Adara Development (USA)

Bridging Worlds

aka Adara Development (USA)   |   Edmonds, WA   |  www.adaragroup.org

Mission

Our mission is to bridge the world of business and the world of people in extreme poverty, and to support vulnerable communities with health, education and other essential services.

Ruling year info

2011

Acting CEO & Chair

Audette Exel AO

Main address

300 Admiral Way Suite 106

Edmonds, WA 98020 USA

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EIN

98-0634789

NTEE code info

International Development, Relief Services (Q30)

Community Health Systems (E21)

Children's and Youth Services (P30)

IRS filing requirement

This organization is required to file an IRS Form 990 or 990-EZ.

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Communication

Programs and results

What we aim to solve

SOURCE: Self-reported by organization

The Adara Group was founded in 1998 by Audette Exel AO with the mission of bridging the worlds of business and international development, with a focus on serving vulnerable communities in some of the world’s most remote places. MNCH - Despite gains made in reducing maternal and infant mortality across the globe, rates in low resource settings are still unacceptably high. In fact, 99% of all maternal and infant deaths occur in low-resource countries. Most could be prevented. Adara's global health work focuses on ending the preventable deaths of women, children, adolescents, and in particular, newborns. RCD - Across the developing world, rural and remote communities face extreme challenges in terms of health and education coverage and access. 70% of the developing world's 1.4 billion extremely poor people live in rural and remote areas. A person's place of residence largely determines their access health and education. Adara's Remote Community Development work makes a significant contr

Our programs

SOURCE: Self-reported by organization

What are the organization's current programs, how do they measure success, and who do the programs serve?

Maternal, newborn and child health

Adara specialises in delivering high-quality healthcare to women, newborns, and children at health facilities, in the community and at home, in low resource settings. Prematurity is the leading cause of death worldwide for children under 5. An additional 2 million under-five deaths could occur globally in just 12 months due to COVID related reductions in health service. The vast majority of these deaths will occur in low-income countries.

Since 1998, Adara’s work has focused on strengthening maternal newborn and child health (MNCH) services in Uganda. Working in partnership with Kiwoko Hospital, a non-profit hospital in central Uganda which serves a catchment area of one million people, we have demonstrated the impact of an integrated model of care. This encompasses training, clinical support and high standard facility and community-based care across antenatal, maternity and neonatal intensive care.

Together, Adara and Kiwoko Hospital have:

• provided women with antenatal care
• helped women deliver their babies safely
• helped newborn babies needing specialised care in the neonatal intensive care unit
• provided community outreach services and health promotion
• trained village health workers and clinicians from the local district health system
•Worked with Makere University to pilot our Hospital to Home program in 2019 - a holistic, low-cost, family-centred discharge package that ensures babies receive the support they need once they leave the Kiwoko Hospital NICU

Since 2009, more than 10,500 of the tiniest newborns have received expert care in the neonatal intensive care unit (NICU) at Kiwoko and close to 40,000 women have given birth safely.

Kiwoko Hospital has been named a national Centre of Excellence in newborn care and this pioneering model has global ramifications. Adara is a member of the National Newborn Steering Committee in Uganda and has been working with the Ministry of Health for a number of years, laying the foundations for us to now move to scale.

Our work already reaches health facilities across the country, with the Ministry of Health calling on Adara and Kiwoko to help train others in the care of small and sick babies. Sharing our knowledge locally, nationally and globally continues to be a huge priority for us in 2021.

We have demonstrated that newborn deaths can be dramatically reduced in facilities and communities with the right holistic care. At our Centre of Excellence more than 85% of sick and vulnerable newborns survived in 2020. Since 2009, NICU admissions rose by 93% and maternal deaths as a proportion of hospital births fell by 25% in the same period. We have been able to reach thousands of women through our community outreach (safe motherhood) clinics and have followed-up over 94% of our high-risk infants in communities by a network of trained community health volunteers in Uganda.

