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The Eleanor Crook Foundation

Name:                      The Eleanor Crook Foundation

Address:                                 Suite 1110, 150 Fayetteville Street Raleigh, NC 27601

Tel:                                         (512) 609-0694

Email:                                     info@eleanorcrookfoundation.org

No of staff worldwide:            Six

Director:                                 William Moore

Website:                                 www.eleanorcrookfoundation.org

The Field Exchange editors conducted an interview with William Moore, Executive Director of The Eleanor Crook Foundation (ECF), for this issue’s agency profile slot.

William has been with the Foundation for three and a half years. Before he joined ECF, he worked for the Millennium Campaign in the run-up to the launch of the Sustainable Development Goals (SDGs). Perhaps it isn’t surprising that William is serving as ECF’s Executive Director (ED), given that his grandmother is Eleanor Crook. The story of William’s appointment goes something like this.

Just before Christmas 2014, he got a call from his grandmother saying that ECF had just had a pleasant surprise from their finance department: they had US$1 million to give away before year’s end. She wanted to use it to help improve nutrition among Syrian refugees and wondered if William knew which organisations were doing the most effective humanitarian work in response to the Syrian crisis. This US$1 million donation was a turning point for ECF: it was suddenly clear that they were no longer a small, family foundation giving out modest grants, mostly in the form of unrestricted gifts, to a circle of entities they already knew.

On the back of this experience, Eleanor and William talked about new systems that needed to be put in place to strengthen their grant-making process and to begin monitoring and evaluating the now much larger grants that Eleanor’s Foundation was making. William was asked to come on board at this point to help put this new infrastructure in. Fast forward a few years and ECF now has team members based in North Carolina and Washington, with a newly appointed Technical Director based in the UK.

Eleanor set up the Foundation in 1997. It always had a focus on global hunger issues, which had been her concern since the 1980s, volunteering for the Church World Service and other international non-governmental organisations (NGOs); her first exposure to famine was the 1984 Ethiopia famine. Her husband had also spent time in Ethiopia during one of the famines. Eleanor was particularly angry seeing mothers unable to feed their infants and powerless to stop them dying. This anger translated into a passion to do something about global hunger.

When William joined the Foundation, he came with a specific vision. He believed that ECF needed a targeted focus and to take “smart risks”, filling obvious gaps by investing in areas that governments and business are unable or unwilling to invest in. His experience working in the SDG community meant he was aware that the nutrition sector needed more investment. Given hunger was an issue close to Eleanor’s heart, he knew that nutrition was going to be a good fit. At the same time, ECF was “no Gates” in terms of size and therefore needed to define a clear area of investment focus.

After a lengthy period of consultation with various actors in the nutrition community, William/ECF arrived at a strategy and approach which they hoped would enable them to become a leader in the sector. ECF wants a dual focus on nutrition research and nutrition advocacy, as these seem to be the areas where investment is most needed. In many respects, advocacy and research are two sides of the same coin. Good advocacy needs to be rooted in real evidence but at the same time rigorous evidence won’t necessarily be ‘picked up’ by decision-makers. There are many examples of promising interventions not being adopted. You need advocacy and, as part of that, creative approaches to dissemination and financing.

The Foundation’s endowment and disbursements have been on a rapid growth trajectory in recent years and Eleanor intends to provide the organisation’s endowment with the resources it needs to operate in perpetuity. Global nutrition is now ECF’s sole focus. Overseeing all the project portfolios are William, two nutritionists with considerable research and implementation experience, a former Obama appointee at the United States Agency for International Development (USAID), a recent graduate from the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin, and a Senior Advocacy Advisor who runs a prominent consulting firm based in Washington, DC.

ECF has a clear research strategy and approach, partnering with NGOs and universities to conduct implementation research through its RISE (Research, Innovate, Scale, Establish) for Nutrition grant programme. It funds rigorous implementation research to identify solutions to current implementation challenges on the ground using existing delivery mechanisms that can impact nutrition at scale. This involves testing discrete improvements to existing programmes.

One example is research through International Rescue Committee (IRC) in South Sudan, which is testing a new, simplified set of tools and algorithm for diagnosing and treating uncomplicated severe acute malnutrition at community level that is suitable for low-literacy community health workers (CHWs). The approach needs to work within a weakly supported health system where there is little CHW training. The first study appears to be very successful (early experiences featured in a 2016 Field Exchange article1) and has therefore progressed to a phase 2 ECF investment, involving piloting in three additional countries through four implementing partners. The objective of this phase is to ensure that the approach is generalisable in multiple contexts.

The South Sudan work is typical of the ECF research approach. It starts with a three to four-year research project with a budget of approximately US$1.2-1.5 million to test the concept and to see if it can work in one setting. If phase 1 has been successful, the next step (phase 2) is to test it in several other settings, with the oversight of new strategic partners. If successful in multiple contexts, phase 3 will involve advocacy and collaborative financing for scale-up. ECF is uniquely positioned due to its strong relationships with government and other private funders.

