<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-10-10T20:30:17+00:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>363990892</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Capin Crouse LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1255 Lakes Parkway Suite 105</AddressLine1Txt>
        <CityNm>Lawrenceville</CityNm>
        <StateAbbreviationCd>GA</StateAbbreviationCd>
        <ZIPCd>30043</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>261303951</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Lwala Community Alliance</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>LWAL</BusinessNameControlTxt>
      <PhoneNum>6157946359</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO Box 60688</AddressLine1Txt>
        <CityNm>Nashville</CityNm>
        <StateAbbreviationCd>TN</StateAbbreviationCd>
        <ZIPCd>37206</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Ash Rogers</PersonNm>
      <PersonTitleTxt>Co-CEO</PersonTitleTxt>
      <PhoneNum>6157946359</PhoneNum>
      <SignatureDt>2023-10-10</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>Erin</PersonFirstNm>
        <PersonLastNm>Ricci</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Luke Burnett</PreparerPersonNm>
      <PTIN>P01079018</PTIN>
      <PhoneNum>5055022746</PhoneNum>
    </PreparerPersonGrp>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="IRS990" softwareId="22016089" softwareVersionNum="2022v5.0">
      <PrincipalOfcrBusinessName>
        <BusinessNameLine1Txt>Ash Rogers</BusinessNameLine1Txt>
      </PrincipalOfcrBusinessName>
      <USAddress>
        <AddressLine1Txt>PO Box 60688</AddressLine1Txt>
        <CityNm>Nashville</CityNm>
        <StateAbbreviationCd>TN</StateAbbreviationCd>
        <ZIPCd>37206</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>10535830</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>lwala.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2007</FormationYr>
      <LegalDomicileStateCd>NH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>To build the capacity of rural communities to advance their own comprehensive wellbeing.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>10</TotalEmployeeCnt>
      <TotalVolunteersCnt>11</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>15920758</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>5106089</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>425497</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>434109</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>14276</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>-43543</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>16360531</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>5496655</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>559337</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1938973</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>2285440</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>197828</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>4039794</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>3601429</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>5978767</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>6446206</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>10381764</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-949551</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>17369042</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>16281420</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>224741</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>302445</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>17144301</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>15978975</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>To build the capacity of rural communities to advance their own comprehensive wellbeing.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>2111635</ExpenseAmt>
      <GrantAmt>391536</GrantAmt>
      <RevenueAmt>434109</RevenueAmt>
      <Desc>Centers of Excellence The community of Lwala village donated land and resources to bring health care to their community and constructed the area's first health clinic. Today, the Lwala Community Hospital provides care to more than 60,000 patient visits a year and delivery for over 700 babies. We test innovations at the Lwala hospital which we then use to improve care in hundreds of health facilities across the health system. Examples include Obstetric Hemorrhage bundle with the Non-pneumatic Antishock Garment (NASG) and neonatal resuscitation (Helping Babies Breathe) that is informing emergency obstetric care practices across Kenya. Our goal is to elevate Lwala Community Hospital as a Center of Excellence, a hospital modeling, teaching and advancing dignified, holistic, patient-centered primary health care.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>1662924</ExpenseAmt>
        <GrantAmt>83901</GrantAmt>
        <Desc>Maternal &amp; Child Health: Lwala deploys professionalized community health workers to deliver care in homes. Core to our model is the incorporation of traditional birth attendants into professionalized cadres of community health workers. We pay, train, supervise and digitally empower community health workers to extend health services to every household. We track individualized data that demonstrates high achievements on immunization coverage, skilled delivery rates and under 5 mortality. We use digital tools and data to support health decision making and accelerate training and support of health workers at scale.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>1097404</ExpenseAmt>
        <Desc>Health Systems Strengthening Through bottom-up innovation, Lwala incubates and measures new programs that improve health outcomes. As a result, we have been called upon by the national Ministry of Health (MOH) to develop or revise national policies, guidelines, and curricula. As these national documents are finalized, Lwala then works with the MOH to pilot, evaluate, and scale-up these approaches. We use the set policies and guidelines to strengthen the county health system and build its ability to deliver healthcare for all.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>729348</ExpenseAmt>
        <GrantAmt>83900</GrantAmt>
