Issue 4 | April 2016

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See What's New and Bold at PSI.

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We're locally rooted and globally connected. Explore the impact we’re making around the world.

Get inspired by five cutting-edge programs in global health.
(And sign up to receive this innovative report by email.)

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To see more innovations from around the world, check out our past issues.

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Simpler Measurement for Reaching The Poor

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households surveyed worldwide using the EquityTool app since December 2015

Programs developed to serve the poor, often don’t know if they are fulfilling their mandate because they lack a means of measuring the exact wealth status of their beneficiaries in real-time. PSI partnered with a panel of experts from USAID; Marie Stopes International; Results for Development; University of California, San Francisco (UCSF); BroadBranch and Metrics for Management to develop a simpler approach to equity assessment. The EquityTool app is an easy-to-use, easy-to-interpret way of assessing the relative wealth of program clients and is free of charge.

The EquityTool uses just 6 to 18 questions from the Demographic and Health Survey (DHS) Wealth Index for each country and benchmarks the results to national or urban-only comparison groups. The survey is pre-translated into local languages and can be completed in a few short minutes. Functioning online and offline, the EquityTool allows multiple survey collectors to gather and upload data simultaneously, securing it in a cloud-based database. Users can calculate results automatically and immediately generate a report to use as a real-time management tool.

WHY?

PSI’s social franchise programs prioritize serving the poor, but because methods for identifying poor clients have been imperfect, expensive and used infrequently, it can be difficult to understand how well they perform against this goal. NGOs everywhere experience this problem. Programs often learn about their impact at the end of a project or after an expensive program evaluation, when it may be too late to improve service delivery. Knowing about the relative wealth of clients in real time permits course correction and can help ensure that programs such as PSI are meeting their goal of providing equitable services to beneficiaries.

So what questions do you imagine measure someone’s wealth in a low- or middle-income country?

Our Partners: Marie Stopes International | UCSF | Results for Development | BroadBranch | Metrics for Management
Funder: USAID
Delve Deeperhttp://www.equitytool.org/
Photo Credit: Emily Carter

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Transforming the Market for Quality Malaria Medications

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additional doses of quality-assured ACT entering the DRC’s private sector in one year

Upwards of 6.5 million cases of malaria are reported in the Democratic Republic of Congo every year, making it the second most malaria-affected country in the world. The majority of individuals seek care and treatment for suspected malaria in private clinics and pharmacies, yet uninformed consumers often receive poor quality and ineffective malaria treatments. With funding from the UK’s Department for International Development (DfID), PSI and network member Association de Santé Familial (ASF) are working to transform the market and ensure all consumers in Kinshasa, DRC, have access to affordable quality malaria medications in the private sector.

The program incentivizes manufacturers of quality-assured artemisinin-based combination therapies (ACTs), the recommended treatment for malaria, to enter the market by making a subsidy available. This also makes the medicines affordable to consumers. Pharmacists and consumers can then identify quality-assured malaria medicines by their “Green Leaf” logo. A strong promotional campaign featuring the “Green Leaf” logo on billboards, radio and TV ads, and grassroots marketing is making both pharmacists and consumers more aware of the importance of quality-assured ACT and increasing demand. By increasing demand and growing the category for “Green Leaf” products, the price of these medicines will be kept low and will gradually allow the subsidy to be phased out, thus, creating demand and a more sustainable market for ensuring access to all quality-assured medicines. By working with manufacturers on the supply side as well as demand creation for the category, PSI achieves market development.

WHY?

The World Health Organization recommends that all fever should be confirmed before treatment with the recommended artemisinin-based combination therapies (ACT). However, in the private sector of Kinshasa— where 90% of malaria medications are procured — uninformed consumers continue to receive malaria medications that lack quality assurance or that are no longer considered effective. Furthermore, with 42% of the population of Kinshasa living on less than $1 a day, higher quality treatments are often out of reach for most of the population, causing consumers to opt for the cheaper, less effective malaria medications. Ineffective treatments not only fail to treat the disease, but also contribute to the spread of artemisinin resistance.

Although quality-assured ACTs are the gold-standard in malaria treatment, the market in the DRC has struggled to be developed.

Our Partners: National Malaria Control Program (PNLP) | The Global Fund
Funder: DfID
Delve Deeper: Quality Malaria Medications to Congolese Through the Private Sector
Photo Credit: Alena Sims

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Increasing Access to Contraception: Designing with Girls

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potential DALYs averted by increasing adolescent contraceptive use across Ethiopia, Nigeria, and Tanzania

One of the critical solutions to ending global poverty is meeting the unmet demand for short and long-acting contraception. Every girl in the world should be able to make choices about her health and future, and have access to the contraceptives and services that would enable her to do so. To put girls first, PSI — in partnership with leaders in user-centered design, developmental neuroscience, market development and technology — is leading Adolescents 360, a four-year project funded by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation.

