In Niger, which has one of the highest rates of teenage marriage and pregnancy in the world, PSI is working with the innovative design team at YLabs, under the USAID-funded Transform/PHARE project, to pave positive pathways for trusted sexual and reproductive health information, products and services.
Watch how the Transform/PHARE team created Sarari to increase support for reproductive health in Niger.
PSI believes all people can and should have control of their sexuality, sexual health and fertility. That this is best achieved when people have greater voice, choice and agency over the processes and services that most affect them. Our mission is clear: every woman and girl—and every man and boy—should have access to the products, information and services they need to plan for the families and lives that they desire. Access to quality-assured contraception and safe abortion where it is legal is a part of that package.
But for too long, consumers in lower- and middle-income countries have faced disproportionate social and structural barriers in making their own reproductive health choices. There are still more than 214 million women and girls who want, but don’t have access to modern contraception, and each year women face 98 million unintended pregnancies. At the current rate, an estimated 470 million women will continue to lack access to sexual and reproductive healthcare in 2030.
Change is in order.
We envision a world in which consumers can move seamlessly through a marketplace with the widest range of options and opportunities available to them in an environment that supports them on the health journeys that shape their lives.
That’s why across the 50+ countries in which we work, PSI’s global goals drive toward ensuring universal access to sexual and reproductive health services. Our approach is grounded in ensuring that the rights of the consumer are protected and promoted so that everyone has access to quality care and comprehensive information without discrimination of any kind. We know that access to contraception isn’t just about preventing an unplanned pregnancy—it’s about paving pathways out of poverty for a better future for all. Across our sexual and reproductive health programming, we’re committed to getting bold—to reimagine what it takes to put the consumer at the center and, whenever possible, bring healthcare to the front door.
By 2030, PSI, as part of the Self-Care Trailblazer Group, commits to ignite and help build a comprehensive, evidence-based self-care agenda and movement for sexual and reproductive health and rights. Healthcare is being transformed by the development of technologies and evidence that strengthen consumers’ power to take greater control and autonomy. This transformation is particularly impactful for sexual and reproductive rights.
The commitment will focus on:
By 2030, PSI pledges to identify, train and deploy a corps of 500 young people from around the world with the skills to co-design and implement adolescent and youth sexual and reproductive health programs alongside technical experts. These Youth Fellows will be employed as practitioners in programs within and beyond PSI, working as researchers, analysts, advocates and community-level champions who can counsel teams on how to apply meaningful youth engagement. And, through inter-generational and peer-to-peer mentorship, they will be supported to develop the confidence and skills needed to successfully influence and deliver public health programming.
In 2018, we aimed to reach consumers with trusted spaces, sources and tools for their sexual and reproductive health--where they are and how they want them. Here’s what we achieved:
people voluntarily chose a modern contraceptive method
people under the age of 25 reached with contraception
consumers opted for long-acting reversible contraceptives
male and female condoms distributed
years of protection against unintended pregnancy provided to couples across the world
unintended pregnancies averted
We work to ensure consumers have reliable access to the full range of reproductive health products and services, from condoms and emergency contraceptives to long-acting reversible contraceptive methods and medical abortion products. We are at the forefront of market shaping and service delivery efforts for the injectable contraceptive DMPA-SC, LNG-IUS (intra-uterine system) and on-demand emergency contraception to expand consumers options for voluntary contraception where, when and how she wants it.
Making choices is a complex process, especially when there are a large number of options. PSI wants to help clients see how different methods will impact their lives, not just how they are administered. Counseling for Choice (C4C) is a PSI initiative that contributes to a positive narrative around the choices clients have. Providers engage each client in a conversation about the things that matter most to her: pregnancy prevention, future pregnancy, privacy, prevention of HIV, changes to periods, and other topics. After matching her with a method that suits her lifestyle and preferred product attributes, providers work with the client on a plan for method use and what to do if she experiences the most common side effects of the method chosen. We believe engaging the client as a partner in the decision process has the potential to revolutionize the way we think about contraceptive counseling and improve the quality of care she receives.
