World Lung Foundation

What it reported doing in 2014

Reducing maternal mortality: overview & executive summarythe maternal health program in tanzania made significant progress in supporting the provision and utilization of good-quality comprehensive emergency obstetric and newborn care (cemonc) in rural areas of tanzania. In the 15 wlf-supported health centers and hospitals in kigoma, morogoro and pwani, more women delivered and were treated on-site rather than being referred out to distant facilities. The thamini uhai (value life) campaign taught women and their families in the kigoma region the benefits of delivering their babies in health facilities.wlf worked toward the sustainability of all interventions, as well as transitioning responsibility and oversight of its activities to the local tanzanian government. Lessons learned from the project were shared regularly with tanzanian government officials at all levels, and media coverage helped to spread the lessons from the project to even wider audiences.family planning: in partnership with the government of kigoma, wlf launched the thamini uhai (value life) media campaign in october 2014 with the objective of:1. Making the risks of home delivery more salient 2. Increasing knowledge of pregnancy danger signs3. Encouraging families to make a birth plan, including planning for costs/transport/supplies 4. While considering structural barriers, tipping the balance towards facility delivery.the second phase of thamini uhai focuses on the longer term benefits of contraceptive use.maternal health: the maternal health program made great progress towards maintaining rural communities' access to high-quality cemonc and increasing utilization of those services.in the 15 wlf-supported facilities:1. The number of deliveries increased by 19.5% (from 21,809 to 26,055);2. The number of cesarean sections increased by 6.7% (from 2,427 to 2,590); 3. The number of vacuum deliveries increased dramatically (from 34 to 396);4. The number of referrals out from the 10 wlf-supported health centers to hospitals was halved (from 460 to 215).5. Facility-based maternal and neonatal mortality, relative to the number of deliveries, decreased over the reporting period.6. To maintain and improve the quality of clinical care provided at the 15 wlf-supported facilities, wlf provided support to trained assistant medical officers (amos) and clinical officers / nurse-midwives in the provision of cemonc and anesthesia. Monitoring, mentoring, and supervision support included: a. Post-course assessments (pca) to supplement the initial four-month competency-based cemonc training course b. On-site supervision and mentoring visits -all 15 wlf-supported facilities received monthly supervision and mentoring visits, later changed to a quarterly basis. C. Monthly monitoring template and clinical audits to capture clinical problems and identify examples where the quality of care and decision making improved over time. This includes routine service statistics, and clinical audits of cesarean sections, maternal deaths, stillbirths, neonatal deaths, and near misses. D. Weekly calls e. Continuing medical education (cme) workshops f. Emergency call system: for health providers to access a senior clinician at any time for consultation on emergency cases.7. Health centers were upgraded with appropriate information communication technologies (ict) to enhance reporting, case management and learning8. To address the challenge of staff retention, two 2-in-1 houses were constructed at nguruka health center (kigoma) and one 2-in-1 house was built at mlimba health center (morogoro). In addition, staff houses at mabamba health center (kigoma) were renovated. Work was completed in early 2015.9. Media advocacy efforts included earned media through news conferences and feature placements, journalists' trainings, editors' forums, a newspaper supplement and social media.10. Wlf made great progress in strengthening its relationship with the tanzanian government at the national, regional and distr

Financial Efficiency

• Mission deployment rate: 100%; rating input score 100
• Program expense ratio: 89.3%; rating input score 89
• Fundraising efficiency: $3.52 raised per $1 spent on fundraising; rating input score 13; 13th percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
• Pay-setting controls: 3 of 6 controls in place; rating input score 50
  • Compensation committee: Pass
  • 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: 100%; rating input score 100; 70th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 84.2%; rating input score 84; 17th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -832.6%; rating input score 0; 0th percentile among comparable filings
• Total-asset coverage ratio: 0.04; rating input score 1; 1st percentile among comparable filings
• Liabilities to assets ratio: 1.62; rating input score 3; 3rd percentile among comparable filings
• Officer compensation ratio: 4%; rating input score 55; 55th percentile among comparable filings

Growth

• Program expense growth: 8.2% per year; rating input score 100; 63rd percentile among comparable filings
• Revenue growth: -25.1% per year; rating input score 0; 2nd percentile among comparable filings
• Asset growth: -24.1% per year; rating input score 0; 2nd percentile among comparable filings