Working in Nigeria, Ethiopia and Tanzania, Adolescents 360 will bring together adolescent girls, health professionals, marketers, designers, and scientists to design innovative solutions to improving access to voluntary modern contraception among 15-19 year old girls. Through the development of a unique adolescent-centered, developmentally and anthropologically informed marketing process, Adolescents 360 aims to transform the way we “do business” in global health and inspire a movement toward improving the health and lives of girls all over the world.

WHY?

Increasing access to high-quality sexual and reproductive health information, products and services will lead to profound health, economic and social benefits for adolescents, their families and their communities. The unmet need for modern contraception among adolescent girls is high. In sub-Saharan Africa alone, 40% of girls and young women want to use contraception but aren’t able to access it. Despite a long history of work in this space, the global health community still struggles to truly understand and navigate the complex web of barriers that girls face. By bringing adolescent girls into the design lab, we hope to cut through that complexity and co-create solutions that are effective and replicable across settings.

Interested in seeing what can happen when you co-design solutions with teens using insights from their peers, parents and partners?

Our Partners: Society for Family Health Nigeria | IDEO.org | Triggerise | Ogilvy & Mather Africa | The Center on the Developing Adolescent at the University of California, Berkeley
Funders: Bill & Melinda Gates Foundation | Children’s Investment Fund Foundation
Delve Deeper: PSI and Consortium Members Launch Adolescents 360 – PSI Impact
Photo Credit: Sameer Kermalli

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Monitoring Modern Family Planning Markets

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outlets, such as clinics and pharmacies, surveyed for quality, quantity and variety of contraception offered across Ethiopia

To help inform program and policy decision-making, PSI aims to understand the total family planning market in high-priority FP2020 countries. FPwatch, a multi-country research project, uses standardized tools and approaches to provide comparable data for modern family planning methods across countries and time. Launched with funding from the Bill & Melinda Gates Foundation, and later from the Three Millennium Development Goals Fund, the project has been implemented in five countries: Ethiopia, Nigeria, the Democratic Republic of Congo, Myanmar and India.

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Data collectors conduct quantitative, cross-sectional surveys from a sample of public and private outlets with the potential to sell or distribute modern contraceptives and/or offer family planning services. These outlets include health facilities, community health workers, pharmacies, drug stores, retail outlets, market stalls and mobile providers. Sampling public and private sector outlets allows PSI to understand the total market for FP products and services.

FPwatch audits all modern contraceptives available and interviews providers at eligible outlets to learn the quantity available, consumer price and sale/distribution volumes for each product. Additionally, brand types and prices for male and female condoms are collected. Findings provide an estimate of contraceptive availability and relative market share across the entire market, as well as within key market segments.

WHY?

FPwatch is designed to provide timely, relevant and high-quality market evidence to inform national and global policy, strategy and funding decisions for family planning markets. The program monitors family planning markets to promote strategic investments in family planning as part of the FP2020 Initiative, a partnership aiming to expand access to family planning information, services and supplies to an additional 120 million women and girls in 69 of the world’s poorest countries by 2020.

Think you know the FP2020 objectives for Ethiopia?

Funders: Bill & Melinda Gates Foundation | Three Millennium Development Goals Fund
Delve Deeper: www.fpwatch.info
Photo Credit: Jake Lyell

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Eliminating Malaria in the Greater Mekong Subregion

PSI’s Three-Pronged Approach

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Improve case management to rapidly test, treat and track every malaria case

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Establish state-of-the-art surveillance procedures to report case data directly into the national systems

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Use data to drive decisions, course correct and build up the evidence to inform private sector strategies more widely

gms-insetAcross the Greater Mekong Subregion (GMS), the private sector remains the source of health care for a sizeable proportion of the population and therefore, failing to address poor case management in the private sector poses a serious threat towards malaria elimination goals.

PSI launched a $20 million project, funded by the Bill & Melinda Gates Foundation, to improve malaria case management in the private sector in four key countries: Cambodia, Lao PDR, Myanmar and Vietnam. Building on a strong foundation of PMI-funded quality assurance innovations and mHealth tools, this new funding will ensure that all cases are rapidly detected and appropriately treated; establishing reporting systems that will accurately track each case and reporting this data into the national health system; as well as building resources to inform private sector strategies in other malaria-endemic countries aiming for elimination.

WHY?

