Office Discussions: How Effective is Max Foundation?


How effective is Max Foundation?


Let’s introduce myself. I’m Edmond Hilhorst, a novice board member with zero experience in WASH or non-profits. Based on my experience as an entrepreneur and impact investor I’m trying to support Max on marketing and strategy. In the past few months, I’ve witnessed very committed people dedicated to reduce child mortality and provide children with a ‘healthy start’ in life. Max receives donations from leading philanthropic foundations. All team members I met are passionate and open-minded.

During a Mini-Masters from Effective Giving that I joined past May I was introduced to a framework for Effective Giving. The co-founder of Effective Giving, Kellie Liket, privately, expressed some doubts about Max. She recognized Max is passionate about cost-effectiveness but is concerned about our integrated approach which she believes is less effective as the most exceptional international single focussed non-profits.

Kellie questions, the effectiveness of the integrated approach and concludes Max Foundation is unlikely to be maximally cost-effective

Perspective Kellie

Don’t blame Kellie, I challenged her to be frank and straightforward:

  1. Considering the scale of the problem, there are many resources for the WASH Cause Area relative to others, like extreme poverty
  2. Max applies a (wide) combination (cocktail) of interventions with varying levels of evidence for their individual cost-effectiveness in varying context
  3. A combination of proven interventions is not necessarily equally cost-effective
  4. The effects of these combined interventions are a response to a problem-definition that doesn’t seem exceptionally thorough
  5. Max does not seem to be particularly well-placed to create its own cocktail of interventions, implement it consistently and validate it thoroughly (i.e., collaborate with a university to conduct multiple RCTs)
  6. High-quality research of cost-effectiveness requires organisations that are able to offer exceptionally consistent implementation
  7. Max has been engaged in updating of its cocktail of interventions posing new challenges to its implementation excellence

As a result of the above Kellie questions, the effectiveness of the integrated approach and concludes Max is unlikely to be maximally cost-effective and thereby “steals” funding away from other single focusses international non-profits that operate with a stronger evidence-base of the impact they can achieve per dollar. Kellie suggests considering alternative tracks such as becoming a fundraiser for the most cost-effective programs for child mortality, especially if we insist on using the effective altruist rhetoric.

After various meetings, we concluded we may need to articulate our mission and strategy even more specifically to design the proper KPIs.

My Perspective; Agile over Consistency

Kellie’s perspective is quite contrary to Max’s approach and conviction. They believe that an integrated approach of single proven interventions is more effective, being aware that the integrated approach is not proven as a whole. I experience positive energy and a commitment to improve and advance child health. There are promising analyses with current Max programs indicating stunting is greatly reduced in Max Healthy Villages. Max continues to be applauded and funded by critical and professionally managed large donors.

I understand the relevance of scientific evidence and consistent implementation. However, RCTs are expensive and time-consuming. It hinders the velocity of learning and improving. Not all NGO’s can focus on malaria nets and at some point, malaria will be cured. During the development of Independer, as any successful online business, we adopted the “fail faster” agile design principle to overcome the lack of speed of the traditional scientific “plan – design – implement” approach. The agile methodology has since been adopted by many corporates and probably also applies to NGOs. Agile requires clear goal setting, continuous testing and excellent reporting to be effective.

This all relates to the work of our working group on the impact measurement of Max. We started the group with the assumptions we need to improve our communication and proof our effectiveness. After various meetings, we concluded we may need to articulate our mission and strategy even more specifically to design the proper KPIs.

Topics to be agreed upon

  1. Do we continue our “agile” and “cocktail” implementation approach?
  2. Do we agree our mission has evolved from “Reduce child mortality” to “Providing a healthy start”?
  3. Do we dare to share this discussion and solicit feedback?

When we agree on the first 3 topics we can proceed with the next step in the design of our desired KPIs to measure and improve effectiveness. During the development of these KPIs, we also need to formulate or surface answers on other strategic topics like:

  1. Is WASH our Cause Area or would we define it differently?
  2. What is our theory of change?
  3. What part of this theory is (scientifically) proven?
  4. How do our interventions fit in and complement each other?
  5. Why do we think they are effective and how can we prove that?
  6. Who are our benchmark organisations and what can we learn where?

Book Tip: Lean Impact - How to Innovate for Radically Greater Social Good, by Ann My Chang

What I'm trying to point out in this brief blog post has been said earlier, in more detail, and arguably, better by Ann Mei Chang in her book Lean Impact. She builds her argument on the question: "Despite enormous investments of time and money, are we making a dent on the social and environmental challenges of our time?" Similarly, we hold this as the starting point for our discussions and actions for impact. Ann Mei, as a previous tech executive from Silicon Valley and former Chief Innovation Officer at USAID, innovatively applies the lean startup ideas on our global need for greater (and more rapidly delivered) social change via social innovations. 

"To make a lasting difference, solutions must be embraced by beneficiaries, address root causes, and include an engine that can accelerate growth to reach the scale of the need. Lean Impact offers bold ideas to reach audacious goals through customer insight, rapid experimentation and iteration, and a relentless pursuit of impact." (Lean Impact, Ann Mei Chang) 

So, what do you think?
We want our pursuit of evidence to be transparent and for everyone within Max Foundation to reflect and comment on the thoughts, doubts and learnings that we encounter during the phases where we explore the why, how, and what. Stay tuned for our next blog posts, with some more thoughts on the next steps.

In the meantime, chime in via Facebook and share your thoughts with us.

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