Igniting Youth Access to Contraceptives

by Sandy Garçon, External Relations and Communications Manager, PSI, and Alia McKee, Principal, Sea Change Strategies

Although there is progress, use of modern contraceptives in Haiti remains stubbornly low. At 31 percent, the country’s unmet need for family planning is among the highest in the world.


Haiti also has a high rate of teen pregnancy, which intensifies risks for both girls and their babies. A startling one in three of those who give birth are under 20 years old. Fifty percent of girls and women ages 15 to 24 want contraception but don’t have access to it.

“We cannot continue to bury our heads in the sand when we have pregnancies that are happening to 14 and 15-year-olds,” says Dr. Reynold Grand’ Pierre, director of the Family Health Unit of Haiti’s Ministry of Health.

In support of efforts to reverse adolescent and youth sexual and reproductive health and rights (AYSRHR) trends in the country, PSI and the Dutch Ministry of Foreign Affairs have joined forces with the government of Haiti. Countering the risks associated with early pregnancy and unsafe abortions necessitates radically broadening how girls can source sexual and reproductive health services. Doing so effectively, however, requires better addressing the supply and demand realities on the ground.

Through the Ignite project, PSI is working to give young consumers easier access to family planning solutions by transforming the health market and ensuring sustainability beyond the life of the project.

We take a look at the different players along the supply chain working to increase and sustain the informed use of contraception among Haitian girls and women aged 15 to 24.


PSI has a long been a key player in the family planning space in Haiti. In the early 1990s, PSI, in collaboration with USAID, successfully introduced the socially marketed Pantè condom brand, which became a household name.

Despite widespread familiarity with condoms, injectables and oral contraceptives (OC), close analysis of the market revealed that most modern methods were largely unknown or simply absent in the private sector, where most Haitians seek care. OHMaSS, PSI’s local affiliate, discovered that the challenge was not getting commodities to Haiti, but instead was the means for wholesale distribution once the products arrived in the country.

With a focus on increasing the availability and variety of contraceptive products, OHMaSS found a likely partner and presented Disprophar, a commercial distributor, an opportunity to become a leader in the contraception space.

As a result, the distribution partner added to its business model a portfolio of family planning products, including OC, emergency contraception, intrauterine devices (IUDs), implants, the injectable Sayana® Press and medical vacuum aspiration kits for post-abortion care.

The OHMaSS staff outside their office in Port-au-Prince. (Photo credit: OHMaSS/Maxence Bradley)

“In addition to our own brands, we leveraged our partnerships with manufacturers Merck and Pfizer to offer a menu of high-quality contraceptives at competitive prices,” explains Stéphane Docteur, OHMaSS medical services coordinator.

“We took a big bet that we could change the way we do business in Haiti,” says Frédérick Persoons, OHMaSS executive director. “Now it’s a matter of promoting and making women aware that these methods are available on the market.”

As a market convener, OHMaSS not only unblocked obstacles to supply, but also started to drive demand. Frédérick and his team looked no further than PSI’s Adolescents 360 (A360) project, which aims to increase contraceptive access for adolescent girls in Ethiopia, Nigeria and Tanzania.

Applying an A360-inspired Human-Centered Design approach, OHMaSS worked alongside adolescent girls and young women (aged 15-24) to understand their experiences, needs and barriers surrounding contraceptive access and use. Utilizing insights gathered, OHMaSS launched a multilayered marketing campaign built around the idea of creating a youth movement.

The campaign is Djanm, which symbolizes strength, determination, vigor, dynamism and tenacity in Haitian Creole. It encompasses participation in major cultural events such as Carnival, organization of youth-focused events called Djanm Buzz in local communities and a presence on social media channels like Facebook and Instagram. Djanm’s dedicated Facebook page features videos, live Q&A with providers and other interactive content that has become a viable touch point to reach youth with AYSRHR information and services.

At the community level, Djanm’s trained youth ambassadors are another element of the campaign critical to spreading the message to their peers.

Already, Frédérick and his team have a greater vision for Djanm, “We want to create a movement that can serve as a sponsor to any form of positive attitude or activities that are related to sexual and reproductive health.”


Disprophar General Director Daniel Malherbe. (Photo credit: OHMaSS/Maxence Bradley)

Daniel Malherbe greets guests at Disprophar, the pharmaceutical distribution company he founded with two colleagues 30 years ago, like he’s welcoming guests in his home. Disprophar’s founders, who started their careers as pharmaceutical sales representatives, are bringing their vast experience to help OMHaSS create a market for family planning products and services in the Port-au-Prince metropolitan area.


Until recently, the family planning market in Haiti was completely supported by international nongovernmental organizations (NGOs). But a gap in NGO-provided reproductive health products has opened up the opportunity for a sustainable private sector market.

