Population Services International (PSI) and its local implementing partners in Pakistan, Greenstar Social Marketing (GSM), Health and Nutrition Development Society (HANDS), and Rural Support Program Network (RSPN), are currently implementing “Delivering Accelerated Family Planning in Pakistan” (DAFPAK) program. Funded by the Foreign, Commonwealth and Development Office (FCDO), the objective of the program is to reduce maternal deaths, unintended pregnancies and unsafe abortions through increased usage and availability of family planning (FP) products-and-services.

With the primary focus on rural areas, the program has two main components: 1) community mobilization and service delivery in remote areas through a network of community mobilizers and service providers, and 2) social marketing approaches through distribution channels to streamline product availability. Both of these components are heavily driven by person to person contact, either within the organizations or with the consumer base. This exposes the program to high potential risk of infection spread, further exacerbated by the limited access to healthcare facilities in the intervention-areas.

This called for PSI Pakistan to initiate a response while the pandemic was in its initial stages in order to safeguard the interests of consumers, PSI and partner staff and the intervention.


PSI Pakistan’s response to the pandemic was based on our global approach to program design. We focus on designing and implementing interventions and systems that have people at the center. Our goal was to pre-emptively strategize around addressing the challenge before it became significant, in order to minimize its impact. Based on decades of experience in leading successful interventions, PSI conceptualized and implemented the Keystone Design Framework which has a focus on users at the core, and behavior change as its driving force to actualize intervention objectives and have a sustained impact. The framework allows developers to diagnose health needs, decide where PSI or other market actors can most effectively intervene, design user-centered interventions and deliver measurable health impact in a sustainable way.

Diagnose. Decide. Design. Deliver.

There are four key moments to consider using this framework. The Diagnosis stage involved assessing the ground realities, identifying the limitations and opportunities for intervention, and articulating the stakeholders involved and mitigation measures needed to minimize impact. The Decide phase allowed us to assess who the stakeholders are, prioritizing areas of focus and shortlisting implementers best suited to positively impact the situation and sustain business continuity.

During the Design stage, following the principles of human-centered design, the best practices were collected and adapted to ensure the uptake of the desired behavior through listing out barriers and countering misinformation and apathy to the situation at hand. Whereas our Deliver strategy focused on developing the workplan, defining the budgets, aligning the agenda and compiling trackers to monitor progress and carry out course corrections if needed. Identified high-risk and vulnerable populations within the intervention areas and the consumer base who are at higher risk of getting the infection.

For more on how PSI-Pakistan’s applied the Keystone Framework to respond to the COVID-19 pandemic as it picked momentum-in-Pakistan, find our latest brief here.

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