Thanks for choosing an important topic (maternal health) which can greatly affect infant and whole family health and prosperity.

Historically, the interventions which lead to a very helpful 2 year gap between pregnancies are called "birth spacing" or just "spacing". If others are interested in this, or stunting, or impacts on educational attainment/IQ, a lot is available.

USAID's work on the BASICS programme and its successors is especially important, and produced a lot of effectiveness outputs and lessons learned, available now through me, in books, and via Scholar searches like this one on Ghana. 

Some categories to bear in mind:

- for behaviour change in parental or sexual practices, single interventions of a limited duration are rarely effective; multiple tactics over an extended period work better; good examples include USAID BASICS approach to increasing breast-feeding and vaccination in Madagascar, using women's drama groups, radio, artists, flags on clinics, positive deviants, income-generation etc all in the same district

- a properly participatory approach (PLA) and (ideally) community-led approach is more likely to work and sustain itself; this takes more initial negotiation, and experienced community workers, but it pays off handsomely. 

- this is an area where expertise and field experience in specific IRL context do matter: there are so many things to get wrong, and people have been working on effectiveness, health economics and RTCs for decades. This does not mean EAs have no role, but talking to larger NGOs/sector funders and asking them to identify gaps can be a good strategy. If an NGO repeatedly gets USAID, GIZ and French funding and has been around in a country for 20 years, they have probably achieved some good impacts and know some unmet needs and opportunities. NGOs are often friendly about networking and referals. (Try the Hash House Harriers or English-speaking church or embassy events, ot stop by at the Netherlands Embassy, often helpful and pragmatic)

I'm happy to be called about this, and any global health/poverty issues.


 

This is perhaps even more important post SBF scandal, where putting out a large amount of positive information for the public to find is quite crucial.
 

If EAs don't talk to journalists they will miss out on one really important learning:

.... how to talk to journalists!

This seems very focused on EA and policy in USA and DC, rather than EA as a whole. 

One of the original themes of EA was global health and poverty - it would be nice if you could do a part 2 with a wider focus? After all, DC has plenty of global policy think tanks, IFPRI, USAID etc.

That's brilliant - is the work being extended to other countries?

That's brilliant - is the work being extended to other countries?

I agree that global health and poverty need giving now, and admire your willingness with being OK to create a drop in the bucket!

I'm working on interventions that interrupt inter-generational poverty / the poverty cycle, and some excellent USAID health research has identified infant cognitive stunting as a key lock on intergenerational poverty in Africa, and aflatoxin B1 as a key cause of that stunting, along with smoke, lead and malnutrition of mothers and adolescent girls.

Great post, very comprehensive - I'm sad it got less response.

I think it's wise to separate the FTX and due diligence issue from the broader thesis. Here I'm just commenting on due diligence with donors.

Who was/is responsible for checking the probity or criminality of ...

 (a) FTX and Almeda?

 (b) donors to a given charity like CEA? (I put some links on this below)

(a) First it's their own board/customers/investors, but presumably supervisory responsibility is or should also be with central bank regulators, FBI, etc. If the CEO of a company is a member of Rotary, donates to Oxfam, invests in a football team, it doesn't suddenly become the primary responsibility of all of those entities (ahead of board, FBI etc) to check out his business and ethics and views, unless (and this is important) he's going to donate big and then have influence on programmes, membership etc. 

(See the links below on how both due diligence and reputational considerations* can matter a lot to the recipient charity. If there is some room for doubt about the donor, but it doesn't reach a threshold, it may be possible to create a layer of distance or supervision e.g. create a trust with it's own board, which does the donating.)

(b) Plenty of charities accepted donations from Enron, Bernie Madoff and others. 

Traditionally, their job is to do their job, not evaluate the probity of all their donors. However, there has been a change of mood since oil industry disinvestment campaigns and the opioid crisis (with the donations from the Sackler family, here in the UK at least**). Political parties are required to do checks on donors. 

Marshall Rosenberg turned down lots of people who wanted to fund NVC and the cNVC nonprofit, because he felt that taking money put him into relationship with them, and some companies he just didn't want to be in relationship with. This worked well for him, and made sure there was no pressure to shift focus, but it did frustrate his staff team quite often.

It might be possible as a matter of routine policy to ask large donors if they are happy to have their main income checked, especially if they want to be publicly associated with a particular project, or to go more discreetly to ratings agencies and so on. A central repository of donor checks could be maintained, to minimise costs. This wouldn't be perfect, but a due diligence process, ideally open and transparent, would sometimes be a good defence if problems arise later? 

These are the (more minimal) UK Charity Commission guidelines on checking out your donors, and even this might have helped if it had been done rigorously:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/550694/Tool_6.pdf 

Here's a plain English version where the overall advice is "be reasonable":

https://manchestercommunitycentral.org/sites/manchestercommunitycentral.co.uk/files/Ethical%20fundraising%20-%20how%20to%20conduct%20due%20diligence%20on%20potential%20donors_0.pdf 

**This is for bigger donations:
https://www.nao.org.uk/wp-content/uploads/2017/08/Due-diligence-processes-for-potential-donations.pdf  

*This is about how things went wrong for Prince Charles's charities:
https://www.charitytoday.co.uk/due-diligence-for-charities-ensuring-transparency-and-trustworthiness/ 

> healthy for people to separate giving to their community from altruism.

Is this realistically achievable, with the community we have now? How?

(I imagine it would take a comms team with a social psychology genius and a huge budget, and still would only work partially, and would require very strong buy in from current power players, and a revision of how EA is presented and introduced? but perhaps you think another, leaner and more viable approach is possible?)

>The simpler your path to impact is, the fewer failure points exist

That's not always true. 

Some extreme counter-examples:

a. Programmes on infant stunting keep failing, partly because an overly simple approach has been adopted (intensive infant feeding, Plumpy Nuts etc, with insufficient attention to maternal nutrition, aflatoxin removal, treating parasites in pregnancy, adolescent nutrition, conditional cash transfers etc)

b. A critical path plan was used for Apollo, and worked much better than the simpler Soviet approach, despite being much more complicated. 

c. The Brexit Leave campaign SEEMED simple but was actually formed through practice on previous campaigns, and was very sophisticated "under the hood", which made it hard to oppose.