Adara is looking to expand our high-impact model of maternal and newborn care to other health facilities across Uganda serving populations with high numbers of newborn deaths. This will encompass multiple components including adequate infrastructure, equipment, staffing and biomedical support. It also includes training and mentoring from a strong team of Ugandan specialists, alongside strong quality improvement systems. We are also proposing an open-access, online 'knowledge sharing' platform to facilitate best practices among partners and encourage further replication of the model to other low resource settings. We are committed to sharing our learnings and this model to save many more lives.

Adara is also working in partnership with other global health leaders on projects to improve newborn survival globally. We are working with PATH and the University of Washington on a Safe Bubble CPAP kit to address the lack of access in low-resource settings to safe and affordable treatment for respiratory distress syndrome—the most common cause of disease and death for babies born before 34 weeks gestation. In 2019, Adara served as the implementation partner with the London School of Hygiene and Tropical Medicine and the Medical Research Council on an Early Intervention Programme for newborns at risk of disability. The ABAaNA programme, which provides holistic support to families caring for children with a disability, to improve their health, wellbeing and growth, proved to be feasible and acceptable in the communities in which it was trialled. We are now looking to roll this programme out more widely.

Population(s) Served
Women and girls
Families

Adara specialises in delivering excellent health and education services in some of the most remote regions of the world and has worked hand in hand with remote communities since 1998. Primarily, this work has taken place in Humla, a remote and mountainous region of Nepal, home to more than 50,000 people.
Our focus in Humla is on long term sustainable support to improve health and education for the region. Our health initiatives in Humla aim to improve local health services, health awareness, nutrition, hygiene and sanitation. Our education initiatives focus on school improvement, including teacher employment and training, school infrastructure and materials, after-school activities and vocational scholarships. By improving education in the district we also aim to eliminate child trafficking.

Following the Nepal earthquake in 2015, Adara’s remote community development work expanded to the district of Ghyangfedi, a small remote community in the Nuwakot district, northeast of Kathmandu. Immediately after the earthquake, Adara delivered emergency food, medical, and shelter support to this community. Using the expertise gained delivering remote education programmes in Humla since 1998, Adara built and continues to support a new earthquake-resistant school. The Shree Ghyangfedi School opened in June 2017. The school population quickly grew from 17 to 624 students in 2020. This is a growth of 3500% since 2017. This success, and the poor quality of local primary schools, meant many students were choosing to walk up to three hours each way on steep, dangerous mountain paths, to get an education. In 2019, Adara partnered with the surrounding seven primary schools to improve their facilities, provide supplies, equipment and midday meals for all 294 students so that they can access quality education closer to home. This also alleviated the pressure on the Shree Ghyangfedi School, which was bursting at the seams. 52.4% of the students in the 16 Adara-supported schools in Nepal are girls - a group traditionally excluded from education in 2020. 1,013 Humli and Ghyangfedi children received support including school supplies and uniforms in 2020.

Adara also works with a handful of grassroots Nepali NGOs in the capital, Kathmandu, to improve health and education outcomes for vulnerable community groups. 6,450 patients were treated at five Adara-supported health posts in Humla in 2020.

In 2021, Adara’s work in Nepal revolves heavily around responding to the nation’s devastating second wave of COVID-19. Adara is playing our part in the coordinated national response, working in collaboration with the Association of International NGOs, the UN Cluster System, and the Nepal government and other key COVID responders. Our response thus far has involved supporting Nepalis returning across the Indian border with masks and drinking water, coordinating a distance learning programme for school students, raising awareness of COVID-19 symptoms and prevention methods, and distributing PPE and oxygen concentrators to local health posts and hospitals.

Population(s) Served
Children and youth
Women and girls

Where we work

Our results

SOURCE: Self-reported by organization

How does this organization measure their results? It's a hard question but an important one.

Number of practicing nurse practitioners

This metric is no longer tracked.
Totals By Year
Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

# of nurses supported by Adara at health posts in Nepal, at Kiwoko and Nakaseke Hospitals in Uganda.

Rate of student attendance during the reporting period

This metric is no longer tracked.
Totals By Year
Population(s) Served

Children and youth, Adolescents

Related Program

Remote Community Development

Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Number of students at or above a 90% attendance rate

This metric is no longer tracked.
Totals By Year
Population(s) Served

Children and youth

Related Program

Remote Community Development

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

Attendance was reported for the days schools were open in 2020 (schools were closed for a period due to the pandemic). Data is not available for Humla.

