PSI Impact Relies Less on Contraceptives, More on Mosquito Nets, Water

WASHINGTON, DC, Feb. 20, 2004 — PSI, which built a reputation in the social marketing of condoms and contraceptives, has derived in 2003, for the first time, more than half of its annual measurable health impact from non-contraceptive products and services, according to the nonprofit organization's December 2003 health impact report. "Couple years of protection (CYPs)," for years the predominant source of PSI's health impact, contributed 49% of PSI's health impact in 2003, down from 57% in 2002.

That is not to say that PSI CYPs declined in 2003; in fact, they increased by 11% over 2002. It's just that PSI increased its health impact even more in other areas, such as malaria prevention and safe water.

PSI achieved almost 22.4 million Persons Years of Protection (PYPs) in 2003, 30% higher than 2002 (PYP is a formula developed by PSI which combines several indices of protection into one generic unit estimating the person years of protection PSI provides through sales of its products and services. Details on these indices can be found in the Notes section.

The report also showed that PSI improved its cost-efficiency dramatically and surpassed every financial target, with the "cost per PYP" dropping to $8.34. This represents a decrease of 19% over the last five years.

These figures include only sales of PSI's own health products and services delivered through social marketing. PSI also promotes behavior not related to sales of products or services — such as abstinence, fidelity, partner reduction, hand-washing, oral rehydration therapy and use of iodized salt — but these are not taken into account here due to the difficulty of measuring the impact of such behavior. Sales of commercial products and services stimulated by PSI's programs are also not counted here.

The biggest contributors to this increase, in absolute terms, were Person Years of Malaria Protection (PYMP) with an increase of 2.9 million from 2002 to 2003, Person Years of Treated Water (PYTW), with an increase of 1.15 million and CYPs, with an increase of 1 million. In percentage terms, the biggest increases were in PYTW, which increased 126%, and PYMP, with an increase of 68%. The only type of PYP to decrease was Child Years of Rehydration (CYRH), down by 1%, mostly due to lower sales of oral rehydration salts in Burkina Faso, Côte d'Ivoire, Togo and Benin.

CYPs, for many years PSI's main source of PYPs, contributed 49% of PYPs in 2003, down from 57% in 2002. PYMPs now account for 32% of total PYPs (up from 25% in 2002). PYTW produced 9.2% of PYPs, up from 5.3% in 2002, and CYRH accounted for 8.9%, down from 11.7% in the previous year.

PSI uses models to convert sales and PYPs into health outcomes. It easily exceeded its 2003 goals for averting primary HIV/AIDS infections (goal of 547,000 compared to 650,000 actually achieved), malaria episodes (36.3 million compared to 47.2 million) and pregnancies (5.9 million compared to 6.2 million). "These health outcomes are PSI's bottom line and are very impressive accomplishments," said Senior Vice President Will Warshauer.

Eastern and Southern Africa, where PYPs increased by 4.1 million (an increase of 65%), was the region driving the overall increase. Eastern Europe also increased by an impressive 60% although from a much lower base of 91,252 PYPs in 2002. Asia PYPs increased by 23% and West and Central Africa by 16%. The Americas dropped by 31% and "Other Africa" (Nigeria, Morocco, Uganda and Namibia) fell by 6%, mostly due to commodity shortages in Nigeria.

Countries averting the most pregnancies were Pakistan (1,059,126), Nigeria (1,032,803), India (819,172), Zimbabwe (300,880), Côte d'Ivoire (211,862), Nepal (207,232) and Tanzania (202,363).

Countries averting the most primary cases of HIV/AIDS (according to a formula developed by PSI's AIDSMark Project) include Nigeria (135,247), Zimbabwe (111,738), Cote d'Ivoire (48,303), Tanzania (48,237), South Africa (44,415) and Zambia (44,125).

Countries averting the most episodes of malaria were Malawi (15.2 million episodes), Kenya (9.9), Tanzania (4.6), Zambia (3.6), Mozambique 2.8) and Madagascar (2.5).

Person years of protection is a formula developed by PSI which combines five indices of protection (contraception, rehydration, malaria, water and vitamin supplementation) into one generic unit which estimates the person years of protection PSI provides through the sale of its products and services. PYPs only take into account sales of PSI's own products and services and not other types of protection generated by PSI's considerable generic behavior change communication campaigns (promoting abstinence, fidelity and partner reduction) or sales of commercial product and services stimulated by PSI's programs.

— David J. Olson, PSI/Washington

• Archives

PSI/Rwanda educators demonstrate the proper use of the safe water system Sûr Eau which helps prevent diarrheal episodes and combats child mortality due to the consumption of dirty water.