Expanding access to artemisinin-based combination therapies (ACTs) has been pivotal in reducing the global malaria burden. From 2000-2013, major investments have successfully dropped the mortality by 47%, but progress is fragile. The Greater Mekong Subregion is the historical starting point for drug resistance and artemisinin-resistant parasites have been detected in Cambodia, Laos, Myanmar, Thailand and Vietnam. Should resistance spread, it has the potential to derail recent successes both within the region and on the African continent with devastating effect. Malaria elimination in the GMS will not only eliminate the roughly 1.8 million annual cases in the region, but will stop resistance popping up independently and spreading. Early detection, strong surveillance and patient follow up in both the public and private sectors will be the key.

Think you know about the fight against malaria?

Our Partners: PLAN, University of Baltimore | PATH |
Ministries of Health: Cambodia, Lao PDR, Myanmar and Vietnam
Funder: Bill & Melinda Gates Foundation | President’s Malaria Initiative (PMI)
Delve Deeper: Malaria Elimination Efforts in the Greater Mekong Subregion – PSI Impact
Photo Credit: Jake Lyell

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2015 Health Impact

The Scale of PSI Programming In 2015
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LIVES CHANGED (ESTIMATED)

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3,896,671 unintended pregnancies prevented.

9,246 maternal deaths prevented.

379,286 deaths due to malaria, diarrhea & pneumonia prevented.

234,367 HIV infections prevented.

SERVICES PROVIDED

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694,301 long-acting, reversible contraceptives inserted (including implants and intrauterine devices), empowering women and couples to plan for the families they desire.

282,018 voluntary adult medical male circumcisions performed, preventing HIV and other sexually transmitted infections (STIs).

1,578,027 voluntary testing and counseling sessions for HIV and other STIs conducted, reducing transmission rates and increasing access to treatment through referrals.

PRODUCTS DISTRIBUTED

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44,221,302 long-lasting insecticide-treated nets, protecting families from malaria.

1,137,857,646 male and female condoms, preventing transmission of HIV and other STIs and empowering women and couples to plan for the families they desire.

3,395,326 diarrhea treatment kits, saving children’s lives by reducing the severity and duration of diarrheal disease.

24,298 courses of directly observed therapy, saving lives by treating tuberculosis.

1,274,413 pre-packaged antibiotics, saving lives by treating pneumonia.

11,121,111 courses of artemisinin–based combination therapy, saving lives by treating malaria.

10.6 billion liters of water treated with water treatment products.

In 2015, PSI added an estimated 44.9 million years of healthy life with our products and services.

HOW DOES PSI CALCULATE YEARS OF HEALTHY LIFE ADDED?

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One DALY averted = one year of healthy life

PSI estimates the impact of its health interventions using the Disability-Adjusted Life Year (DALY), a unit of measurement developed by the World Bank and the World Health Organization to estimate years of life lost due to death and disability. We track each product we deliver and service we provide. We then use mathematical models to calculate the DALYs averted by our work.

OUR IMPACT: Years of Healthy Life Added

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About PSI

Group of smiling, waving African children

At PSI, we believe that extreme poverty can be eradicated in our lifetime only by breaking the traditional development model. Together with our partners, we develop and test breakthrough concepts that actually have the potential to go to scale and make it easier for people in the developing world to lead healthier lives.

ONLY PSI HAS

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A global network structure of more than 65 member organizations.

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A 45-year track record of developing cutting-edge health solutions.

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The ability to take proven health interventions to scale.

ONLY TOGETHER WITH OUR PARTNERS CAN WE

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Invent effective health solutions.

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Test concepts and bring investments to the right ideas.

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Free 1.2 billion from poverty within our lifetime.

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Financial Statements

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With every $41.76 you invested in PSI in 2015, you gave a mother and her two children a year of healthy life.

2014 REVENUE BY DONOR

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EXPENSES BY YEAR (IN MILLIONS)

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REVENUE BY YEAR

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DONORS*

AstraZeneca United Kingdom

Australian AID

Barbara Jones

Bill & Melinda Gates Foundation

Civil Society Fund

Global Fund to Fight AIDS, Tuberculosis and Malaria

Government of India

Government of the Netherlands

Government of South Africa

Indrani Goradia

KfW

Merck & Co., Inc.

Swedish International Development Cooperation Agency

Unilever

United Kingdom Department for International Development

United Nations Children’s Fund

United Nations Office for Project Services

United Nations Population Fund

United States Agency for International Development

United States Centers for Disease Control and Prevention

United States Department of Defense

World Health Organization

* Donors listed contributed a minimum of U.S. $1 million in 2014.

The figures on this page are excerpted from statements and schedules issued by PSI’s external auditors. Copies of audited statements are available upon request from PSI in Washington, DC. Please email info@psi.org.

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