Number of students who perform at average or above on standardized testing

This metric is no longer tracked.
Totals By Year
Population(s) Served

Adolescents

Related Program

Remote Community Development

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

# includes all Adara supported students who sat the School Education Examination in Nepal in 2019. 100% scored above average grade (C).

Number of parents, community members, and non-teaching staff helping to set goals for the school

This metric is no longer tracked.
Totals By Year
Related Program

Remote Community Development

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

# includes number of School Management Committee members, parents, and non-teaching staff across 16 target schools in Nepal.

Number of students enrolled

This metric is no longer tracked.
Totals By Year
Population(s) Served

Infants and toddlers, Children and youth

Related Program

Remote Community Development

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

Total # of students enrolled across Adara's 16 target schools in Ghyangfedi and Humla, Nepal. This also includes students enrolled in ECD classes.

Number of participants who are promoted to the next grade on time

This metric is no longer tracked.
Totals By Year
Population(s) Served

Children and youth

Related Program

Remote Community Development

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Holding steady

Context Notes

This includes all children enrolled, ECD to grade 10. Note that this excludes students from Ghyangfedi.

Number of students who receive scholarship funds and/or tuition assistance

This metric is no longer tracked.
Totals By Year
Population(s) Served

Children and youth, Adolescents, Young adults

Related Program

Remote Community Development

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

# of students supported with scholarship funds across 16 partner schools in Nepal, as well as youth scholarships for young adults.

Number of vaccines administered

This metric is no longer tracked.
Totals By Year
Population(s) Served

Infants and toddlers, Parents

Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Context Notes

# of vaccines administered to mothers, children and babies through community health programmes. In 2020, vaccine distribution was heavily impacted by the pandemic and disruptions to healthcare access.

Number of pregnant women giving birth at a health facility

This metric is no longer tracked.
Totals By Year
Population(s) Served

Women and girls

Related Program

Maternal, newborn and child health

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Holding steady

Context Notes

Births take place at Kiwoko Hospital in Uganda, and at Health Posts in Humla, Nepal. In 2020, disruptions to healthcare access meant more women gave birth outside of facility-based care.

Number of clients served

This metric is no longer tracked.
Totals By Year
Population(s) Served

Economically disadvantaged people

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

Across three programme sites: Humla and Ghyangfedi in Nepal, and Kiwoko and Nakaseke in Uganda.

Number of volunteer health care providers

This metric is no longer tracked.
Totals By Year
Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Context Notes

# includes female community health volunteers in Nepal, volunteer health trainers in Uganda and interstate medical volunteers.

Number of mothers who initiate breastfeeding

This metric is no longer tracked.
Totals By Year
Population(s) Served

Women and girls

Related Program

Maternal, newborn and child health

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

Babies breastfed within 1 hr of birth at Kiwoko Hospital in Uganda or health posts in Humla, Nepal

Maternal Survival (%)

This metric is no longer tracked.
Totals By Year
Population(s) Served

Women and girls

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Holding steady

Number of meals served or provided

This metric is no longer tracked.
Totals By Year
Population(s) Served

Children and youth

Related Program

Remote Community Development

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

602 students in Ghyangfedi receive 1 daily meal at school + 120 students boarding in Humla receive 2 major meals daily - although in 2020 school closures impacted out ability to provide this service.

Number of teachers recruited

This metric is no longer tracked.
Totals By Year
Related Program

Remote Community Development

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

School closures and the pandemic impacted our ability to recruit teachers in 2020.

Number of students per teacher during the reporting period

This metric is no longer tracked.
Totals By Year
Related Program

Remote Community Development

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

There were a total of 61 teachers in Humla (1:16 student - teacher ratio) and 30 teachers in Ghyangfedi (1:20) in Adara supported schools.

Survival for low birth weight babies (<2.5kg) %

This metric is no longer tracked.
Totals By Year
Population(s) Served

Infants and toddlers

Related Program

Maternal, newborn and child health

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Holding steady

Context Notes

88% survival rate for babies weighing less than 2.5kg at birth in Kiwoko Hospital and Nakaseke Hospital in Uganda

Number of infants delivered with low birth weight

This metric is no longer tracked.
Totals By Year
Related Program

Maternal, newborn and child health

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Decreasing

Context Notes

Infants delivered at Nakaseke and Kiwoko Hospitals.

