Show Notes
Clubfoot, a congenital condition where children are born with one or both feet twisted inward, affects roughly one in 800 newborns globally. Most of those cases are in low- and middle-income countries, where only about 20% of children with clubfoot receive treatment. While most donations to GiveWell are directed to programs that reduce child mortality, our growing research capacity over the last several years has expanded what we’re able to evaluate and fund. One outcome of that work is that we’re better able to direct donations to highly cost-effective programs addressing disabling conditions, like clubfoot, and meaningfully improve quality of life.
In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Meika Ball about GiveWell’s grant to MiracleFeet, an organization that expands access to clubfoot treatment. Their conversation walks through MiracleFeet’s program, how we estimated its cost-effectiveness, and Meika’s recent site visit to see the program in action in Côte d’Ivoire.
Elie and Meika discuss: How MiracleFeet supports clubfoot treatment: Clubfoot is treated using the Ponseti method, which involves casts to correct the foot’s position, a small surgical procedure, and a period of bracing. MiracleFeet supports this treatment by partnering with local health facilities, training healthcare workers, educating local communities about clubfoot, providing treatment materials, and working with Ministries of Health. Because of this support, treatment is provided at no cost to patients or their caregivers. GiveWell-funded independent surveys in Côte d’Ivoire and Chad indicated that very few children with clubfoot were being treated before the program, and hundreds have been enrolled since the program’s launch. What we learned from a recent site visit: Two GiveWell staff members recently traveled to Côte d’Ivoire to visit health facilities and see children being treated through MiracleFeet’s program. We spoke with a range of stakeholders, including healthcare workers, implementing partners, representatives from the Ministry of Health, caregivers of children receiving treatment, and disability advocates. Seeing the program in action increased our confidence that it is leading more children with clubfoot to receive treatment and is having an important impact on their lives. We also saw early signs of the program being integrated into national health systems, such as clubfoot being added to a maternal child health booklet that parents and midwives review after a child is born. What makes this grant different: Most of GiveWell’s grantmaking focuses on preventing child deaths from widespread conditions like malaria or diarrhea. Clubfoot is a relatively rare condition that causes disability, not death. The treatment costs more per child than many other programs we fund, such as distributing vitamin A supplements or malaria nets, and requires sustained caregiver adherence over several years. To assess this grant opportunity, GiveWell applied moral weights, or subjective valuations, for the impact of clubfoot so it could be compared with other programs’ outcomes. We also made a separate grant to support monitoring and evaluation of the program to assess how much MiracleFeet’s support increases the number of children receiving appropriate and effective treatment.
Our ability to evaluate, fund, and monitor a program like MiracleFeet’s is possible because of years of investment in our research team. This program exemplifies how our growing capacity is enabling us to expand our search for cost-effective opportunities where donors can do exceptional good.
Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates. This episode was recorded on March 30, 2026 and represents our best understanding at that time.
More from GiveWell Conversations
In an effort to direct substantially more funding to the most cost-effective opportunities we can find to help people, GiveWell’s research is expanding in two directions at once: going broader, to cover more areas of global health and development, and going deeper, to improve the inputs that inform our decision-making.
GiveWell works to continually improve our research so we can make better grant decisions and direct donations where we believe they can do the most good. GiveWell’s Cross-Cutting research subteam is an important part of that effort—it investigates the impact of the programs we fund, works to resolve our largest uncertainties, and aims to improve our research. As GiveWell’s grantmaking grows, the Cross-Cutting subteam is strengthening our data collection and analysis to support that growth. In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Program Director Alex Cohen, who leads the Cross-Cutting subteam, about how better data can improve our decision-making, our work to gather stronger evidence, and the ways we’ve tested AI as a tool to increase our research capacity and quality.
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