“We have a social responsibility to diminish the number of unwanted children in Haiti,” remarks Daniel. “But first, we must sell family planning—not just the products, but family planning as a concept—to the Haitian people.”

They’ve done it before and intend to do it again.

Haitians are predisposed to eye diseases like glaucoma. But until recently, there was little demand for ophthalmology services due to lack of awareness. The Disprophar team identified the opportunity and launched a large-scale campaign to raise awareness about glaucoma and the importance of regular eye exams.

With the help of a robust radio and television advertising campaign, Disprophar reached millions of Haitians and changed behaviors related to eye care. “We sold the disease, not the products,” Daniel says. “We must do the same thing for family planning.”

From left: Staff members Daniel Malherbe, Raphaëlle Jean-Baptiste, and Jean Clifford Deshommes at Disprophar headquarters. (Photo credit: OHMaSS/Maxence Bradley)

Marie Lucie Poteau is part of the dedicated team of medical detailers employed by Disprophar to do just that. She focuses on getting doctors to both carry the family planning products that OHMaSS procures and counsel their patients— especially young women—on the benefits of contraception. She also connects the providers to trainings offered by OHMaSS.

A team of commercial detailers focuses on working through pharmacies to get the products into the hands of consumers. They cater to more than 200 outlets in the Port-au-Prince metropolitan area, ranging from pharmaceutical depots, to high-end drugstores, to small shops.

To help them more effectively sell their products, OHMaSS used an application called BaseCase. The tool helps manage potential objections from providers. Individual providers are categorized as one of the following: ‘aware of the products,’ ‘ready for trial,’ ‘already adopted,’ ‘advocate.’ Depending on where the provider falls, BaseCase provides videos and information sheets that medical and commercial detailers can use to influence behaviors at each level.

But Marie Lucie emphasizes that she doesn’t encounter much pushback from doctors. “My experience is that most doctors are willing and just need us to help them cut through the myths Haitians have about family planning.”

Daniel and his team are optimistic about the market. “There is a huge unmet need for family planning services here. I only see demand going up.”


Many people are under the impression that women in Haiti do not take the proper precautions to avoid unwanted pregnancy. The truth is that most often these women don’t know they have options or where to turn.

This is the reality that Dr. Pascal Thierry often faces.

He is among the 150 providers— nurses and doctors—in the Port-au-Prince metropolitan area who were trained by Disprophar and OHMaSS to provide youth-friendly modern contraception services.

He takes a break from his busy patient schedule to chat with Marie Lucie, the Disprophar medical detailer who sells him family planning products, including implants and IUDs.

Few of his patients request family planning methods. “Those with more education ask for it,” says Dr. Thierry, “but other women, they don’t mention it at all.”

Nevertheless, Dr. Thierry counsels women on family planning when he thinks the time is right.

“After I deliver a baby, I talk about a method. Twenty to 30 percent of women come back for one. If I think someone is sexually active, I’ll counsel her, too. But it can be awkward, especially if she comes in with her parents.”

Dr. Thierry thinks PSI’s Djanm initiative is crucial to turn things around. “It’s a good project. We must reach young women in their early 20s who don’t want to get pregnant. I want them to say to me, ‘I saw this on Facebook and I want a method.’”

Across town, more than 100 women crowd into the local community center in Simon-Pelé, a neighborhood bordering the infamous Cité Soleil slums. They are gathering for the OHMaSS mobile clinic that calls the community center home once every three months.

OHMaSS Nurse Maritane Henry offers a client Meuri oral contraception. (Photo credit: OHMaSS/Maxence Bradley)

Nurse Maritane Henry, whose mobile clinic team regularly visits underserved areas like Simon-Pelé, credits improved awareness in the community for the turnout.

Many of the women learned of this mobile team through community criers who circulated through the neighborhood announcing the upcoming services.

“The mobile clinic is a way to provide services for those who cannot pay,” explains Maritane. Distribution is capped at 10 percent of the market so as not to interrupt the long-term health of efforts to go beyond aid.

All of the women who visited the clinic were aware of at least one modern contraceptive method, the most common being condoms and injectables. Some were afraid of contraception after having heard stories of medical procedures gone wrong or being told by parents or peers that birth control is not good.

At their local pharmacies, consumers can now purchase emergency contraceptives and, with a prescription, birth control pills and injectables. “There is always a shortage of emergency pills, because it is less expensive. We often have to suggest alternative methods because we stockout,” remarks pharmacist Leo Guerson.

Providers like Leo must also get acquainted with new products and new brands that have replaced those that were discontinued. But there is much excitement for the new arrivals and providers are eager to test how the new products and brands fare with consumers.

The next big challenge for OHMaSS is to design a network of clinics to help ensure service providers are youth-friendly, and to build partnerships that effectively spread the word.


