By Jennifer Pope, VP, Sexual and Reproductive Health, HIV, and TB, PSI

As we come together for this International Conference on Family Planning (ICFP), we have an opportunity to collectively reflect on key questions critical to achieving universal access to sexual and reproductive health and rights:

  • How do we break down barriers standing between people and their sexual and reproductive health and rights (SRHR)?
  • How do we support health providers to deliver quality, empathetic care?
  • How do we expand our definition of health systems to include self-care… and then build those systems including digital solutions to be responsive, equitable and accountable to the people and communities we serve?

And, perhaps most importantly, how do we achieve Universal Health Coverage (UHC) that is inclusive of SRHR needs?

Individual people – their unique needs and lived experiences – are at the center of these questions, and our collective work to find sustainable SRHR solutions. Through PSI’s FP2030 commitment, we have pledged to innovate and scale person-centered solutions that enable 100M people to make full, free, and informed sexual and reproductive health choices throughout their life course. Core to our approach is #PeoplePowered healthcare, and why this ICFP issue of Impact centers on how #PeoplePowered solutions can help get us to UHC, and beyond.

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Women attend a group counseling session on methods of contraception led by PSI staff member Doung Mao at Sovannay Health Care Room, a Sun Quality provider in Kampong Cham, Cambodia. November, 2010 – PSI Cambodia. Photo by Jake Lyell

By Dorine Irankunda,  SRH Senior Technical Advisor, Quality of Care, PSI

#PeoplePowered healthcare necessitates stronger, resilient and inclusive health systems that uplift the voices, needs and experiences of the people and communities we serve. It supports us to go beyond traditional problem-based, vertical strategies and take a holistic approach to meeting people’s needs.

As this Impact underscores, to get #PeoplePowered, we must disrupt the status quo. SRHR movers and shakers—including youth activist Brown Niyonsaba, ICFP’s Dr. Jose “Oying” Rimon II, Ouagadougou Partnership’s Marie Ba, Fos Feminista’s Fadekemi Akinfaderin, CIFF’s Faustina Fynn-Nyame, PSI Ethiopia’s Metsehate Ayenekulu, UNFPA’s Dr. Natalia Kanem, and PSI Uganda’s Dr. Lillian Sekabembe, among so many others, probe us to consider how.

Specifically, what will it take to…

As these authors share, we can and will achieve UHC if we invest in #PeoplePowered health solutions and systems. This #ICFP2022, let’s chat how.

Advancing consumer-powered healthcare (CPH) – namely, care that is dignified, respectful, responsive and adaptive to consumers’ preferences and needs – is inextricably linked to achieving Universal Health Coverage (UHC).

That’s why, as part of Family Planning 2030 (FP2030), PSI commits to accelerating consumer-powered health systems that enable 100 million people in low-and middle-income countries to make full, free and informed sexual and reproductive health choices throughout their lives – all by 2030.

To achieve this commitment, PSI will focus on advancing autonomy, agency and self-empowerment in sexual and reproductive health and rights (SRHR) systems, including developing standard indicators to track the person-centeredness of PSI’s programs.

“Everything we do is informed by consumers of healthcare. For more than five decades, we have used consumer insights and research to guide every aspect of our work; we know that health outcomes are better when designed with people rather than for them,” says Karl Hofmann, PSI President & CEO. “Meeting consumers where they are by incorporating consumers’ voices into the system and equipping consumers to be agents of their own health through digital, self-care and private sector integration will make health systems more resilient, responsive and powered by the people we work with and for.”

“FP2030 pledges from partners like PSI advance the ultimate goal: ensuring that every person, no matter where they live, can make the sexual and reproductive health decisions that enable them to participate as equals in society. When we commit to sexual and reproductive health equity, we commit to catalyzing the change needed to achieve UHC,” says FP2030 Executive Director Dr. Samukeliso Dube.