Several other research projects are currently in phase 1. In Uganda, Food for the Hungry is conducting a study looking at the linkages between maternal depression and child stunting and testing the effectiveness of an interpersonal therapy group (IPT-G) approach to depression treatment through weekly group therapy. Horrifying experiences that mothers have faced emerge here but, encouragingly, testing this approach has reduced the prevalence of depression in low-income settings. The hypothesis is that, by reducing depression, mothers will have improved functionality and improved infant and young child feeding practices.

ECF is also funding two randomised control trials (RCTs) in Tanzania. Helen Keller International (HKI) is examining the impact and cost effectiveness of interpersonal messaging, SMS messaging and a combination of the two on health and nutrition. This multi-armed study involves public-private partnership and uses an interpersonal messaging approach that Tanzania is currently in the process of scaling up nationally. A second RCT in Tanzania working with Project Concern International (PCI) is examining new models for encouraging more male engagement and investment in child health and its impact on nutrition and early child development.

Evidence generated from this portfolio of research will drive a targeted advocacy agenda (phase 3); ECF is moving towards phase 3 for the community-based diagnosis and treatment tool tested by IRC, working closely with USAID, the UK Department for International Development (DFID), No Wasted Lives (NWL) and IRC.

ECF has a Foundation Request for Applications (RFA) to guide applications from potential grantees (invitation-only application process). This sets out the ECF approach to research and emphasises strong monitoring and evaluation, multi-sector approaches to improve nutrition and the need to think about scale at every phase of programme design. The organisation is also developing specific theories and frameworks on scale-up and sustainability. This work should be out later this year.

William has strong views about sustainability of interventions. He is critical of the international development sector for not addressing this issue properly and singles out donors, believing they need to step up and drive change. He argues that they should be able to do this not only by evaluating success based on surveys on the last day of programming – the typical approach – but by also building in follow-up several years after implementation (which gives a more accurate picture); William is of the firm conviction that many post hoc evaluations of current nutrition programming would not make great reading.

With regard to how funders are discussing ways to work together; he believes the implementation community do a better job of coordination and alignment than the funding community. In reality it is quite difficult to co-fund, since the incentives are simply not there. His experience is that, when there is disagreement or misalignment, the immediate solution seems to be for funders to go their separate ways. Having said that, there are successful efforts: ECF is currently working closely with Gates, Hilton, Child Relief International (CRI), Vitol, Open Road Alliance and other funders.

He singles out NWL as a great example of how funding could/should be arranged. The consortium is set up to drive research on wasting and the best ways to scale up effective programming and policy. As well as attracting new funders, it has real promise in getting bilateral donors to open their global health envelopes to small sets of relevant interventions.

We had an interesting exchange about some of the tensions between funders and grantees. ECF, in common with some other funders, likes to “get its hands dirty” and see projects close up; however this can be threatening to some implementing partners. It can be a delicate dance where, as a funder, one has to respect partner wishes. It is a never-ending process of building strong relationships and cultivating trust. It is important that organisations can hear criticism but, at the same time, “tell us we may be wrong”. The personalities of those overseeing projects can be critical here. This reflects why ECF seeks “kindred spirits” when it comes to support.

William is also concerned about the so-called advocacy and research nexus and how, in his view, there is a profound disconnect between the two communities. As he moves between the two worlds in ECF, he finds that they rarely talk about the same things, even though they are working on the same issues.

As with all agency profile interviews, we asked William how he would characterise ECF and what makes it different from other foundations. His comments are best summarised by saying ECF is a ‘family’ foundation with a tight focus on filling targeted gaps and identifying practical solutions. He also points out that ECF is relatively flexible and can issue grants with less bureaucratic hurdles than many larger donors. Quite often, it provides seed funding up front to get initiatives off the ground.  

We finished off the interview by asking William what he thinks may have changed over the last 20 years in the nutrition world. His first thought is that there wasn’t as much of a nutrition ‘sector’ 20 years ago as there is now, with far more coordination and alignment. His second thought is that there is a rather insular perspective among many nutrition staff and agencies and there is a need for a more multi-sector vision. (He recounts a conversation he recently had with someone in the agriculture sector who said that the nutrition crowd are a bit annoying and act like a secret cult of the holy grail.)

William would like to extend the challenge to the Field Exchange readership that Jessica Fanzo laid down at the recent Global Nutrition Report meeting. It goes something like this: “At some point this year, I challenge you as a nutritionist to attend at least one gathering where you are the only nutrition person in the room. Ask other sectors not what they can do for nutrition, but rather what can nutrition do to help your sector”.

A succinct call to action to end a refreshing and engaging discussion.

Read more...

Endnotes

1Casie Tesfai, Bethany Marron, Anna Kim and Irene Makura (2016). Enabling low-literacy community health workers to treat uncomplicated SAM as part of community case management: innovation and field tests. Field Exchange 52, June 2016. p3. www.ennonline.net/fex/52/communityhealthworkerssam

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The Eleanor Crook Foundation. Field Exchange 57, March 2018. p92. www.ennonline.net/fex/57/theeleanorcrookfoundation

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