Lindsay Toulouse leads a Djanm youth session outside of the local Catholic church. (Photo credit: PSI/Evelyn Hockstein)

“Yell loud so the priest can hear!” As usual, Lindsay Toulouse starts her peer counseling session by encouraging the young participants to belt out the Djanm motto: My life is my choice.

Not only are most of the participants members of Lindsay’s own Eucharistic Youth Movement chapter, this particular session is being held in the courtyard of a local Catholic church, with full blessings from the priest.

At 22 years old, Lindsay is one of 19 peer mentors with the Djanm campaign, which aims to educate young Haitian women and men about family planning and empower them to play an active role in choosing the method that is right for them.

“Many girls in my neighborhood are getting pregnant. I see it a lot, especially when I go to the mobile clinic. Last week, there was a 14-year-old holding twins.”

Lindsay is a second-generation helper. Her father died when she was three years old. From that moment on, her mother Marie Carol Laurent dedicated herself to raising her children. She never remarried, and her professional career centered on helping people as a nurse, which inspired Lindsay to join the OHMaSS team as a community health worker.

Marie Carol has seen all too well the damage unwanted pregnancy can inflict on young Haitian women. She mentions a girl who got pregnant and tried traditional methods to end her pregnancy. She was unsuccessful and after she had the baby, she visited Marie Carol, who told her about modern contraception.

“It’s so important. Young kids don’t want to get pregnant and now that they can see Lindsay beforehand, it’s better.”

Lindsay just finished her law studies and is writing her thesis. She also works full-time with Djanm. Every other day, she conducts one or two sessions educating her peers on contraceptive options and connecting them to providers through referrals. She also identifies community leaders in churches, schools and community centers who she can approach to advocate for the Djanm campaign.

Getting people to attend her trainings is the hardest part of her job. But she remains confident in her message. She wants people in her community to be aware of how they can protect themselves from unwanted pregnancies.


Junie Joseph receives her regular contraceptive injection from Nurse Maritane Henry at the Djanm community clinic. (Photo credit: PSI/Evelyn Hockstein)

It takes Junie Joseph nearly two hours to travel to the clinic. To get there, she takes a tap tap, one of the iconic colorful buses that are most Haitians’ favored mode of public transportation. Then she hails a private taxi. She makes this trek every three months. She trusts the OHMaSS-trained nurses and doesn’t want to go anywhere else.

“I came for the first time in December 2017,” Junie says. “I got an implant, but I had to take it out.”

Junie lives with her older brother and sister. When they saw the implant under the skin in her arm, they told her to move out of the house. “They said I’m living a messed-up life. But I just don’t want a baby.”

After an open talk with her siblings, they agreed to turn a blind eye as long as they couldn’t see the method. That’s why she asked Nurse Maritane Henry, the woman who runs the OHMaSS mobile clinic, to remove the implant and start giving her injections. And that’s why she returns to this clinic every three months.

After each visit Maritane gives Junie a note reminding her when to return.

Junie is open about why she’s here. She is sexually active with her boyfriend Augustin, who is 22. They met when she was visiting a relative’s neighborhood. He saw her on the street and said, “You look like a model. Can you spare two minutes?” She agreed, and they made a date. They’ve been an item since, going to movies and spending time at each other’s homes.

Augustin is supportive of Junie’s decision. “He appreciates that we don’t have the economic means,” she says. “He knows I have dreams.”

Junie wants to be a nurse just like Maritane. “I’d like to be in her place. I would like to help women protect themselves. I would like to serve people like that.”

Banner photo: © PSI/Evelyn Hockstein




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Better data for stronger health systems

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In this video, Wycliffe Waweru – Head of Digital Health & Monitoring at Population Services International – outlines three barriers to the use of data for decision-making in health in low- and middle-income countries. For each barrier, Wycliffe proposes some concrete solutions that can help overcome it.

In this video, Dominic Montagu, Professor Emeritus at the University of California, San Francisco, and CEO of Metrics for Management outlines the three levels of data from private healthcare providers in low- and middle-income countries that need to be sequentially integrated into a country’s health information system to assure that governments can manage the overall health system more effectively.

Join us in this illuminating session as we explore the evolution of the STAR self-testing project, sharing insights, challenges, and successes that have emerged over the years. By examining the lessons learned and considering the implications for future healthcare strategies, we hope to foster a deeper understanding of the transformative potential of self-testing in improving healthcare accessibility and patient-centric services.   

This enlightening session promises to provide updates from WHO guidelines and share insights on the journey toward viral hepatitis elimination. It will also showcase outcomes from the STAR hepatitis C self-testing research and discuss how these findings could potentially inform hepatitis B antigen self-testing and the use of multiplex test kits in the context of triple elimination. Join us in this crucial discussion as we work together to fast-track the global journey toward a hepatitis-free world by 2030. 