PSI’s FP2030 commitment follows the organization surpassing its FP2020 commitment to support 10 million consumers under the age of 25 to choose modern contraception.

And still, millions of people in low and middle-income countries remain without access to modern contraception methods and basic SRHR care. Taking a person-centered, consumer-powered approach to healthcare delivery is critical for expanding access to contraception, safe abortion and other SRHR services as the global health community works together to achieve UHC.

“The time is now to reimagine how we design, deliver, measure and scale consumer-powered care. We join the global health community in committing to investing in and strengthening how we measure SRH programs that advance people’s autonomy, agency and self-empowerment,” says Jennifer Pope, PSI’s VP of SRH, HIV and TB.

To expand access to person-centered care, PSI will:

  • Partner to accelerate implementation of person-centered SRH delivery models, reaching 100 million people.
  • Support healthcare systems to integrate routine monitoring and accountability mechanisms for person-centered care.
  • Support development and adoption of policies to expand person-centered SRH care.

To advance measurement of client experience of care, PSI will:

  • Develop, test, validate and integrate new indicators of client experience with a focus on measurement in the context of routine programming.
  • Develop measures specific to private sector healthcare consumers, adolescents and youth, and or self-care including digitally enhanced health solutions.

For media requests, please contact [email protected].  

By Dr. Tlaleng Mofokeng, MD and the UN Special Rapporteur on the Right to Health; and Kerigo Odada, Lawyer and PhD researcher at the University of Pretoria, Centre for Human Rights

Under Sustainable Development Goal (SDG) 3, target 3.7, universal access to sexual and reproductive healthcare services includes family planning (FP), information and education, and the integration of reproductive health into national strategies by 2030.

According to UNFPA, in 2021, 49 percent of women aged 15–49 years worldwide, and 32 percent in least developed countries, were using some type of method of contraception. This drives the International Conference on Family Planning which, since 2009, has brought together the global development community to take stock of developments around access to family planning, and chart the way forward for achieving the shared vision of universal FP access.

FP, which refers to supplies and services that enable individuals and couples to attain and plan for their desired number of children, including the spacing and timing of births, is fundamental to the health and survival of women and girls.

Access to FP, including emergency contraception, safe abortion services, and post-abortion care, is a component of the right to health and, in particular, the right to sexual and reproductive health (SRH). The United Nations Department of Economic and Social Affairs, Population Division, reports that the past two decades have witnessed a rise in the demand for FP; use of modern contraceptives increased from 663 million to 851 million between 2000 and 2020. This growth is expected to continue by 2030.

All plans for universal coverage must include FP access.

Regrettably, a large gap persists between women’s reproductive needs and options. Significant disparities remain across countries and regions due to limited choice of methods; limited access to services; stigma; cultural or religious opposition; poor quality of available services; and users’ and providers’ bias against some methods. Gender-based barriers exacerbated by underlying structural, social and political systems of discrimination, continue to disproportionately affect young women, indigenous women, women with disabilities, rural women, migrant women, and LGBTQIA+ persons. Many people still do not have complete bodily autonomy and reproductive choices as envisioned in the International Conference on Population and Development program of action and Beijing declaration and platform for action.

Against this backdrop, therefore, ICFP 2022 must reinforce all existing policy, structural and social measures meant to safeguard access to FP globally and further advocate for new and renewed support for access to family planning and protection of bodily autonomy as a whole. Bodily autonomy is a political, social and legal principle that underscores the importance of respecting the capacity of persons to think for themselves, and make judgments about what they deem to be good for them.

FP is a fundamental pillar in universal health coverage, and in ensuring the well-being of individuals, families, and communities worldwide. The ICFP is a community of changemakers, and must continue to be resourced to continue the various work on policy, services, research, and funding of programs to ensure the realization of SRH and rights.

By Dr. Natalia Kanem, Executive Director, United Nations Population Fund (UNFPA)

On November 15th, the world’s population will hit 8 billion.

