Miraclefeet

What it reported doing in 2024

Miraclefeet is committed to eliminating untreated clubfoot, a common birth defect that causes one or both feet to turn inwards and down, making walking painful and difficult if left untreated. Affecting about 1 in 800 newborns worldwide, clubfoot is correctible with the ponseti method, the low-cost, nonsurgical standard of care routinely provided in advanced health systems. Miraclefeet works with local partners to increase access to treatment for children born with clubfoot in high-need countries worldwide where fewer than 1 in 5 have access to treatment. More than 95% of cases can be treated at an average cost of $500 per child. (see schedule o for continuation)miraclefeet expands access to clubfoot treatment by partnering with local healthcare providers and governments, providing the organizational, technical, and financial resources needed to create and support clubfoot clinics in low- and middle-income countries. Miraclefeet funds are used to provide treatment supplies like foot abduction braces; hire clinic assistants to provide follow-up and parent education; execute clubfoot awareness campaigns; train healthcare workers in the ponseti method; and create early diagnosis and referral (edr) pathways. All miraclefeet programs are designed to integrate clubfoot care into national health systems, ensuring long-term sustainability through collaboration with local ministries of health, public hospitals, and local partner organizations. In the past fiscal year, miraclefeet and our network of 49 partners enrolled 17,846 new children in clubfoot treatment, and our reach grew to 37 total countries and 515 clinics. Since our founding in 2010, over 116,000 children have been enrolled in care. We worked across west and central africa, east africa, middle east and north africa, south asia, east asia and the pacific, and latin america. Training providers is at the heart of ensuring clubfoot care is accessible and sustainable. This year we facilitated clinical trainings for 1,407 ponseti clinicians at 139 trainings across 27 partner countries. An additional 131 clinicians participated in training through act online, our online platform designed for learning ponseti skills in low-resource settings. Further, we organized three regional supportive supervision trainings and one train-the-trainer course to equip experienced clinicians from our partner countries with the skills they need to deliver high-quality, hands-on ponseti training and mentorship to their peers. Since early treatment in infants leads to faster and less complex correction, we prioritize early detection and referral pathways and provide funding to partners to conduct edr trainings. In the past fiscal year, our partners held 212 edr trainings and an additional 34 community awareness sessions. In addition, the pan american health organization's (paho) online edr training, launched in 2023, has now been completed by nearly 10,000 health workers, mostly in latin america. Prioritizing clubfoot awareness among healthcare providers who routinely see newborns and babies, rather than the general population, has proven highly effective: a large majority of our partner countries now meet or exceed our kpi for enrolling children in their first year of life.recognizing that bracing is critical to long-term treatment success, miraclefeet collaborated with stanford university, suncast, and clarks shoes to develop a low-cost, high-quality brace. Last year, miraclefeet distributed nearly 32,000 pairs of shoes and over 19,000 bars (brace components) to 29 countries.

Financial Efficiency

• Mission deployment rate: 89%; rating input score 89
• Program expense ratio: 79.9%; rating input score 80
• Fundraising efficiency: $7.69 raised per $1 spent on fundraising; rating input score 29; 29th percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: 2 of 6 controls in place; rating input score 33
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Pass
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: 4 of 8 controls in place; rating input score 50
  • Claims monitoring procedures: Pass
  • Requires narrative reports: Fail
  • Conducts field audits: Fail
  • May suspend future funding: Fail
  • Requires financial reports: Pass
  • Conducts site visits: Pass
  • Requires grant agreements: Pass
  • May require repayment: Fail
• Grant itemization coverage: 99.9%; rating input score 100; 42nd percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 91.7%; rating input score 92; 22nd percentile among comparable filings
• Governance controls: 8 of 9 controls in place; rating input score 89
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -11.1%; rating input score 12; 12th percentile among comparable filings
• Total-asset coverage ratio: 1.73; rating input score 57; 57th percentile among comparable filings
• Liabilities to assets ratio: 0.01; rating input score 87; 87th percentile among comparable filings
• Officer compensation ratio: 9.8%; rating input score 30; 30th percentile among comparable filings

Growth

• Program expense growth: 14.7% per year; rating input score 100; 77th percentile among comparable filings
• Revenue growth: 13.5% per year; rating input score 100; 78th percentile among comparable filings
• Asset growth: 17.3% per year; rating input score 100; 79th percentile among comparable filings