In this two-part session, the Bill & Melinda Gates Foundation, PSI, and Population Solutions for Health will share lessons and best practices from rigorous research and hands-on implementation experience in Zimbabwe. The session will cover important topics like client-centered, community-led demand creation, differentiated service delivery, sustainable financing, and digital solutions. The sessions will also cover lessons in the program.  

In this session, PSI and PSH will share lessons for optimizing access to comprehensive, culturally sensitive HIV and sexual and reproductive health services. Topics will include enhancing the accuracy and reliability of sex worker population data, improving HIV case finding among men who have sex with men (MSM) through reverse index case testing, and scaling differentiated service delivery models. The session will also cover integrating mental health and substance abuse in key populations (KP) programming and lessons in public sector strengthening.  

Additionally, the session will showcase solutions that MSMs have co-designed, highlighting how this collaboration has improved the consumer care experience. It will demonstrate the critical role of KP communities in establishing strong and sustainable HIV responses, including amplifying KP voices, strengthening community-led demand, and establishing safe spaces at national and subnational levels for KP communities to shape and lead the HIV response.

This enlightening session promises to provide updates from WHO guidelines and share insights on the journey toward viral hepatitis elimination. It will also showcase outcomes from the STAR hepatitis C self-testing research and discuss how these findings could potentially inform hepatitis B antigen self-testing and the use of multiplex test kits in the context of triple elimination. Join us in this crucial discussion as we work together to fast-track the global journey toward a hepatitis-free world by 2030. 

In this two-part session, the Bill & Melinda Gates Foundation, PSI, and PSH will share lessons and best practices from rigorous research and hands-on implementation experience in Zimbabwe. The session will cover important topics like client-centered, community-led demand creation, differentiated service delivery, sustainable financing, and digital solutions. The sessions will also cover lessons in program management. These insights are applicable beyond Zimbabwe and can be used to scale up HIV prevention efforts in the region.


Scaling Digital Solutions for Disease Surveillance

Strong surveillance systems are essential to detect and respond to infectious disease outbreaks. Since 2019, PSI has worked alongside the Ministries of Health in Cambodia, Laos, Myanmar, and Vietnam to strengthen disease surveillance systems and response. Learn more here.


Misinformation and Vaccine Hesitancy

As COVID-19 spread globally, so did misinformation about countering the pandemic. In response, PSI partnered with Meta to inspire 160 million people to choose COVID-19 preventative behaviors and promote vaccine uptake. Watch the video to learn how. 


The Frontline of Epidemic Preparedness and Response 

Early warning of possible outbreaks, and swift containment actions, are key to preventing epidemics: disease surveillance, investigation and response need to be embedded within the communities. Public Health Emergency Operations Centers (PHEOCs) are designed to monitor public health events, define policies, standards and operating procedures, and build capacity for disease surveillance and response. Learn more here. 

integrating pharmacies and drug shops into the health system



Private sector pharmacies and drug shops play an important role in improving access to essential health services and products for millions of people living in low- and middle-income countries (LMICs), where healthcare resources are often limited. However, the way in which these outlets are, or are not, integrated into health systems holds significant importance. Do they serve as facilitators of affordable, high-quality care? Or have they become sources of substandard health services and products?

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The Consumer as CEO

For over 50 years, PSI’s social businesses have worked globally to generate demand, design health solutions with our consumers, and work with local partners to bring quality and affordable healthcare products and services to the market. Now consolidating under VIYA, PSI’s first sexual health and wellness brand and social business, our portfolio represents the evolution from traditionally donorfunded projects towards a stronger focus on sustainability for health impact over the long term. Across 26 countries, the VIYA model takes a locally rooted, globally connected approach. We have local staff, partners and providers with a deep understanding of the markets we work in. In 2022, we partnered with over 47,000 pharmacies and 10,000 providers to reach 11 million consumers with products and services, delivering 137 million products. VIYA delivers lasting health impact across the reproductive health continuum, from menstruation to menopause. Consumer insights drive our work from start to finish. Their voices, from product exploration to design, launch, and sales, ensure that products not only meet consumers’ needs but exceed their expectations. The consumer is our CEO. 

In 2019, our human-centered design work in East Africa explored ways that our work could support and accompany young women as they navigate the various choices required for a healthy, enjoyable sexual and reproductive life. Harnessing insights from consumers, VIYA is revolutionizing women’s health by addressing the confusion, stigma, and unreliability surrounding sexual wellness. Across five markets – Guatemala, Kenya, South Africa, Uganda and Pakistan – VIYA utilizes technology to provide women with convenient, discreet, and enjoyable tools for making informed choices about their bodies. The platform offers a wealth of high-quality sexual wellness information, covering topics from periods to pleasure in an accessible and relatable manner. Additionally, VIYA fosters a supportive community where users can share experiences and receive guidance from counselors. In 2023, VIYA will begin offering a diverse range of sexual wellness products and connect users with trusted healthcare providers, ensuring comprehensive care tailored to individual needs.  

Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

By: Fana Abay, Marketing and Communications Director, PSI Ethiopia 

In rural Ethiopia, women and girls often face significant barriers in accessing healthcare facilities, which can be located hours away. Moreover, there is a prevailing stigma surrounding the use of contraception, with concerns about potential infertility or the perception of promiscuity. To address these challenges, the Smart Start initiative has emerged, linking financial well-being with family planning through clear and relatable messaging that addresses the immediate needs of young couples—planning for the lives and families they envision. Smart Start takes a community-based approach, utilizing a network of dedicated Navigators who engage with women in their localities. These Navigators provide counseling and refer interested clients to Health Extension Workers or healthcare providers within Marie Stopes International-operated clinics for comprehensive contraceptive counseling and services.  

In a significant development, PSI Ethiopia has digitized the proven counseling messaging of Smart Start, expanding its reach to more adolescent girls, young women, and couples. This approach aligns with the priorities set by the Ethiopian Ministry of Health (MOH) and is made possible through funding from Global Affairs Canada. The interactive and engaging digital messaging has revolutionized counseling services, enabling clients to make informed and confident decisions regarding both their finances and contraceptive choices. 

Clients who received counseling with the digital Smart Start tool reported a higher understanding of their options and were more likely to choose contraception (74 percent) compared to those counseled with the manual version of Smart Start (64 percent). Navigators also found the digital tool more effective in connecting with clients, leading to higher ratings for the quality of their counseling. 

By December 2023, PSI Ethiopia, working in close collaboration with the MOH, aims to reach over 50 thousand new clients by leveraging the digital counseling tool offered by Smart Start. This innovative approach allows for greater accessibility and effectiveness in providing sexual and reproductive health services, contributing to improved reproductive health outcomes for women and couples across the country. 

Building community health worker capacity to deliver malaria care

By: Christopher Lourenço, Deputy Director, Malaria, PSI Global 

Community health workers (CHWs) are critical lifelines in their communities. Ensuring they have the training, support, and equipment they need is essential to keep their communities safe from malaria, especially in the hardest to reach contexts. 

For example, in Mali, access to formal health services remains challenging, with four in ten people living several miles from the nearest health center, all without reliable transportation or access. In 2009, the Ministry of Health adopted a community health strategy to reach this population. The U.S. President’s Malaria Initiative (PMI) Impact Malaria project, funded by USAID and led by PSI, supports the Ministry with CHW training and supervision to localize health services.  

In 2022, 328 thousand malaria cases were recorded by CHWs); 6.5 thousand severe malaria cases were referred to health centers, according to the national health information system. 

During that time, the PMI Impact Malaria project (IM) designed and supported two rounds of supportive supervision of 123 CHWs in their workplaces in the IM-supported regions of Kayes and Koulikoro. This included developing and digitizing a standardized supervision checklist; and developing a methodology for selecting which CHWs to visit. Once a long list of CHW sites had been determined as accessible to supervisors for a day trip (including security reasons), the supervisors telephoned the CHWs to check when they would be available to receive a visit [as being a CHW is not a full-time job, and certain times of the year they are busy with agricultural work (planting, harvesting) or supporting  health campaigns like mosquito net distribution].  

Supervisors directly observed how CHWs performed malaria rapid diagnostic tests (RDTs) and administered artemisinin-based combination therapy (ACT). They recorded CHW performance using the digitized checklist, interviewed community members, reviewed records, and provided on-the-spot coaching. They also interviewed the CHWs and tried to resolve challenges they expressed, including with resupply of commodities or equipment immediately or soon afterwards.  

Beyond the observed interactions with patients, supervisors heard from community members that they were pleased that CHWs were able to provide essential malaria services in the community. And the data shows the impact. 

In IM-supported areas of Mali, 36% of CHWs in the first round were competent in performing the RDT, which rose to 53% in the second. 24% of CHWs in the first round compared to 38% in the second were competent in the treatment of fever cases and pre-referral counseling. Between both rounds, availability of ACT increased from 80 percent to 90 percent. 

Supportive supervision with interviews and observations at sites improved the basic competencies of CHWs between the first and second rounds, and additional rounds will help to understand the longer-term programmatic benefits.

Taking a market-based approach to scale sanitation in Ethiopia

By: Dr. Dorothy Balaba, Country Representative, PSI Ethiopia  

In Ethiopia, PSI leads the implementation of USAID Transform WASH (T/WASH) activity with consortium partners, SNV and IRC WASH. Contrary to traditional models that rely on distribution of free or heavily subsidized sanitation products, T/WASH utilizes a market-based sanitation approach. This approach creates sustainable and affordable solutions, by integrating market forces and supporting businesses to grow, while creating demand at the household level. 

