In the Spaces Between: Moments of Change at Tara Health in 2024

By Elise Belusa, Executive Director  

Dear Friends, 

As I reflect on 2024, I find myself grappling with a year that defied easy narratives. We continue to discover that transforming from the inside out is never black and white - it's a constant practice of showing up, making mistakes, trying again, and sometimes getting it right. Yet our commitment to truly living our values has become some of the most nourishing and joyful work we've ever done. Being authentic, just, equitable, and transparent in our practices and relationships will remain our north star through our closure in December 2028. 

Our work has always centered on relationships – they are the foundation of everything we do. This year, we experienced their power while working supporting all-trimester abortion providers during an urgent funding crisis, watching our anchor organizations continue their vital work, and conducting our first grantee perception report to understand how we have (and haven't) shown up in alignment with our values.

We also intentionally invested in our relationships between board and staff. Through shared experiences and vulnerable conversations, we moved from a framework of "power over" to connecting from a place of shared humanity. This deeper connection resulted in new, nourishing relationships while also revealing that our past efforts to shift decision-making authority from board to staff had created distance between different parts of our organization. Now we're learning that we need new ways to shift power without building walls – and figuring out what that actually means in practice.

2024 also taught us, sometimes painfully, that we don't always show up the way we intend to, and we lost some important relationships because of this. These losses pushed us to examine how we still unconsciously hold onto control, perpetuate harmful dynamics, and sometimes prioritize our own comfort over real change. While sitting with these hard truths, I am deeply moved by how we continued to live into our core belief: when we create spaces for real relationships – the hard parts, the good, and all the spaces between – something transforms. 

As we look ahead to 2025, we know there will be challenges – indeed, there already have been. So, we want to bring forward a spirit of joy and celebration for the work we're proud of, which you'll find highlighted in the sections below. Through our newly launched blog, LinkedIn, and video storytelling, we've also started sharing both our successes and our struggles as we navigate this complex work, and in the coming year, we’ll expand these efforts significantly. 

I hope you’ll join us and follow along. 

In partnership, 

Elise Belusa 

OPENING UP: Centering Relationships and Transparency  

In April, staff and board gathered in Montgomery, Alabama to engage directly with our country's history of racial terror. We visited the Equal Justice Initiative's Legacy Sites, and honored Anarcha, Lucy, and Betsey at the Mothers of Gynecology Monument. Alongside our experiences of grief and despair, we also experienced the power of remembrance and healing, guided by Keecha Harris and Associates and somatic practitioner Panya Walker. These days cracked open our relationships to one another as we began to imagine what healing could look like in practice. 

Some of our deepest work happened in December, when we brought together our board, staff, and anchor organizations. We grappled with fundamental questions: What does this work really mean? How do we authentically reckon with power? How do we even talk about power? How do we tell a story about ourselves without centering ourselves? 

Across these experiences, our time was both joyful and challenging, but through difficult conversations and moments of connection, shared meals and honest feedback, we lived our values of authenticity and deepened our commitment to relationships as a key component of change. 

BUILDING UP: Leveraging All of Our Resources

We took concrete steps toward our spend-down commitments this year, realigning our investment portfolio while continuing strategic grantmaking. While the majority of our grants supported our anchor partners, we also continued significant investments in the Race, Healing, and Joy project, our Southern Fund portfolio, and provided rapid response support through our Flex Fund. We also forgave $1.5 million in debt to support our partners - a reminder that sometimes the most impactful move is to simply let go, whether of financial control, traditional investment approaches, or established ways of working.

As our work evolved, so did our team. We welcomed Mia Reilly to staff and formed partnerships with Studio Mesh, 1R Productions, and Langhum Mitchell Communications - expanding our capacity to document and share the insights emerging from this work.

BLOOMING FORTH: Anchor Organizations in Action 

Our anchor organizations are at the heart of how we're trying to approach spend-down differently. Rather than simply closing our doors and hoping our impact continues, we're working to transfer both resources and relationships to organizations deeply rooted in their communities. It's a strategy we're still figuring out together.

Rhia Ventures helped us see what was possible here. They showed us early on in Tara’s existence that we could do more than just move money – we could seed new institutions that carry forward not just funding, but relationships and knowledge built over years. As we developed our spend down strategy, we expanded this approach, supporting the creation of additional anchor organizations led by our former portfolio leads who brought their own deep expertise and connections to the work.

This year, we watched Orchid Capital Collective, The Center for Business and Social Justice at BSR, and the Oasis Institute (website forthcoming) demonstrate what’s possible when philanthropy commits to transferring both financial and human capital to leaders deeply rooted in their movements and communities. We encourage you to learn more and explore their work, and look forward to sharing more about these organizations in the coming months.

Transformative Philanthropy

It’s messier, deeper, and more profound than I anticipated.

By Ruth Shaber, MD, Founder and President

When I founded Tara Health in 2014, I carried the certainty of a physician. I was convinced that clear metrics, evidence-based solutions, and innovative tools would solve systemic problems. With decades of experience in women's healthcare and systems engineering, I set out to apply medical rigor to philanthropy, believing that data-driven decisions and creative deployment of capital would transform the lives of women and girls. I believed our approach was transformative, but the journey ahead would challenge not just our methods, but our core assumptions about transformation itself. 