As the Executive Director of the United Nations Population Fund (UNFPA), I believe the international community should view this day as a success story. After all, we have gotten to this point because people are living longer, fewer women are dying giving birth, childhood mortality has declined, and healthcare systems are getting better. While many have used this milestone in population growth—and every other before it—to focus on the climate crisis and other challenges the world faces, let us instead focus on the opportunities.

No demographic trend is solely bad or good, and with the right investments, sound policies, and advance planning, governments can empower every person in their population to achieve a good quality of life. At UNFPA, we help countries unlock this potential by helping them understand their changing demographics, project their future population, and devise policies that build healthy and inclusive societies, with a focus on ensuring rights and choices for all.

Let us address the topic most fundamental to our growing population—reproductive health and rights. Nearly half of all pregnancies are unintended and more than 250 million women do not want to become pregnant, but are not using modern contraception. Yet, in our research and programmes we see firsthand that providing every person with access to safe, voluntary family planning is one of the best investments a country can make. Access to contraceptives not only prevents unintended pregnancies and lowers maternal death rates, it also reduces poverty and helps people complete their education. These benefits pay dividends to the development of countries’ economies and social structures. In fact, some estimate that the long-term socioeconomic benefits of achieving universal access to quality sexual and reproductive health services, including contraception, would yield returns of $120 for every dollar invested.

When we invest in family planning, we’re investing in girls’ futures. Teaching adolescents about their reproductive health and options improves their long-term health outcomes and lowers their chance of pregnancy and childbirth complications—the leading cause of death among adolescent girls. Together, knowledge and access to reproductive health services benefit all areas of girls’ lives, from their education to their level of autonomy in the household.

Let’s plan for a future in which all 8 billion of us can fulfill our potential. By prioritizing the issues that impact the most vulnerable, we can support those bearing the brunt of the world’s most pressing challenges. In our increasingly unequal world, we need to invest in people and the promise they hold – irrespective of their gender, race, nationality or creed. When we do, a future in which all 8 billion of us can thrive will be within our grasp.

This blog post was originally published on UN DESA Voice.

By Marie Ba, Director, Ouagadougou Partnership Coordination Unit (OPCU)

In 2011 – the year the Ouagadougou Partnership (OP) launched—the nine Francophone West Africa (FWA) countries (Benin, Burkina Faso, Côte d’Ivoire, Guinee, Mali, Mauritania, Niger, Senegal, and Togo) had some of the lowest contraceptive rates in the world.

Here we are, a decade late later.

OP has changed the narrative, supporting 4 million new modern users to choose contraception, and powering countries to double their contraceptive rates. The factors enabling this success are well documented. They include firm commitments to family planning (FP) by member countries driven by emulation and healthy competition, national costed implementation plans (CIP), active participation by civil society, notably youth and religious leaders, and donor coordination to avoid duplication and optimize alignment with country plans.

However, much more needs to be done to maintain the momentum in the region.

Many countries have reached the easier segments of users, and new strategies and innovations are required to continue strong growth. We collectively must address these four key priorities to achieve our new ambitious goal of doubling the current number of modern contraceptive users of 6.5 million to reach 13 million by 2030.

  • Social behavior change (SBC). OP countries must move beyond availability and toward the acceptability of contraception services. We must focus on shifting social norms and behaviors to generate organic demand for family planning services. The OP will continue to fund SBC projects and research in the region, gather, develop and publicize SBC resources in French, and track measures of provider behavior and quality of services.
  • With up to 70 percent of its population under 30, the OP sees youth as agents of change. Our youth strategy catalyzes leadership and skills development for the emergence of a capable generation of young leaders. It also tackles obstacles preventing access to quality contraceptive services and options for young people.
  • There is a significant gap in FP knowledge and research on SBC and youth attitudes in Francophone West Africa. The OP launched a research fund for local institutions to build evidence in order to advance and improve current national family planning strategies and programs and better inform future policies. The fund will prioritize applied research on youth and SBC, help develop research agendas and funding criteria collaboratively with regional experts, and make local and regional FP research more useful, visible, and accessible from FWA to the continent and globally.
  • Family planning in a crisis context. Many OP countries are facing security, health, and humanitarian crisis. The OP must involve humanitarian experts in CIP development to plan for FP in emergency situations, build partnerships with humanitarian organizations and participate in resiliency projects, activities, and conferences.