Our Sustainable Development Goals

SOURCE: Self-reported by organization

Learn more about Sustainable Development Goals.

Goals & Strategy

SOURCE: Self-reported by organization

Learn about the organization's key goals, strategies, capabilities, and progress.

Charting impact

Four powerful questions that require reflection about what really matters - results.

1. Work with our communities and development partners to mitigate and prevent the spread of COVID-19 and ensure continuity of essential services.
2. Reduce preventable maternal, newborn and child deaths and improve the health and well-being of communities in low resource settings.
3. Improve the lives of people in remote communities through impactful health, education and child protection programmes.
4. Build local systems to monitor and evaluate our work, integrate IT and engage stakeholders in the feedback loop.
5. Inform our work with cutting-edge research and innovations that expand impact and share how Adara teams worldwide are defining best practice.
6. Exponentially widen Adara’s impact through sharing and exchange of knowledge.
7. Ensure research, monitoring and evaluation is integrated into all we do and our work is evidenced based.
8. Build brilliance and support and develop our exceptional teams.

1. Reduce preventable maternal, newborn and child deaths and improve the health and well-being of communities in low resource settings:
• Work to prioritise the health and safety of health workers, and work to mitigate and prevent the spread of COVID-19.
• Maintain and build on service excellence in the neonatal intensive care unit (NICU), antenatal department, maternity ward, and safe motherhood outreach services at Kiwoko Hospital (KH), Uganda.
• Maintain and build on the Hospital to Home programme to ensure every infant discharged from the Kiwoko Hospital NICU has the best chance possible to survive and thrive.
• Introduce and trial a new Safe Bubble Continuous Positive Airway Pressure (bCPAP) kit at Kiwoko Hospital.
• Implement the ABAaNA programme at Kiwoko Hospital with the aim of identifying and providing a better quality of life for children who are at risk of disabilities and their families.
• Establish Nakaseke Hospital as the first ‘AdaraNewborn’ site by establishing a level 2 newborn unit and working to strengthen the quality of care across antenatal, maternity, family planning, and newborn care.
• Increase newborn care capacity in selected Ugandan health facilities, working in partnership with the National Newborn Steering Committee and the Ugandan Ministry of Health.
• Continue to develop AdaraNewborn and lay the foundations for a wider roll out in 2022.
• Support Kiwoko Hospital to provide a high standard of care for families living with chronic conditions (including diabetes, HIV/AIDS, TB, disabilities, mental health issues and epilepsy) by providing services in the hospital and through outreach.
• Establish a youth health and education centre focussed on sexual and reproductive health to address the devastating secondary impacts of COVID-19.
• Share knowledge locally, nationally, and globally.
• Develop well functioning healthcare services in Humla, Nepal.
• Improve nutrition, sanitation, hygiene, livelihoods and the environment in Humla and Ghyangfedi in Nepal.



2. Improve the lives of people in remote communities through model health and education programmes:
• Work to prioritise the health and safety of front-line workers, and work to mitigate and prevent the spread of COVID-19.
• Respond to the devastating impacts of COVID-19 with a focus on food security.
• Improve access to quality healthcare services in Adara’s partner communities.
• Ensure all children in Adara supported schools can access quality primary, secondary, and tertiary education (including distance learning programmes throughout periods of lockdown)
• Raise awareness of and work towards ending child trafficking
• Build capacity and continue supporting the work of our partner organisations in Nepal – Hands in Outreach, The Himalayan Children’s Society, Himalayan Medical Foundation, the Women’s Foundation and THIS

Adara has established two key pillars of excellence that guide our development work. These capabilities ensure that our communities are getting quality health, education and other essential services. These pillars are fundamental to our strategy and achieving our goals.

BEST-PRACTICE SERVICE DELIVERY
We believe service excellence comes through listening to the community on what needs to be done, working with them to avoid dependence, supporting local economies, being accountable for donor funds, and continually monitoring and evaluating our work. To serve our communities better, we work to a standard of global excellence and implement evidence-based and holistic projects that improve health and education outcomes.