We work with networks of public and private providers at different levels of the health system, including over 12,000 locally managed social franchise clinics in 26 countries, mobile outreach teams, community-based health workers and distribution agents. PSI provides training and ongoing support to providers across a range of reproductive health and related services including contraception, abortion and post-abortion care, gender-based violence screening and referral, cervical cancer screening and HIV and sexually transmitted infection testing and treatment. Our approach is centered around empathetic, client-centered care, quality assurance and ongoing quality improvement in both counseling and service provision.
PSI works to de-medicalize abortion so that products and information are placed directly in our consumers’ hands; develop sustainable medical abortion and misoprostol markets that maximize access and ensure affordability; and destigmatize abortion providers and society so that supply and demand are unencumbered.
We are committed to delivering a youth-powered platform, with and for young people, to better understand their lives, needs and experiences and authentically deliver what matters to them most today, allowing us to position contraception in service of their self-expressed desires and dreams. Together, we co-design, implement and evaluate programs with more than 680 young people across the PSI network to ensure they both desire and can access all sexual and reproductive health needs, including access to safe abortion for those who want it.
PSI’s commitment to ethics in youth-powered design recognizes the diversity of youth, ages 10-24 years, and the need for deeper reflection on who adolescents are and the life experiences that often define them. We apply the latest evidence and adaptively implement, to stay nimble to the changing needs of young people and build out our learnings to deepen the adolescent and youth sexual and reproductive health evidence base. Our aim is a system that delivers trust and value to the young people we serve.
In countries where cervical cancer rates are highest, informed access to contraception also remains a critical need. By integrating cervical cancer screening services and preventive treatment and referrals within existing voluntary reproductive health service delivery platforms, PSI is working to better meet women’s health needs across her life cycle and increase the health impact of our sexual and reproductive health interventions. In Mozambique, under the PEER project, PSI is systematically designing, testing and refining integrated reproductive health and cervical cancer service delivery models that can meet consumer needs, while improving health outcomes.
From HPV vaccine promotion, early detection and treatment of cervical pre-cancers and referral for follow-on care, we support the WHO’s plan for global cervical cancer elimination, designed with national and regional 2030 targets. We engage consumers, healthcare providers, government and partners across the public and private sectors to move consumers from awareness to screening, diagnosis, treatment and continued management of cervical cancer care.
See how our cervical cancer prevention program in Trinidad & Tobago, supported through PSI’s Maverick Collective, partnered with the Ministry of Health to pilot new technologies for improved cervical cancer screening and bolstering national efforts to raise awareness of cervical cancer and the need for HPV vaccine and regular screening:
With funding from the Government of the Kingdom of the Netherlands, PSI’s network of Tem+ clinics in Mozambique are delivering contraceptive counseling and products directly to schools, challenging negative attitudes towards youth access to sexual and reproductive health services while simultaneously creating a positive, enabling environment at the service delivery level. Schools create safe spaces to access information, products or counseling and referrals to services from a network of trained nurses and community health promoters.
For many rural communities, transportation to high-quality health services remains a major barrier to accessing care. Mobile outreach turns this reality around: it transports the health services to the consumer instead. In Mali, Côte d’Ivoire and Niger, PSI works with public health authorities to bring sexual and reproductive health services to remote communities with support from Global Affairs Canada to advance sexual and reproductive health and rights in the region. As a result, women and girls living in villages can access the methods they want without spending long days walking to the closest city or town.
As part of our organizational commitments, PSI is scaling up access to the injectable contraceptive DMPA-SC within the context of informed choice to bring care closer to the consumer. Our work, supported centrally by the USAID-funded SIFPO2 project and the Children’s Investment Fund Foundation, has a global focus on private sector engagement, optimized service delivery and shaping more sustainable markets. From delivering more than 2.5 million DMPA-SC units worldwide, to growing demand through digital omnichannel consumer platforms, to learning more about women’s preferences and willingness to pay for this method, our work expanding access to DMPA-SC is delivering stronger voice, choice and agency for our consumers.
The Challenge Initiative for Healthy Cities in India, co-funded by the Gates Institute and USAID, delivers both impact and sustainability to the urban poor. Under this project, city governments invest their own funds and resources to deliver quality health interventions to their citizens with technical expertise and planning from PSI. This way, we’re tapping into existing and formerly under-utilized government funds while building local capacity.