Looking toward 2030, we envision a Francophone West Africa where easy access to quality family planning services saves and improves women’s and young people’s lives and serves as a catalyst for sustainable development for all. We are confident that our new strategies will help pave the way for a stronger and more successful partnership.

By Duff Gillespie,  Project Director, Advance Family Planning

Effective, evidence-based advocacy can increase access to quality and voluntary family planning. From its beginning in 2009, the Advance Family Planning (AFP) initiative has aimed  to demonstrate just that. Using the  SMART Advocacy[1] approach, AFP advocates have achieved nearly 3,000 advocacy wins contributed to improved family planning policies, and generated $168 million in funds from national and local governments and the private sector.

What have we learned in the last decade that can help advocates in future? We offer five lessons advocates may find useful over the next decade.

1. Devolution is a Game Changer

Context: Historically, governments centralized family planning policy and funding decisions. Today, many national governments have transferred power over family planning programs to local or regional officials. Sub-national decision-makers –  governors, legislators, district medical officers, mayors, and many others—now hold the success or failure of global and national family planning commitments in their hands. The result is a kaleidoscope of local programs and policy priorities that can spur innovation and influence neighboring decision-makers as well as those in the national government.

Learning: To be effective, advocates should continually assess the diversity of local political and socioeconomic factors and be on the lookout for local leaders ready to act.


2. Advocate for Policy Implementation

Context: Compared to 30 years ago, most countries in Africa, Asia, and Latin America have policies promoting and supporting family planning.[2] Despite these favorable policies, policy implementation faltered in many countries.

Learning: Advocates can ask decision-makers for discrete actions such as funding or regulatory change that will facilitate the government reaching their own policy goals. Indeed, government officials very often became active players in the advocacy efforts. Civil society can play a critical partnership role in helping the government achieve policy aims that it is already on record as wanting.


3. Evidence Is Not Enough

Context: Advocates often point to “evidence-based advocacy” to highlight what contributed to their advocacy successes. The reality is that most decisions are not based solely on evidence.

Learning: Advocates need to know how emotions, ethics, and relationships factor alongside evidence in developing messages. Advocates should be strong storytellers who are able to make any evidence connect to a decision-makers personal beliefs and objectives. While evidence is not everything, developing messages based on truth and data is essential to avoid running counter to existing knowledge.


4. Local Ownership is Here to Stay

Context: Development assistance is donor driven with major donors dictating who, how, and on what their funds will be spent. External donor funds make up 45 percent of family planning funds in the Global South.[3] While donors philosophically have long embraced local ownership, they are now actually, albeit slowly changing funding strategies to support locally led, indigenous non-governmental organizations (NGOs). Many of these NGOs have limited administrative capacity and fiduciary control to compete for and be able to fully implement awarded programs, i.e., effectively spend donor funds.

Learning: The transition to local ownership would significantly shorten if donors designated more resources to organizational capacity so that local organizations would be better situated to receive and administer direct donor funding.


5. Monitor Advocacy Impact

Context: Tracking outputs and outcomes of advocacy wins is often more difficult and more expensive than achieving the initial win. And therefore, there is little interest to include and fund monitoring and evaluation activities in the overall advocacy effort.

Learning: Determining if advocacy wins resulted in the desired policy and programmatic changes is essential to progress and an important way for others to replicate success.