During the last six years, T/WASH has worked alongside the private sector and government (Ethiopia’s Ministry of Health, Ministry of Water and Energy, and Ministry of Labor and Skills), among other stakeholders, to increase household access to affordable, quality sanitation products and services. For example, more than 158 thousand households have invested in upgraded sanitation solutions with rapid expansion to come as the initiative scales and market growth accelerates. 

T/WASH has successfully trained more than 500 small businesses, including community masons and other construction-related enterprises, with technical know-how in sanitation product installation, operational capacities, and marketing and sales skills needed to run successful, growing businesses. The Ethiopian government is now scaling the approach to all districts through various national, regional, and local institutions with requisite expertise. T/WASH has also worked the One WASH National Program, Ministry of Health, Ministry of Water and Energy, and Ministry of Labor and Skills to examine policies that influence increased household uptake of basic WASH services, such as targeted sanitation subsidies, tax reduction to increase affordability, and increased access to loan capital for business seeking to expand and households needing help to improve their facilities. 

To share the journey to market-based sanitation, representatives of the Ethiopian Ministry of Health and the USAID Transform WASH team took to the stage at the UN Water Conference in 2023.

“Rather than relying on traditional aid models that often distribute free or heavily subsidized sanitation products, market-based sanitation creates sustainable and affordable solutions, integrating market forces and supporting businesses to grow.”  

— Michael Negash, Deputy Chief Party of T/WASH 

Promoting self-managed care like Self-testing and Self-Sampling

By: Dr Karin Hatzold, Associate Director HIV/TB/Hepatitis

Building upon the success and insights gained from our work with HIV self-testing (HIVST), PSI is actively applying this approach to better integrate self-care, more broadly, in the health system beginning with Hepatitis C and COVID-19. Self-testing has emerged as a powerful tool to increase access to integrated, differentiated, and decentralized health services, accelerating prevention, care, and treatment for various diseases, while also increasing health system resilience against COVID-19.

Here’s how we got there.

Seven years ago, the landscape of HIV self-testing lacked global guidelines, and only the U.S., the UK and France had policies in place that allowed for HIV self-testing. High disease burdened countries in low-and-middle-income-countries (LMICs) lacked evidence and guidance for HIVST despite major gaps in HIV diagnosis.

However, through the groundbreaking research from the Unitaid-funded HIV Self-Testing Africa (STAR) initiative led by PSI, we demonstrated that HIVST is not only safe and acceptable but also cost-effective for reaching populations at high risk with limited access to conventional HIV testing. This research played a pivotal role in informing the normative guidelines of the World Health Organization (WHO) and shaping policies at the country level. As a result, more than 108 countries globally now have reported HIVST policies, with an increasing number of countries implementing and scaling up HIVST to complement and  partially replace conventional testing services. This became especially significant as nations tried to sustain HIV services amidst the disruptions caused by the COVID-19 pandemic.

By leveraging our expertise, PSI is conducting research to identify specific areas and populations where the adoption of Hepatitis C and COVID-19 self-testing could significantly enhance testing uptake and coverage. This research serves as the foundation for developing targeted strategies and interventions to expand access to self-testing, ensure that individuals have convenient and timely options for testing for these diseases, and are linked to care, treatment and prevention services through differentiated test and treat approaches.

Using peer coaches to counter HIV stigma in South Africa

By: Shawn Malone, Project Director, HIV/AIDS Gates Project in South Africa, PSI Global

In South Africa, where the HIV response has lagged in reaching men, PSI’s Coach Mpilo model has transformed the role of an HIV counselor or case manager into that of a coach and mentor who provides empathetic guidance and support based on his own experience of living with HIV. Coaches are men who are not just stable on treatment but also living proudly and openly with HIV. Situated within the community and collaborating closely with clinic staff, they identify and connect with men struggling with barriers to treatment and support them in overcoming those barriers, whether that means navigating the clinic or disclosing their HIV status to their loved ones.

PSI and Matchboxology first piloted the model in 2020 with implementing partners BroadReach Healthcare and Right to Care as well as the Department of Health in three districts of South Africa. Since then, the model has been rolled out by eight implementing partners in South Africa, employing more than 300 coaches and reaching tens of thousands of men living with HIV. To date, the model has linked 98 percent of clients to care and retained 94 percent of them, in sharp contrast to the estimated 70 percent of men with HIV in South Africa who are currently on treatment.

Given the success of the program, South Africa’s Department of Health and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) have each embraced the Coach Mpilo model in their health strategy and are embedding it in their strategies and programs. 