        <Desc>Adolescents &amp; Youth Working with the youth to reach fellow young people, we deliver innovative adolescent and youth sexual reproductive health in and out of school. We create youth friendly spaces for accessing SRH services, distribute contraceptives in the community, and build agency of girls and boys to make informed choices and to complete school.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>188858</ExpenseAmt>
        <Desc>WASH &amp; Vulnerable Groups Consistent with our belief that holistic interventions best serve at-risk populations, Lwala addresses HIV and Water, Sanitation, and Hygiene (WASH) together in an integrated program. Research shows that HIV-positive individuals are more susceptible to malaria, diarrhea, and other enteric diseases. Therefore, we implement WASH interventions in conjunction with HIV care to reduce the relative risk for malaria and diarrheal diseases among people living with HIV/AIDS. Our model empowers community members to elevate WASH standards in their own communities and is implemented alongside the Migori County Ministry of Health.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>918206</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>83900</TotalOtherProgSrvcGrantAmt>
      <TotalProgramServiceExpensesAmt>5790169</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
      <ConservationEasementsInd>false</ConservationEasementsInd>
      <CollectionsOfArtInd>false</CollectionsOfArtInd>
      <CreditCounselingInd>false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd>false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd>false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>true</ForeignOfficeInd>
      <ForeignActivitiesInd referenceDocumentId="IRS990ScheduleF">true</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd referenceDocumentId="IRS990ScheduleF">true</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="IRS990ScheduleM">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="IRS990ScheduleR">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd>false</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>5</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>10</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>true</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>TN</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Stephanie Skryzowski</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>6157946359</PhoneNum>
        <USAddress>
          <AddressLine1Txt>PO Box 60688</AddressLine1Txt>
          <CityNm>Nashville</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37206</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>George Srour</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director and Secretary</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Jessie Adams</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director and Chair</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Melizsa Mugyenyi</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director and Vice-Chair</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Stephen Carr</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director and Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Constance Shumba</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Erin Ricci</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Fred Ochieng'</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Gladys Onyango</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Mamka Anyona</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Milton Ochieng'</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Richard Wamai</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Ashley Rogers</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Executive Director</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>175710</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12277</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Katelin Gray</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Communications &amp; Development Manager</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>114499</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10684</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>290209</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>22961</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>5106089</AllOtherContributionsAmt>
      <NoncashContributionsAmt>171735</NoncashContributionsAmt>
      <TotalContributionsAmt>5106089</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Health Service Fee</Desc>
        <BusinessCd>621498</BusinessCd>
        <TotalRevenueColumnAmt>370348</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>370348</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>63761</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>63761</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>434109</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>158457</TotalRevenueColumnAmt>
        <ExclusionAmt>158457</ExclusionAmt>
      </InvestmentIncomeGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>4837175</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>4944118</SecuritiesAmt>
        <OtherAmt>95057</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-106943</SecuritiesAmt>
        <OtherAmt>-95057</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-202000</TotalRevenueColumnAmt>
        <ExclusionAmt>-202000</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>5496655</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>434109</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-43543</ExclusionAmt>
      </TotalRevenueGrp>
      <ForeignGrantsGrp>
        <TotalAmt>559337</TotalAmt>
        <ProgramServicesAmt>559337</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>187988</TotalAmt>
        <ProgramServicesAmt>122192</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18799</ManagementAndGeneralAmt>
        <FundraisingAmt>46997</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>2018152</TotalAmt>
        <ProgramServicesAmt>1701622</ProgramServicesAmt>
        <ManagementAndGeneralAmt>238664</ManagementAndGeneralAmt>
        <FundraisingAmt>77866</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>8542</TotalAmt>