Research is also key to best-practice service, and is at the heart of what we do, and informs all our projects. It contributes to the planning process, accounting for community issues and needs during project design. This ensures that all our decisions are evidence-based. We are now beginning to expand our research work to conduct regular studies in Uganda and Nepal so we can better understand our impact in the short, medium and long term.

KNOWLEDGE-SHARING
To touch more lives, we are committed to deepening our service delivery and sharing our knowledge widely. As experts in remote community development and in the care of at-risk babies, our goal is to take our very best ideas and our biggest mistakes, distilled from more than two decades of working in the field and share them locally, nationally and globally. We are proud of our accomplishments and have learned from our mistakes and struggles along the way. We know we don’t have all the answers, however by sharing and opening dialogue we can help lead the way and provide a blueprint for others.

Adara is passionate about advancing innovations that improve health and education outcomes for women, children and help ensure more newborns survive and thrive. We seek out high-impact and low-cost innovations that can scale widely in low resource settings and share these ideas globally. For example, we are participating in several research studies to improve early intervention for high-risk infants.

Adara is at an exciting crossroad in our works. After working hard since 1998 to develop best-practice programmes, we are now looking at how we can take our successes, mistakes and learnings to make a bigger impact. Despite the huge strides we have made in improving community access to quality health and education in both the Nakaseke district of Uganda and in Nepal, there is still so much left to do. We are now at the point where we are looking to considerably scale up our work. We will continue to build our areas of expertise to reach more communities through research, service delivery and knowledge sharing with the goal of reaching many more people globally.
In 2020 and continuing in 2021, the pandemic continues to impact and shape our work. Despite the primary and secondary impacts of COVID-19 being felt across all our programme sites, Adara has worked hard to maintain essential service delivery whilst responding to the pandemic efficiently.

Below is a snapshot of some of our achievements across our areas of expertise in 2020.

Maternal Newborn Child Health
• Increase in survival for low-birth-weight babies at the Adara-Kiwoko Hospital (weighing less than 2.5kg) between 2005 and 2020 of 61% to 83%.
• 1,192 newborns cared for in the NICU at Adara-Kiwoko Hospital. Admissions have increased by 169% since the new NICU opened in 2010.
• Maternal survival in the maternity unit was 99.9%.
• There were 3,436 admissions to the maternity ward in 2020.
• 7, 212 immunisations were delivered to children in 2020.

Remote Community Development
• We successfully ran training sessions on greenhouse construction, repair and use for over 450 households and distributed vegetable seeds to over 470 households throughout Humla to ensure they have access to nutritious food throughout winter.
• More than 62% of our higher education scholarship recipients in 2020 were girls.
• 100% of Adara supported students passed their School Education Examination in 2020, 54% of whom were girls. All students in our target schools in Humla and Ghyangfedi passed with above C+ grades.
• Adara was the first organisation in Nepal to launch a distance education programme via radio. By airing school lessons over two local FM stations 6 days a week, we have been able to reach approximately 17,000 children and their families with radio education. As a result, nearly 100% of the children engaged in Adara supported schools remained engaged in education with only a 1% dropout rate.2, 941 patients treated at five Adara-supported health posts in Humla in 2020, despite COVID-19 restrictions impacting the health services that could be provided.

Financials

Adara Development (USA)
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Operations

The people, governance practices, and partners that make the organization tick.

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Adara Development (USA)

Board of directors
as of 7/4/2021
SOURCE: Self-reported by organization
Board chair

Audette Exel

Adara Advisors; Adara Partners

Derek Stapley

Thomas Dickson

Meetinghouse LLC

Organizational demographics

SOURCE: Self-reported; last updated 05/27/2021

Who works and leads organizations that serve our diverse communities? GuideStar partnered on this section with CHANGE Philanthropy and Equity in the Center.

Leadership

The organization's leader identifies as:

Race & ethnicity
White/Caucasian/European
Gender identity
Female
Sexual orientation
Heterosexual or Straight

Race & ethnicity

Gender identity

 

Sexual orientation

No data

Disability

No data