“The men we spoke to [while I was traveling to South Africa for a PrEP project with Maverick Collective by PSI] were not only decidedly open to the idea of taking a daily pill…many were willing to spread the word and encourage friends to get on PrEP too. We were able to uncover and support this new way forward because we had flexible funding to focus on truly understanding the community and the root barriers to PrEP adoption. This is the philanthropic funding model we need to effectively fight the HIV epidemic, and it’s beneficial for all sorts of social challenges.”

– Anu Khosla, Member, Maverick Collective by PSI

simplifying consumers’ journey to care in Vietnam

By: Hoa Nguyen, Country Director, PSI Vietnam

In late 2022, with funding from the Patrick J. McGovern Foundation, PSI and Babylon partnered to pilot AIOI in Vietnam. By combining Babylon’s AI symptom checker with PSI’s health provider locator tool, this digital health solution analyzes symptoms, recommends the appropriate level of care, and points them to health providers in their local area. The main goal is to support people in low-income communities to make informed decisions about their health and efficiently navigate the healthcare system, while reducing the burden on the healthcare workforce. The free 24/7 service saves people time and subsequent loss of income from taking time off work and from having to pay unnecessary out-of-pocket expenses. Under our global partnership with Meta, PSI launched a digital campaign to put this innovative product in the hands of people in Vietnam. By the end of June 2023 (in the nine months since product launch), 210 thousand people accessed the AIOI platform; 2.4 thousand people created personal accounts on the AIOI website, 4.8 thousand triages to Symptom Checker and linked 2.2 thousand people to health facilities.   

Babylon’s AI symptom checker and PSI’s health provider locator tool captures real-time, quality data that supports health systems to plan, monitor and respond to consumer and provider needs. But for this data to be effective and useable, it needs to be available across the health system. Fast Healthcare Interoperability Resources (FHIR) standard provides a common, open standard that enables this data exchange.
PSI’s first consumer-facing implementation of FHIR was launched in September 2022 as part of the Babylon Symptom Checker project in Vietnam, enabling rapid alignment between PSI and Babylon’s FHIR-enabled client records systems. PSI already has several other consumer health FHIR implementations under active development in 2023, including PSI’s collaboration with the Kenya MOH to launch a FHIR-enabled WhatsApp national health line for COVID-19 health information. PSI will also look to adopt and scale health workforce-facing FHIR-enabled tools, such as OpenSRP2, which will be piloted in an SRH-HIV prevention project in eSwatini in partnership with Ona by the end of 2023.

— Martin Dale, Director, Digital Health and Monitoring, PSI

Engaging the private sector for disease surveillance in Myanmar

By: Dr. Zayar Kyaw, Head of Health Security & Innovation, PSI Myanmar

Under a three-year investment from the Indo-Pacific Center for Health Security under Australia’s Department for Foreign Affairs and Trade (DFAT), PSI is enhancing disease outbreak surveillance and public health emergency preparedness and response capacities in Myanmar, Cambodia, Laos, and Vietnam. When PSI conducted a review of existing disease surveillance systems in Myanmar, it identified several gaps: although the Ministry of Health had systems in place for HIV, tuberculosis, malaria and other communicable diseases, they were fragmented, with different reporting formats and reliance on paper-based reporting. In addition, private sector case surveillance data were not routinely captured, yet private clinics and pharmacies are the dominant health service delivery channel in the country. This hindered effective disease prevention and control efforts.

Building on our extensive private sector malaria surveillance work under the BMGF-funded GEMS project in the Greater Mekong Subregion, PSI implemented a case-based disease notification system using social media channels to overcome the limitations of paper-based and custom-built mobile reporting tools. These chatbots, accessible through popular social media platforms like Facebook Messenger and Viber, proved to be user-friendly and required minimal training, maintenance, and troubleshooting. The system was implemented in more than 550 clinics of the Sun Quality Health social franchise network as well as nearly 470 pharmacies. The captured information flows to a DHIS2 database used for real-time monitoring and analysis, enabling rapid detection of potential outbreaks. Local health authorities receive instant automated SMS notifications, enabling them to promptly perform case investigation and outbreak response.

In 2022, private clinics reported 1,440 malaria cases through the social media chatbots, while community mobilizers working with 475 private providers and community-based malaria volunteers reported more than 5,500 cases, leading to the detection of two local malaria outbreaks. Local health authorities were instantly notified, allowing them to take action to contain these surges in malaria transmission. During the same time, pharmacies referred 1,630 presumptive tuberculosis cases for confirmatory testing – a third of which were diagnosed as tuberculosis and enrolled into treatment programs.

Training health workers in Angola

By: Anya Fedorova, Country Representative, PSI Angola  

The shortage of skilled health workers is widely acknowledged as a significant barrier to achieving Universal Health Coverage. To address this challenge, PSI supported ministries of health to develop a digital ecosystem that brings together stewardship, learning, and performance management (SLPM). The ecosystem enhances training, data-driven decision-making, and the efficiency of healthcare delivery.