        <ProgramServicesAmt>5731</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1429</ManagementAndGeneralAmt>
        <FundraisingAmt>1382</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>31665</TotalAmt>
        <ProgramServicesAmt>21094</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4811</ManagementAndGeneralAmt>
        <FundraisingAmt>5760</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>39093</TotalAmt>
        <ProgramServicesAmt>24434</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6416</ManagementAndGeneralAmt>
        <FundraisingAmt>8243</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>81436</TotalAmt>
        <ManagementAndGeneralAmt>81436</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>20597</TotalAmt>
        <ManagementAndGeneralAmt>20597</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>58190</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16148</ManagementAndGeneralAmt>
        <FundraisingAmt>42042</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>273913</TotalAmt>
        <ProgramServicesAmt>245214</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24031</ManagementAndGeneralAmt>
        <FundraisingAmt>4668</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>38579</TotalAmt>
        <ManagementAndGeneralAmt>27752</ManagementAndGeneralAmt>
        <FundraisingAmt>10827</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>222198</TotalAmt>
        <ProgramServicesAmt>222198</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>127151</TotalAmt>
        <ProgramServicesAmt>119692</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7416</ManagementAndGeneralAmt>
        <FundraisingAmt>43</FundraisingAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>5723</TotalAmt>
        <ManagementAndGeneralAmt>5723</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>98761</TotalAmt>
        <ProgramServicesAmt>97056</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1705</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>50669</TotalAmt>
        <ProgramServicesAmt>47387</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3282</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Program Activity Expense</Desc>
        <TotalAmt>2330243</TotalAmt>
        <ProgramServicesAmt>2330243</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Monitoring and Evaluation Expenses</Desc>
        <TotalAmt>163772</TotalAmt>
        <ProgramServicesAmt>163772</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Clinical Facility Expenses</Desc>
        <TotalAmt>130197</TotalAmt>
        <ProgramServicesAmt>130197</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>6446206</TotalAmt>
        <ProgramServicesAmt>5790169</ProgramServicesAmt>
        <ManagementAndGeneralAmt>458209</ManagementAndGeneralAmt>
        <FundraisingAmt>197828</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2149760</BOYAmt>
        <EOYAmt>2676800</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>8796170</BOYAmt>
        <EOYAmt>6228513</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>5239884</BOYAmt>
        <EOYAmt>3741909</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <EOYAmt>27041</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>254174</BOYAmt>
        <EOYAmt>153499</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>69996</BOYAmt>
        <EOYAmt>90427</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>1245153</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>386888</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>794115</BOYAmt>
        <EOYAmt>858265</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <EOYAmt>2464673</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>64943</BOYAmt>
        <EOYAmt>40293</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>17369042</BOYAmt>
        <EOYAmt>16281420</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>224741</BOYAmt>
        <EOYAmt>302445</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <LoansFromOfficersDirectorsGrp>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>224741</BOYAmt>
        <EOYAmt>302445</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>9581231</BOYAmt>
        <EOYAmt>8073414</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>7563070</BOYAmt>
        <EOYAmt>7905561</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>17144301</BOYAmt>
        <EOYAmt>15978975</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>17369042</BOYAmt>
        <EOYAmt>16281420</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-949551</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-274371</NetUnrlzdGainsLossesInvstAmt>
      <InvestmentExpenseAmt>20597</InvestmentExpenseAmt>
      <OtherChangesInNetAssetsAmt>37999</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="22016089" softwareVersionNum="2022v5.0">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>2363500</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3632691</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6122093</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15920758</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5106089</CurrentTaxYearAmt>
        <TotalAmt>33145131</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TaxRevLeviedOrgnztnlBnft170Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft170Grp>
      <GovtFurnSrvcFcltsVl170Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>2363500</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3632691</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6122093</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15920758</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5106089</CurrentTaxYearAmt>
        <TotalAmt>33145131</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>3065900</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>30079231</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>7510</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>16478</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8377</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>14276</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>94763</CurrentTaxYearAmt>