From the start, we committed to aligning 100% of our assets — financial and human — with our mission. Working with the Foust/Meeker team at Merrill Lynch, we began in public markets, building what we hoped would be a fully mission-aligned portfolio. When we found metrics and evidence lacking, we deployed grant dollars to develop frameworks like the XX Factor and Four for Women, adding tools and rigor to the field of gender-lens investing. As our corpus grew from $10 million to $82 million, we expanded into private investments, taking direct stakes in companies advancing women's health and bringing other funders alongside us to build lasting infrastructure in the field.

This comprehensive approach to deploying capital remains core to our work today. We match capital types to problems: blending grants with low-interest loans for abortion clinics, providing capital alongside technical expertise for early-stage companies.

But our commitment has always extended beyond writing checks. From the beginning, we believed that contributing our time, networks, and expertise was essential to strengthening our partners' work. In our early years, this meant my hands-on involvement in initiatives like reproductive healthcare quality measurement with Planned Parenthood Federation of America, and the Center for Youth Wellness's groundbreaking work to advance evidence-based interventions for children exposed to Adverse Childhood Experiences (ACEs). 

Today, this same commitment to building deep relationships as catalysts for change guides our partnerships with our anchor organizations: Rhia Ventures, Orchid Capital Collective, the BSR Center for Business and Social Justice, and the Oasis Institute (website forthcoming). As we move through our spend-down, our fundamental belief remains unchanged: transforming unjust systems requires leveraging every resource — grant dollars, investment capital, and the power of people working in genuine partnership with one another.

The Profound Messiness of Power

Yet, even as we built these innovative structures and solutions, questions began to surface that would fundamentally reshape my understanding of power, expertise, and transformation. The metrics and frameworks we developed reflected deeper assumptions about whose knowledge counted and what impact meant. The certainty I'd relied on as a physician and philanthropist - the very certainty that had guided my entire professional life — was about to be challenged in ways I never expected.

What began to unfold through relationships with partners and grantees was messier, deeper, and more profound than I could have anticipated. It pushed me to examine not just how we deployed resources, but the deeper assumptions about power and change that I had never thought to question — assumptions that had shaped not just my work, but my sense of self. 

As we kick off a new chapter of our work, focused on telling our stories and grappling with our learnings, I look forward to sharing more about my ongoing journey — one that continues to surface new questions, challenges, and joys even as I write these words. I invite you to watch the video below where I begin unpacking my journey through a more personal lens.

A New Chapter for Tara Health

By Elise Belusa, Executive Director, Tara Health Foundation 

Dear friends, 

In the eight years since I joined Tara Health, initially as a program officer, almost everything has changed. And yet, as I write this, I see that the foundation’s most enduring spark still persists: our eagerness to challenge norms, take risks and push beyond the comfortable boundaries of conventional philanthropic practice.

They say the middle part of a story is the hardest to tell. In my current role as executive director of Tara Health, I'm acutely aware that we're navigating through the middle. Our beginning is behind us, our conclusion is visible on the horizon, yet we're embarking on a significant new phase of our work — one we hope will contribute meaningfully to the broader conversation about the role of institutions and people in creating change.

The Call to Action 

For years, our grantees, partners, and peers called on powerful institutions, like ours, to confront an uncomfortable truth: the money and power we hold and steward are often built upon the very unjust systems we seek to change. Their call to action has been clear: break from the status quo, dismantle long-standing power structures, and redistribute to reimagine. 

Like many of you, we’ve done our best to listen deeply. Though spending down has always been Tara Health’s plan, we have shaped the “how” of our spend down in response to these calls to action. We’ve committed to transferring 100% of our resources to the movements we support over the next three to five years. We’re now also committed to engaging with the broader philanthropic and investment landscape, seeking to understand our place within it and how we might contribute meaningfully to its transformation. 

What’s unfolding at Tara Health is a long, incomplete, and nonlinear journey of transformation. We are reimagining nearly everything: from how we build and support staff, to who serves on our board, to how we’re governed, how we invest, make grants, define impact, and more. We’ve shifted our mission, our vision, our organizational structure, our relationships, and ourselves in response to our growing understanding of power — how we hold it, how it shapes our work, and how transforming it could perhaps be our most meaningful impact. 

The Landscape

The contours of this new landscape are both encouraging and challenging. The tools for transformative change are largely at our fingertips — documented and ready for use. Yet, something crucial seems missing: the collective will and courage to fully embrace this change. Many of us who steward significant resources grapple with deep, disquieting questions about transforming our power, privilege, and control. At Tara Health, we’ve found that doing so can be complex and sometimes painful. But beyond the discomfort, beyond the fear of loss, we’re discovering unexpected purpose, connection and even joy. 

This discovery guides our final commitment: to document and share, honestly and vulnerably, our collective and individual experiences reckoning with and relinquishing our historically unjust status, capital and power. By telling our stories — the struggles, breakthroughs, and ongoing questions — we can contribute to building the collective will our world needs and deserves. 

Transforming power is a complicated, often winding journey. It is deeply personal and profoundly collective. As we move from the middle of our story to our final chapters, we’re committed to sharing what “transforming in action” has looked like for us in its raw, unpolished truth. Hopefully, our experiences will inspire others to do the same. 

Join us in the months and years ahead as we continue sharing our experiences in this new blog. Next month’s post will feature our founder’s perspective, and we invite you to engage with these stories, challenge our thinking and share your own journey. 

Your story, like ours, is part of this broader narrative of reimagining what’s possible. As we move forward, we hope you will breathe with us, dream with us and grow with us. Because ultimately, the transformation of philanthropy — and beyond —  isn’t just about changing systems or practices. It’s about changing ourselves and, in doing so, expanding what’s possible in our work and shared world.

Best, 
Elise