In conclusion, AFP’s experience suggests that change in the next decade will be incremental, at the subnational or local level, and with less headline-grabbing policy implementation. There are governments that remain hostile toward many SRHR issues, which makes advocacy feel impossible. However, advocates are equipped with the ingenuity and grit to achieve change through diverse coalitions, evidence-based strategies, and stronger local advocacy organizations.


[1] David-Rivera,V.,Whitmarsh, S., Gillespie, D., and Fredrick, B. (2021). SMART Advocacy User’s Guide. April 2021.

[2] United Nations Department of Economic and Social Affairs, Population Division (2021). World Population Policies 2021: Policies related to fertility. UN DESA/POP/2021/TR/NO. 1.

[3] FP2030. (2021) FP2030 Measurement Report 2021. January 2022.

Section 1/4


Building Resilient, Consumer-Powered Health Systems

PSI’s Health Systems Accelerator is built on 50+ years of experience collecting and elevating consumer and health system insights, scaling innovations and partnering with government and private sector actors to shape stronger, more integrated health systems that work for consumers. Learn more here.


In the absence of a trusted and dedicated Primary Healthcare (PHC) provider, individuals often spend valuable time and resources navigating through a multitude of health facilities, visiting various providers in search of the right place to address their health concerns. Challenges navigating the health system can result in delays in assessment, diagnosis, and treatment, potentially leading to poor quality of care and adverse health outcomes. One promising solution is the digital locator, which can enable healthcare consumers to promptly find high quality, affordable health products and services when they need them. What are current applications of digital locator tools?  How can they be improved? What are the challenges faced in utilizing these tools?

Explore our resources

listen to the podcast

Better data for stronger health systems

In the ever-evolving health landscape, a robust health management information system (HMIS) stands as a cornerstone of a strong health system. It not only guides decision-making and resource allocation but also shapes the well-being of individuals and communities. However, despite technological advancements that have revolutionized data collection, analytics, and visualization, health systems in low- and middle-income countries (LMICs) continue to grapple with a fundamental challenge: fragmented data and limited effective data use for decision-making. What are some promising solutions?

Explore our resources

View our short interviews

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. 


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?

Explore our resources

listen to the podcast

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.



PSI does not tolerate retaliation or adverse employment action of any kind against anyone who in good faith reports a suspected violation or misconduct under this policy, provides information to an external investigator, a law enforcement official or agency, or assists in the investigation of a suspected violation, even if a subsequent investigation determines that no violation occurred, provided the employee report is made in good faith and with reasonable belief in its accuracy.


Global Code of Business Conduct And Ethics

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.


Zero Tolerance for Modern-Day Slavery and Human Trafficking

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.


Environmental Sustainability

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.


Affirmative Action and Equal Employment Opportunity

PSI does not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, protected veteran status or any other classification protected by applicable federal, state or local law. Read our full affirmative action and equal employment opportunity policy here.


Zero Tolerance for Discrimination and Harassment

PSI is committed to establishing and maintaining a work environment that fosters harmonious, productive working relationships and encourages mutual respect among team members. Read our policy against discrimination and harassment here.

PSI is committed to serving all health consumers with respect, and strives for the highest standards of ethical behavior. PSI is dedicated to complying with the letter and spirit of all laws, regulations and contractual obligations to which it is subject, and to ensuring that all funds with which it is entrusted are used to achieve maximum impact on its programs. PSI provides exceptionally strong financial, operational and program management systems to ensure rigorous internal controls are in place to prevent and detect fraud, waste and abuse and ensure compliance with the highest standards. Essential to this commitment is protecting the safety and well-being of our program consumers, including the most vulnerable, such as women and children. PSI maintains zero tolerance for child abuse, sexual abuse, or exploitative acts or threats by our employees, consultants, volunteers or anyone associated with the delivery of our programs and services, and takes seriously all complaints of misconduct brought to our attention.


Diversity and Inclusion

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.


01 #PeoplePowered

02 Breaking Taboos

03 Moving Care Closer to Consumers

04 Innovating on Investments

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