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        <Desc>Clinical Care Innovation: The Ihangane Project works with local healthcare workers and the Rwanda Ministry of Health to improve the quality of direct patient care services by ensuring that frontline healthcare workers have the tools they need to successfully deliver primary healthcare. We have co-created tools such as E-Heza Data Solutions, the TIP Education Model and the 5 Pillars of Quality Improvement Framework alongside frontline healthcare workers to overcome barriers and celebrate improvements in processes and health outcomes. E-Heza is a point of care digital health record designed by and for the health care worker, used to improve quality of maternal-child care by making it easier for nurses to do their jobs, for mothers to track the wellbeing of their children, and for ministry officials to receive data in real-time.</Desc>
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        <Desc>Aheza Fortified Food (AFF): provides consistent, affordable fortified porridge to hospitals, nongovernmental orgs, and community members while subsidizing the cost of free distribution to the highest risk children. Nutrition is an essential component of adequate primary care; health centers have long struggled with stock outs of fortified porridge and commercial products are often too expensive for rural families to access. AFF is a social enterprise established by TIP in 2015 to address stock outs of porridge needed to treat childhood malnutrition. Porridge is sold in bulk to NGOs, governments and social enterprises who then provide the porridge to their beneficiaries for free or low cost. Profits from Aheza sales subsidize the cost of free distribution of porridge to high risk children in Ruli. Since its launch in 2015, TIPs Aheza program has provided over 2.4 million servings of porridge to over 42,000 Rwandans, 92% of whom are high-risk for malnutrition.</Desc>
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        <Desc>Womens Association and Hope Initiative.Hope Initiative: The Ihangane Project is conducting research on the influence of hope on health outcomes. We began by identifying an objective tool for measurement, called the Herth Hope index. We worked with healthcare workers and healthcare recipients to ensure that this index- originally established in the United States- would be valid and reliable in the Rwandan context. We are conducting an in depth analysis of influencers of hopelessness and hopefulness in health care systems and will identify interventions based upon this analysis. Our first objective is to demonstrate the ability to increase hopefulness among healthcare workers and healthcare recipients. Ultimately, we will demonstrate that hopefulness is critical to improvements in health outcomes and that it must be considered in the design of effective health systems.</Desc>
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        <Desc>Community Health Innovation: We work with over 1000 Community Health Workers, over 6000 farmers, community members and local government across Gakenke District to improve village-level primary health care delivery and to address social determinants of health for the most vulnerable.</Desc>
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        <ManagementAndGeneralAmt>16151</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>18554</TotalAmt>
        <ProgramServicesAmt>13665</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4115</ManagementAndGeneralAmt>
        <FundraisingAmt>774</FundraisingAmt>
      </TravelGrp>
      <InsuranceGrp>
        <TotalAmt>20608</TotalAmt>
        <ManagementAndGeneralAmt>20608</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Materialssupplies</Desc>
        <TotalAmt>19998</TotalAmt>
        <ProgramServicesAmt>17148</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2850</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Board Retreat</Desc>
        <TotalAmt>15143</TotalAmt>
        <ManagementAndGeneralAmt>15143</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TrainingMeetingsEducation</Desc>
        <TotalAmt>21269</TotalAmt>
        <ProgramServicesAmt>18003</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1670</ManagementAndGeneralAmt>
        <FundraisingAmt>1596</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Community Support</Desc>
        <TotalAmt>131333</TotalAmt>
        <ProgramServicesAmt>131333</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>33864</TotalAmt>
        <ProgramServicesAmt>56863</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-22999</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>1560421</TotalAmt>
        <ProgramServicesAmt>1336403</ProgramServicesAmt>
        <ManagementAndGeneralAmt>146471</ManagementAndGeneralAmt>
        <FundraisingAmt>77547</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>403537</BOYAmt>
        <EOYAmt>369347</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1842</BOYAmt>
        <EOYAmt>896</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>17271</BOYAmt>
        <EOYAmt>14786</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <LandBldgEquipCostOrOtherBssAmt>2118</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2118</LandBldgEquipAccumDeprecAmt>
      <TotalAssetsGrp>
        <BOYAmt>422650</BOYAmt>
        <EOYAmt>385029</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1396</BOYAmt>
        <EOYAmt>7240</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>65549</BOYAmt>
        <EOYAmt>99470</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>66945</BOYAmt>
        <EOYAmt>106710</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>355705</BOYAmt>
        <EOYAmt>278319</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>355705</BOYAmt>
        <EOYAmt>278319</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>422650</BOYAmt>
        <EOYAmt>385029</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-77386</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>842047</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>623669</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>590482</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>532699</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>213615</CurrentTaxYearAmt>
        <TotalAmt>2802512</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>77771</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>116964</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>132255</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>158072</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>231381</CurrentTaxYearAmt>
        <TotalAmt>716443</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>919818</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>740633</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>722737</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>690771</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>444996</CurrentTaxYearAmt>
        <TotalAmt>3518955</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>264000</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>335494</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>193679</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>251149</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25000</CurrentTaxYearAmt>
        <TotalAmt>1069322</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus3YearsAmt>18092</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>72008</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>162177</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>252277</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>264000</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>353586</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>265687</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>413326</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25000</CurrentTaxYearAmt>
        <TotalAmt>1321599</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>2197356</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>204</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>69</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>113</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>93</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>172</CurrentTaxYearAmt>
        <TotalAmt>651</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>204</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>69</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>113</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>93</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>172</CurrentTaxYearAmt>
        <TotalAmt>651</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>920022</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>740702</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>722850</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>690864</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>445168</CurrentTaxYearAmt>
        <TotalAmt>3519606</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.62430</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.54570</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Unusual grants Part II or Part III line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Unusual grant 1 - $250,000Unusual grant 2 - $150,000Unusual grant 3 - $119,708Unusual grant 4 - $218,760Unusual grant 5 - $90,000Unusual grant 6 - $117,000Unusual grant 7 - $140,000Unusual grant 8 - $36,500Unusual grant 9 - $91,500</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="990D">
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>2118</InvestmentCostOrOtherBasisAmt>
        <DepreciationAmt>2118</DepreciationAmt>
      </EquipmentGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Credit Card Payable</Desc>
        <Amt>470</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Loan to Aheza</Desc>
        <Amt>15000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Loan Payable</Desc>
        <Amt>34000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Line of Credit</Desc>
        <Amt>50000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>99470</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="990F">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Sub-Saharan Africa</RegionTxt>
        <OfficesCnt>1</OfficesCnt>
        <EmployeeCnt>7</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Program services</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>Health nutrition</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>1336403</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>1</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>7</SubtotalEmployeesCnt>
      <TotalOfficeCnt>1</TotalOfficeCnt>
      <TotalEmployeeCnt>7</TotalEmployeeCnt>
      <SubtotalSpentAmt>1336403</SubtotalSpentAmt>
      <TotalSpentAmt>1336403</TotalSpentAmt>
      <TransferToForeignCorpInd>false</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>false</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>false</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>false</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>false</ForeignPartnershipInd>
      <BoycottCountriesInd>false</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Use of grant monitoring procedures (Part I, line 2)</FormAndLineReferenceDesc>
        <ExplanationTxt>The executive director reviews the funds spent outside of the US on a monthly basis and then disburses additional funds out of country accordingly.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleO documentId="990O">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 governing body review Part VI line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 in its entirety is distributed to all Board members at the time of filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Governing documents etc available to public Part VI line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Distributed upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>List of other fees for services expenses Part IX line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>See supplemental schedule.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