Here’s what it looks like in practice.

In July 2020, PSI Angola, alongside the Angolan digital innovation company Appy People, launched Kassai, an eLearning platform that targets public sector health workers in Angola. Through funding from USAID and the President’s Malaria Initiatve (PMI), Kassai features 16 courses in malaria, family planning, and maternal and child health – with plans to expand learning topic areas through funding from ExxonMobil Foundation and private sector companies. A partnership with UNITEL, the largest telecommunication provider in Angola, provides all public health providers in Angola free internet access to use Kassai.

Kassai’s analytics system to follow learners’ success rate and to adjust the course content to learners’ performance and needs. Kassai analytics are integrated with DHIS2 – the Health Management Information System (HMIS) of Angolan MOH, to be able to link learners’ knowledge and performance with the health outcomes in the health facilities.  The analytics track learners’ performance by course and gives visibility by health provider, health facility, municipality, and province. Each course has pre-and post-evaluation tests to track progress of learning, too.

By the end of 2022, there were 6,600 unique users on the Kassai platform and 31,000 course enrollments. PSI Angola’s partnership with UNITEL, the largest telecommunication provider in Angola, allows for free internet access to learn on the Kassai for all public health providers in Angola. Building on its success for malaria training, Kassai now also provides courses in family planning, COVID-19, and maternal and child health. This reduces training silos and provides cross-cutting benefits beyond a single disease.

Implementing the SLPM digital ecosystem brings numerous benefits to health systems. It allows for more strategic and efficient workforce training and performance management, enabling ministries of health to track changes in health workers’ knowledge, quality of care, service utilization, and health outcomes in real time. The ecosystem also supports better stewardship of mixed health systems by facilitating engagement with the private sector, aligning training programs and standards of care, and integrating private sector data into national HMIS. Furthermore, it enables the integration of community health workers into the broader health system, maximizing their impact and contribution to improving health outcomes and strengthening primary healthcare.



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PSI’s code sets out our basic expectations for conduct that is legal, honest, fair, transparent, ethical, honorable, and respectful. It is designed to guide the conduct of all PSI employees—regardless of location, function, or position—on ethical issues they face during the normal course of business. We also expect that our vendors, suppliers, and contractors will work ethically and honestly.


The Future of Work

With overarching commitments to flexibility in our work, and greater wellbeing for our employees, we want to ensure PSI is positioned for success with a global and holistic view of talent. Under our new “work from (almost) anywhere,” or “WFAA” philosophy, we are making the necessary investments to be an employer of record in more than half of U.S. states, and consider the U.S. as one single labor market for salary purposes. Globally, we recognize the need to compete for talent everywhere; we maintain a talent center in Nairobi and a mini-hub in Abidjan. PSI also already works with our Dutch-based European partner, PSI Europe, and we’re creating a virtual talent center in the UK.


Meaningful Youth Engagement

PSI is firmly committed to the meaningful engagement of young people in our work. As signatories of the Global Consensus Statement on Meaningful Adolescent & Youth Engagement, PSI affirms that young people have a fundamental right to actively and meaningfully engage in all matters that affect their lives. PSI’s commitments aim to serve and partner with diverse young people from 10-24 years, and we have prioritized ethics and integrity in our approach. Read more about our commitments to the three core principles of respect, justice and Do No Harm in the Commitment to Ethics in Youth-Powered Design. And read more about how we are bringing our words to action in our ICPD+25 commitment, Elevating Youth Voices, Building Youth Skills for Health Design.


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PSI works to ensure that its operations and supply chains are free from slavery and human trafficking. Read more about this commitment in our policy statement, endorsed by the PSI Board of Directors.



Since 2017, PSI has been a signatory to the United Nations Global Compact, a commitment to align strategies and operations with universal principles of human rights, labor, environment and anti-corruption. Read about PSI’s commitment to the UN Global Compact here.


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The health of PSI’s consumers is inextricably linked to the health of our planet. That’s why we’ve joined the Climate Accountability in Development as part of our commitment to reducing our greenhouse gas emissions by 30 percent by 2030. Read about our commitment to environmental sustainability.


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PSI affirms its commitment to diversity and believes that when people feel respected and included they can be more honest, collaborative and successful. We believe that everyone deserves respect and equal treatment regardless of gender, race, ethnicity, age, disability, sexual orientation, gender identity, cultural background or religious beliefs. Read our commitment to diversity and inclusion here. Plus, we’ve signed the CREED Pledge for Racial and Ethnic Equity. Learn more.


Gender Equality

PSI affirms gender equality is a universal human right and the achievement of it is essential to PSI’s mission. Read about our commitment to gender equality here.


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