.

Just last month, government launched these new guidelines, put them out into the world is as kind of the stake in the ground of what they would like to see happen.

And we've worked together with Ministry of Health to start training health providers.

We did our first set of trainings just last week, and we'll be training successive cohorts of health providers this month and next month. And so those health providers then will start the screenings for for women, and we're following along with this research that we're doing. We'll run that for about six months and then look at that research, look at the data that we've come with, go back to Ministry of Health, with some recommendations.

And then likely, there would there could be future phases of the work either to go back and ask additional questions or to start partnering with government to really scale up the implementation of those guidelines nationally.

Lewala was intentional about building relationships with government agencies so that they could make a difference across all of Kenya, not just in one village. Having a funding partner like GE Healthcare Foundation was key to forming and sustaining the relationship.

That's absolutely the vision, and it's possible because we've started with collaborating with government from the beginning. And that's something that GE Healthcare Foundation has been really supportive of and and aligned in and and has also been really patient because we needed to line up a bunch of things to be able to to to position this way so that we're positioned well with government. We needed IRB for this study. We needed to wait on the government's timeline for launching these guidelines.

And the way that GE Healthcare Foundation does its funding and the way that they team up with us allows it just allowed for us to take that time and to invest deeply in the relationship with Ministry of Health.

With the partnership with the Ministry of Health, the Lewala team sees a lot of potential for the future with a good chance to save women's lives.

I think that there is a very clear pathway to ensure that every mother in Kenya is able to, access an obstetric ultrasound during her pregnancy. That feels really achievable. And there's a lot of other technologies that could follow a similar scale pathway.

The real optimistic point is that you have, new technologies, heat stable carbetocin.

You have new technologies around. There's a nonpneumatic anti shock garment for for postpartum hemorrhage. There's great technology.

There we know AI is coming into this space and that's gonna allow so much more analysis to happen quickly.

And so you can see a pathway to getting these life saving technologies tested, approved, and aligned with government, make sure that the policy framework is supportive of new technologies coming in, and then getting them actually distributed through Ministry of Health System. So make sure that as health workers are doing their preservice training, that it includes these new packages, that we have in service training as new technologies come in, and that then we're working through national supply chains to make sure that the technologies and commodities are available to, really across every county.

And that doesn't take a lot more resources. That's what's exciting is that there's a way to do that within a budget envelope that's feasible for for government and development partners. And if we're able to do that, we can absolutely reduce maternal mortality. You know, there's forty seven counties in Kenya, and just fifteen of them contribute to ninety percent of maternal deaths.

And so even if you can just focus on this highest burden counties where most of the deaths are taking place, you can really shift the story for the whole country.

As a community nonprofit, Loualla's work hinges on the partnerships they build, particularly with funders. Throughout her experiences, Ash has seen a shift in how foundations are choosing their partners and what's expected along the way.

I would say that we are absolutely seeing a shift in philanthropy away from traditional models of an RFP and, like, a traditional models of an RFP and, like, a highly skilled, large bureaucratic foundation team that feels like it's their job to create projects and then kind of get grantees to comply to them. We're also recipients of a Mackenzie Scott gift and so are really big fans of her vision for philanthropy and really the shifts I think that we're seeing oftentimes from, women who female philanthropists who are increasingly holding more power and more resources in the space, and it looks like we'll continue to do so.

And the way that they are thinking differently about philanthropy. And I think GE Healthcare Foundation absolutely falls into that trend. It's a very trust based approach that they have. It was a relationship focused approach.

They really wanted to know us. They wanted to know what our visions were, who our partners were, how we thought and saw the the work. And then the, you know, and then they asked great questions about the project that we were putting forward, but they but really, they trusted us. And the process also went very quickly.

We had several calls. We sent back and forth several documents, but they were able to make the decision quickly. And then the role that GE Healthcare Foundation sees for itself, I think, is both one of funding, but also one of of ongoing support and connections. And so they've made great connections for us.

They've helped us elevate the positioning of the project.

They have great folks on the corporate side who have really good guidance, and experience about how do you bring something to scale. And so as a corporate foundation, GE Healthcare Foundation is able to bring those kind of skills and expertise and access as well that I think is is unique as compared to some other, private philanthropists.

As norms shift across philanthropy, Ash and her team have seen some funders make it a priority to ease the burden on foundations. And when funders decrease the work grantees have to do to secure funding, they free those organizations up to focus on things like collaborating with government partners and community members.

In my previous work, was part of several different funder coalitions, funders coming together and be like, let's work together, which by the way, funders often ask nonprofits to do. And always like the moonshot of any of those funder collaboratives that I participated in was, what if we made a common application?

And that seems doable. It's like we know that universities have done this. It is you there's I've we we've I've written lots of grant proposals in my life.

I've you know, there's very few questions, and I'm like, wow. What a unique, insightful way to ask the same question. It is it would definitely be possible to have a common application.

That always fell apart, and I think that it's because foundations just often don't have much incentive to collaborate with each other. But if they did and there was the generation of a common application, that would be beautiful.

Or found it if you're in no individual foundation can do that on their own. But what individual foundations could do there on their own is just ask for other people's, applications and ask for other people's proposals. And we do have funders who do that, who will tell us, just send us your strategic plan, your most general proposal you've written lately, your audited financials, these common things, and then we'll just come back to you with some specific questions.

And that really makes the work a lot easier. Or like a Mackenzie Scott, they ask you nothing. They can we have a website where, actually, all of that exists.

They do their own research. They ask they go to the our funders. They can figure out who our funders are. They go to our funders. They ask those funders for all of the things they're interested in, and then they just give us money. And that is also a welcome surprise.

Seeing a partnership like the one between GE Healthcare Foundation and Loyola Community Alliance makes me hopeful. They're both so committed to making real progress for women's health, and they're finding ways to lean into their strengths together.

I think they're a great model for other funders and grantees to look to for inspiration. Here's how you build an effective partnership and create systems change.

That's That's all for me today. Thanks for tuning in to Impact Audio, produced by your friends at Submittable. Until next time.