        <TotalAmt>141404</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>33286535</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>866026</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.9036</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.9459</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="22016089" softwareVersionNum="2022v5.0">
      <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="IRS990ScheduleD" softwareId="22016089" softwareVersionNum="2022v5.0">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>35947</OtherCostOrOtherBasisAmt>
        <BookValueAmt>35947</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>458289</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>22914</DepreciationAmt>
        <BookValueAmt>435375</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>555747</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>254575</DepreciationAmt>
        <BookValueAmt>301172</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>195170</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>109399</DepreciationAmt>
        <BookValueAmt>85771</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>858265</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>5222284</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-253774</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>-253774</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>5476058</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>20597</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>20597</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>5496655</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>6425609</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>6425609</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>20597</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>20597</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>6446206</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="IRS990ScheduleF" softwareId="22016089" softwareVersionNum="2022v5.0">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Sub-Saharan Africa</RegionTxt>
        <OfficesCnt>1</OfficesCnt>
        <EmployeeCnt>138</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Program Services</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>Centers of Excellence, Health Systems Strengthening, WASH &amp; Vulnerable Groups, Adolescents &amp; Youth, Maternal &amp; Child Health, Research &amp; Learning, and PPE</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>5230832</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Sub-Saharan Africa</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Grantmaking</TypeOfActivitiesConductedTxt>
        <RegionTotalExpendituresAmt>559337</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>1</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>138</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>1</TotalOfficeCnt>
      <TotalEmployeeCnt>138</TotalEmployeeCnt>
      <SubtotalSpentAmt>5790169</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>5790169</TotalSpentAmt>
      <ForeignIndividualsGrantsGrp>
        <TypeOfAssistanceTxt>In-Kind Pharmaceuticals</TypeOfAssistanceTxt>
        <RegionTxt>Sub-Saharan Africa</RegionTxt>
        <RecipientCnt>1500</RecipientCnt>
        <NonCashAssistanceAmt>559337</NonCashAssistanceAmt>
        <DescriptionOfNonCashAsstTxt>Pharmaceutical Supplies</DescriptionOfNonCashAsstTxt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
      </ForeignIndividualsGrantsGrp>
      <TransferToForeignCorpInd>false</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>false</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>false</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>false</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>false</ForeignPartnershipInd>
      <BoycottCountriesInd>false</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization employs a monthly review prior to approving transfer of each month's funds to the Kenyan entity. The review includes a financial file and memo accompanying the fund transfer request that reports the current budget vs actual, updated projected expenditures and how the fund request is tired to the month's work plan of activities as well as other monthly internal control checks. This is approved by the executive director. The health center in Kenya also has a separate annual audit by an independent audit firm. The intention of the organization's structure is that the US entity does not control Kenya bank accounts but instead requires detailed wire request, monthly reconciliation, and transparent accounting for all funds released.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements</FormAndLineReferenceDesc>
        <ExplanationTxt>SUB-SAHARAN AFRICA-Accrual</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, Part III Method used to account for expenditures on org's financial statements</FormAndLineReferenceDesc>
        <ExplanationTxt>SUB-SAHARAN AFRICA -</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="22016089" softwareVersionNum="2022v5.0">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Ashley Rogers</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Executive Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>175710</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5046</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7231</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>187987</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="IRS990ScheduleM" softwareId="22016089" softwareVersionNum="2022v5.0">
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Medical Supplies</Desc>
        <ContributionCnt>5</ContributionCnt>
        <NoncashContributionsRptF990Amt>171735</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Selling cost</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule M, Part I Explanations of reporting method for number of contributions</FormAndLineReferenceDesc>
