Child Survival

Global evidence has shown that nearly nine million children under five years of age die each year from causes that are largely preventable: pneumonia, diarrhea, and malaria, with malnutrition as an underlying cause of 35 percent of these deaths. PSI’s child survival efforts are focused on finding the most appropriate channels to reach caretakers and provide them with high quality, cost effective, and integrated health services that address the main causes of childhood morbidity and mortality.

For pneumonia, PSI has developed easy-to-use pre-packaged therapy kits, available through private clinics and community-based health workers to treat the disease in children under five, where national policy permits. To prevent diarrheal diseases, PSI implements programs at scale that ensure access to and use of water and sanitation products and services and promotes improved hygiene behaviors. To treat diarrheal diseases, PSI promotes the benefits of diarrhea treatment, educates caregivers and health providers on why ORS and zinc is the most effective way to manage acute diarrhea, and ensures availability of these life-saving products through private and public sector channels, including community case management of diarrhea. To prevent malaria, PSI increases access and use of long lasting insecticide treated nets through campaigns and routine delivery approaches as the main focus of prevention interventions. Additionally, rapid diagnostic tests and artemisinin-based combination therapies are used for case detection and treatment, respectively. To address one of the major underlying causes of child deaths, PSI promotes appropriate maternal infant and young child nutrition and works to increase access and demand for micronutrient fortified foods. Finally, to reduce neonatal mortality, PSI is focused on increasing access to and demand for safe birthing check lists, clean delivery kits containing misoprostol (where oxytocin is unavailable) for post partum hemorrhage, and 4% chlorhexidine for neonatal sepsis. PSI uses formative research to inform the design of marketing and communications campaigns that stimulate demand for health products and services using a variety of channels such as mass media, community level events and interpersonal communication.


Malaria affects approximately half of the world’s population but the majority of deaths are concentrated among children under five in sub-Saharan Africa. PSI supports efforts to increase access to effective malaria prevention and treatment interventions, and works closely with ministries of health, primarily in Africa and Asia, to scale up proven interventions and sustain coverage over time. These interventions include: delivery of long-lasting insecticide treated nets (LLINs), long-lasting insecticide retreatment tablets, artemisinin-based combination therapies (ACTs), rapid diagnostic tests (RDTs), strategic behavior change communications and applied operational research. PSI uses multiple channels to deliver these interventions, including the public and private sectors and community case management strategies. PSI works in 32 malaria endemic countries, including 24 in Sub Saharan Africa. To date, PSI has delivered more than 150 million insecticide treated mosquito nets and more than 35 million malaria treatments.

Healthy Lives through Partnership
As a result of the organization’s technical and operational capacity, PSI is acknowledged as a key implementing agency of the Roll Back Malaria (RBM) Partnership. PSI is an active member of the NGO delegation to the RBM Board and is a member of eight RBM technical working groups.

>> Learn more about PSI's malaria programs.

Diarrheal Disease

Each year, almost 1.5 million children around the world die from diarrheal disease* due to unsafe water, inadequate sanitation and poor hygiene practices. PSI currently manages diarrhea control programs in more than 30 countries across Africa, Asia and the Caribbean.

In order to effectively prevent diarrheal diseases it is essential that households have good hygiene practices and access to safe drinking water and improved sanitation. To this end, PSI applies its expertise in social marketing to change hygiene behaviors and make markets work for the poor to ensure affordable water, sanitation and hand washing with soap products and services are in demand and easily accessible to consumers at the bottom of the pyramid.

For the management of diarrhea cases, PSI promotes the use of oral rehydration salts (ORS) and zinc. In May 2004, WHO/UNICEF issued a joint statement recommending the use of zinc with ORS as the best way to decrease the incidence, severity and recurrence of diarrheal disease in children. In 2011, PSI distributed 1.3 million DTKs and averted 58,000 DALYs. PSI’s diarrheal disease treatment programs identify the most significant factors that influence diarrhea treatment seeking among caregivers to develop communications and product distribution strategies that respond to their needs and preferences. PSI promotes the benefits of diarrhea treatment, educates caregivers and health providers on why ORS and zinc is the most effective way to manage acute diarrhea, and ensures availability of these life-saving products through private and public sector channels, including community case management of diarrhea.

>> Learn more about PSI's diarrheal disease programs.

* United Nations Children’s Fund and World Health Organization, ‘WHO/UNICEF Joint Statement: Clinical management of acute diarrhoea’, UNICEF, New York, 2004.


