Self-Care Trailblazers Group
- Donor: Children’s Investment Fund Foundation; The William and Flora Hewlett Foundation
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:
9.6 million
people voluntarily chose a modern contraceptive method
14 million
people under the age of 25 reached with contraception
2.24 million
consumers opted for long-acting reversible contraceptives
526 million
male and female condoms distributed
16.2 million
years of protection against unintended pregnancy provided to couples across the world
6.5 million
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:
Our mission is powered by people like you joining our community.
Program Expenses
Management, General, Fundraising Expenses
When consumers can use their own voice and choice, they are best positioned to make decisions for their reproductive health that fit their needs on their own terms. We approach our work from the consumer’s perspective, understanding their behaviors, as well as societal behaviors, inhibit or motivate how and when they make their health and life decisions.
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.
Our role is to meet consumers where they are and how they want. We convert need into demand for closer care experiences, identifying opportunities to bring care to their front door. And we evolve affordable, sustainable service delivery models, supported by digital solutions and multiple channels, to go beyond fixed clinical sites and move quality care where consumers are.
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.
Looking ahead, we see significant promise in self-care approaches, including self-administration and self-initiation of care through new contraceptive, diagnostic and digital technologies which present opportunities to improve client engagement and equity and bring care and information closer to communities with greater privacy. We dig into local contexts to identify what it takes to catalyze and scale access to consumer-powered methods including medical abortion, DMPA-SC (also known as Sayana® Press) and emergency contraception.
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.
From national health insurance programs to socially minded investments, we get creative in seeking new sources of financing. We use real-time information to link consumers and providers to financing mechanisms that are right for them. We expand available, affordable, quality products and services through public and private channels—including social enterprise—finding opportunities to develop global and regional markets and achieve economies of scale where possible.
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.
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.
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.
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.
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.
HOW COULD PRIVATE SECTOR PHARMACIES AND DRUG SHOPS ADVANCE PROGRESS TOWARDS UNIVERSAL HEALTH COVERAGE
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?
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 donor–funded 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.
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.
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.
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
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.
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
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
From ministries of health to regulatory bodies and purchasers, we partner with private and public sector players to provide seamless health services to consumers – no matter their entry point to care.
Across 40+ countries, we scale digital solutions that make it easier for people to take ownership of their own health, and health systems to use resources efficiently and increase health impact.
We support health systems in shaping the policy and regulatory environment for self-care interventions and ensuring self-care is included as an essential part of healthcare services.
Climate change has a wide-ranging impact on health, ranging from infectious disease to food insecurity, heat and pollution-related illnesses, and injuries and death caused by extreme weather events. It also disrupts health systems and access to medical services that exacerbate health challenges. Adapting is key, all with the urgency of now. We explain how, below.