        <ExplanationTxt>Other - Medical Supplies The number of contributions represent the number of contributions received, not the number of items donated.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="22016089" softwareVersionNum="2022v5.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d Description of other program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 729,348 including grants of $ 83,900) Adolescents &amp; Youth Working with the youth to reach fellow young people, we deliver innovative adolescent and youth sexual reproductive health in and out of school. We create youth friendly spaces for accessing SRH services, distribute contraceptives in the community, and build agency of girls and boys to make informed choices and to complete school.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d Description of other program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 188,858 including grants of $) WASH &amp; Vulnerable Groups Consistent with our belief that holistic interventions best serve at-risk populations, Lwala addresses HIV and Water, Sanitation, and Hygiene (WASH) together in an integrated program. Research shows that HIV-positive individuals are more susceptible to malaria, diarrhea, and other enteric diseases. Therefore, we implement WASH interventions in conjunction with HIV care to reduce the relative risk for malaria and diarrheal diseases among people living with HIV/AIDS. Our model empowers community members to elevate WASH standards in their own communities and is implemented alongside the Migori County Ministry of Health.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Delegate broad authority to a committee</FormAndLineReferenceDesc>
        <ExplanationTxt>The Executive Committee consists of 4 members. The committee must include at least one Director among its members. A committee shall have the powers granted to it by the By-Laws and/or as delegated to it by the Board of Directors. A Director may be a member of more than one committee. The Chair shall be an ex-officio member of all committees with voting privilege at all meetings.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 2 Family/business relationships amongst interested persons</FormAndLineReferenceDesc>
        <ExplanationTxt>Fred Ochieng and Milton Ochieng - Family relationship</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>The 990 is reviewed by the finance committee, the Treasurer of the organization and other board members who have expertise in tax related matters. A copy of the return is given to the board prior to filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>Board Chair compiles conflict of interest statements for each Board member. Vice Chair and Co-CEO review all the statements, including the Board Chair's statement. The Board Chair revies the Vice Chair and Co-CEO's statements. Interested persons are any director, principal officer, or member of a committee with governing board delegated powers must disclose the existence of any financial interest in a transaction or arrangement of the organization. The Chairperson of the governing board shall appoint a disinterested person to investigate alternatives to the proposed transaction or arrangement. If a more advantageous transaction or arrangement is not reasonably possible, the governing board will determine by majority vote of the disinterested directors if the transaction or arrangement is in the organization's best interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 15a: The compensation is reviewed by the Board and a Compensation Committee. The organization uses the CNM nonprofit compensation survey as well as the Form 990 for other organizations as a guide to set the target salary range for the Executive Director. The organization contemporaneously substantiates the deliberation and the decisions. Line 15b: The organization does not compensate any other officers or key employees. Therefore, this line was answered no in accordance with the instructions.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>The corporation's annual information return shall be made available for public inspection for a three (3) year period beginning with the due date for the return. In like fashion, the corporation shall make available for public inspection one (1) copy of the application for recognition of federal tax exemption on Form 1023 and one (1) copy of any papers submitted in support of the application and any letter or other document issued by the Internal Revenue Service with respect to such application.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 2f Other Program Service Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>- Total Revenue: 63761, Related or Exempt Function Revenue: 63761, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Translation Adjustment - 37999;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, Part V</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization operates a health center in Lwala, Kenya. Lwala Community Health Centre is a multidimensional organization with programs in clinical care, public health outreach, education, and economic development.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="22016089" softwareVersionNum="2022v5.0">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Lwala Community Health Centre</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <ForeignAddress>
          <AddressLine1Txt>PO Box 24</AddressLine1Txt>
          <CityNm>North Kamagambo</CityNm>
          <ProvinceOrStateNm>Rongo</ProvinceOrStateNm>
          <CountryCd>KE</CountryCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>KE</LegalDomicileForeignCountryCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Lwala Community Alliance</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule R, Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>In order to operate under the laws in Kenya, Lwala Community Alliance established a foreign non-governmental organization (NGO), Lwala Community Health Centre. Lwala Community Health Centre shares five out of six Board members with the filing organization with one Kenyan board member as required by Kenyan law, and its operations represent Lwala Community Alliance's operations in Kenya under Lwala Community Alliance's Board's supervision. Per our interpretation of the Form 990 instructions Lwala Community Health Centre is seen as an extension of US operations and, therefore, in order to file a complete and accurate return, its activity is included on this Form 990 and the NGO is reported in Schedule R, Part II as a related tax-exempt organization.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
