Foundation supports efforts to improve the rate of survival and to encourage the normal physical and cognitive development of disadvantaged infants and young children in the United States and in the developing world. A principal approach has been to encourage the wider use of simple, inexpensive, but effective techniques to prevent or treat the most common childhood maladies, such as diarrhea and malnutrition. Working in poor, mostly rural communities far removed from sophisticated and often prohibitively expensive medical care, Child Survival/Fair Start workers train local practitioners and midwives in preventive and therapeutic techniques; educate community leaders and young women about the nutritional advantages of breast-feeding; and encourage the use of readily available foods—such as salt, sugar, and vegetables—to combat nutritional and intestinal disorders. These approaches have been used effectively in Bangladesh, India, Indonesia, Egypt, and the Sudan.

In the United States, a Foundation-supported home visiting program that aims to improve the health and mental development of Mexican American children in East Austin, Texas, is based on knowledge gained in Latin America. The nurse-practitioner in charge of a Foundation-funded preventive health program for Hispanic migrant farm workers in South Florida is using educational materials and strategies developed in Central America. And a home health record, in which parents record their children's growth and development and keep track of their immunizations and illnesses, originated in West Africa and is now being tested in New York City with newly arrived immigrants from Latin America.

Another area of fruitful interchange between our programs in the United States and in the developing world is the building of community development organizations. The Foundation's long experience with a number of community development corporations in the United States helps us to better understand the problems faced by similar organizations in developing countries. In the Third World, as in the United States, nongovernmental organizations are becoming increasingly important as providers of goods and services that governments are unable or unwilling to provide. Both here and overseas, community development groups must balance the need for projects showing early and obvious results with the need for longer-term efforts that may be less dramatic but no less important. Local development organizations must balance reliance on charismatic leaders with the development of sound organizational structures that ensure continuity and stability, such as strong boards of directors. Development organizations must remain on good terms with local authorities while advocating forcefully on behalf of their constituencies.

Donor organizations must also perform a balancing act of sorts: their desire to provide financial and other assistance must not prevent grantees from managing their own affairs and from developing expertise in obtaining on their own the range of assistance they need. The Foundation's efforts to assist community development organizations