Globally, pneumonia is the leading cause of death among children under five. Each year, pneumonia kills more children than AIDS, malaria, and measles combined. With effective treatment and prevention interventions that target caregivers and providers, 1.6 million deaths from pneumonia can be avoided each year. PSI has developed easy-to-use pre-packaged therapy kits to treat pneumonia in children under five, and made them available in six countries through private clinics and community-based health workers as permitted by national policy. PSI also implements communication campaigns to promote prevention strategies, such as the importance of handwashing and exclusive breastfeeding, raises awareness about the availability of effective pneumonia treatment, and improves the ability of caretakers to recognize pneumonia symptoms, promptly seek care and complete the treatment course.

Behavior Change Communication for Pneumonia Prevention
PSI uses behavior change techniques and communications to promote pneumonia prevention. As part of PSI’s community case management efforts, community health workers are trained to provide pneumonia prevention messages to caregivers of children under five. The messages focus on exclusive breastfeeding for the first six months, reduction of indoor air pollution and hand-washing with soap, which have respectively been shown to lead to 15-23 percent, 75 percent and 50 percent reductions in pneumonia morbidity.*

>> Learn more about PSI's pneumonia programs.

* UNICEF, WHO, Pneumonia: The Forgotten Killer of Children, September 2006.


Recent estimates suggest that maternal and child undernutrition is the underlying cause of 3.5 million deaths. Undernutrition is not merely a result of too little food; rather, it is a consequence of myriad factors, including poverty, repeated illnesses, inadequate access to health services, insufficient macro and micronutrient intake, unsafe water, and lack of access to improved sanitation. Cost-effective and proven interventions, when appropriately tailored and applied during the Window of Opportunity, “The First 1,000 Days” from conception to age two, can break the vicious cycle of undernutrition. PSI seeks to launch and scale up evidence based nutrition interventions including iron folic acid and multivitamin tablets for women of reproductive age, the promotion of exclusive breastfeeding, home fortification with micronutrient powder, and large scale food fortification. PSI reaches women and children with these lifesaving interventions through community health workers, private sector providers as well as public health facilities.

>> Learn more about PSI's malnutrition programs.


Neonatal mortality (death within the first 28 days of life) contributes to 41% of child mortality worldwide. Close to 50% of newborn mortality occurs within the first 48 hours of life. This, coupled with minimal progress in reducing newborn mortality, calls for a concerted, targeted effort in order to make progress towards achieving MDG-4. PSI is fully committed to this call and is consequently focused on increasing demand and access to quality neonatal interventions.

PSI fully endorses and promotes the Essential Newborn Care (ENC) approach, an integrated set of interventions that includes early initiation of exclusive breastfeeding; kangaroo mother care; delayed bathing; and early detection of infection, all of which are delivered by community health workers during home visits. PSI is also working to increase access to 4% Chlorhexidine (CHX), a simple and inexpensive antiseptic shown to reduce all cause newborn mortality by 23%. This product is most effective when applied within the first 24 hours of birth. PSI’s diverse health service delivery approach that includes clean delivery kits, antenatal based services, private provider networks and community based distribution enables increased access to 4% CHX at scale.

>> Learn more about PSI's neonatal programs.

Strategic Partnerships

By working in partnership, PSI is able to maximise the impact of every dollar spent on child health interventions by leveraging the technical and financial resources of partners. PSI collaborates with global institutions such as the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), as well as national ministries of health, the private sector and other non-governmental organizations (NGOs) to implement its programs.

The list below represents the key working groups and task forces that PSI contributes to.

MNCH Roundtable
US Coalition for Child Survival
Health – WASH Network
CORE group (including nutrition, malaria and general updates)
Appropriations Working Group
Budget and Policy Advisory Group
GHI Working Group
Global Health Implementers Advisory Group

Frontline Community Health Workers
Zinc Task Force – external relations, technical working group
CCM Technical Advisory Group
CCM Taskforce (via MCHIP)

1,000 Days Advocacy Working Group
MIYCN (Maternal Infant Young Child Nutrition) Task Force
Food Fortification Initiative Task Force
CMAM (Community Management of Acute Malnutrition) Task Force
SUN – Civil Society Task Force
Private Sector Task Force – Nutrition
HF – TAG (Home Fortification Technical Advisory Group)

Global Water Corps (Challenge)
Household Water Treatment Network
WASH Working Group

RBM – MERG (Monitoring & Evaluation Reference Group)
Malaria Roundtable
RBM Case Management Working Group
RBM Vector Control Working Group (especially the Continuous LLIN Distribution Workstream)
RBM Malaria Advocacy Working Group
RBM Alliance for Malaria Prevention (PSI chairs the Sustaining Gains Working Group)
RBM Harmonization Working Group
ACTwatch Advisory Committee
RBM Procurement & Supply Chain Management Working Group
RBM Sub-Regional Networks – West Africa, Central Africa, East Africa, Southern Africa

Malaria & Child Survival Staff

Malaria & Child Survival Staff