Maverick Collective Ignites a New Model of Engagement

By Marshall Stowell, Vice President, PSI and Editor-in-Chief, Impact magazine

UNMIL Photo/Christophe Herwig - Ganta, Liberia, July 30, 2008 : Tonglewin Village elder Kou Pealea has 30 grandchildren and an infection in her knee. Before the war she was a midwife; however her clinic was burnt to the ground by soldiers. Now she delivers babies inside her home. But every day she works in the field with the other woman in the Ganta Concerned Women's Group.
UNMIL Photo/Christophe Herwig – Ganta, Liberia, July 30, 2008

“When Bill and I started our foundation 15 years ago, we pretty much thought in terms of grant-making, period,” says Melinda Gates, co-chair of the Bill and Melinda Gates Foundation and co-chair of
the newly launched Maverick Collective. “We learned our lesson fast. Making change is about building coalitions. All the grants in the world can’t eradicate a disease, or provide universal access to contraceptives or put empowerment at the top of the agenda. Only making your most powerful case and bringing others along can do that.”

As one of the leading advocates for improving the health and rights of girls and women in the developing world, Gates went looking for meaningful ways to engage others to join the effort.

What she found was a very receptive audience.

The recent release of the Global Goals makes a clear call for increased investment in girls and women, for more advocates and for new health solutions to end extreme poverty by 2030. The authors of the goals argue that there is a unique window of opportunity to make good on the historic advancements in the health, rights and dignity of people worldwide. Gates believes philanthropists have a transformative and unrealized role to play in achieving that goal.

“Traditional philanthropy was defined as waiting until you were really old and very rich and writing a lot of checks,” explains Daniel Schley in Forbes magazine. The chief executive of Foundation Source, a group that helps family foundations become more efficient, went on to write, “but the real power, drive and momentum in modern philanthropy is coming from people in their 40s and 50s who generated a great deal of wealth at an early age and have decided to leverage that wealth in philanthropy.”

This new breed of philanthropists is looking for a deeper level of engagement. They want to collaborate with other philanthropists and they keenly understand the worth of their resources and their voice. The problem is that few find opportunities that leverage their full range of assets.

(RE) IMAGINING PHILANTHROPY

“What we’re hearing is that people want greater engagement with their nonprofit partners — especially women philanthropists,” says Kate Roberts, co-founder of Maverick Collective and PSI’s senior vice president of Corporate Partnerships and Philanthropy. “There is a dire shortage of resources for innovation. To lift girls and women out of extreme poverty, we need new and better health products and services. We need stronger health systems and we need more advocates speaking for those who may otherwise not be heard. This is an ideal role for today’s extremely motivated philanthropist.”

According to Women Moving Millions’ Jessica Houssian, “North American women control approximately $13.2 trillion dollars. By 2026, North American women alone could give one trillion dollars annually if they collectively gave 1.7 percent of their wealth. And in the next 40 years, women will inherit more than 70 percent of the $41 trillion dollars in expected intergenerational wealth transfer. Women today have unprecedented financial power. And with that power comes the opportunity to shift philanthropic priorities to focus on women and girls.”

But so far the funding hasn’t matched the rhetoric. According to the UN Foundation, programs for girls and women receive less than two cents of every development dollar, particularly those targeting girls between 10-14 years old.

AN IDEA QUIETLY BECOMES A REALITY

In 2012, Her Royal Highness the Crown Princess Mette-Marit of Norway visited India as part of her work advocating for girls and women. It was there that she reconnected with Roberts after visiting a PSI-India health project. The two, who had spent time together at global conferences through the years, shared similar frustrations with the amount of talk and lack of action they saw. They decided to develop something together that would engage women outside of the development community to help them become better advocates, and bring in new resources to solve some of the toughest challenges facing girls and women. And, it would be oriented to action.

With 47 years of experience developing and implementing health solutions for girls and women and a network of nonprofit organizations in 65 countries, PSI was a logical fit as the implementing partner to help bring the idea to life. And, PSI had experience in helping people like Ashley Judd, Debra Messing and Mandy Moore become effective and recognized advocates for girls and women.

With support from the Bill & Melinda Gates Foundation, Roberts and The Crown Princess quietly began to build a collective of bold, like-minded women philanthropists and advocates. Given Melinda Gates’ drive to build advocates herself, she and Her Royal Highness would serve as co-chairs. A powerful new initiative was born: Maverick Collective.

“The Global Goals make a clear call for more advocates, greater innovation, new resources and a sharp focus on improving the health and rights of girls and women,” says HRH The Crown Princess Mette-Marit. “Maverick Collective was designed to respond to this call. When everyone contributes what they have to offer, we help lift girls and women everywhere.”

PILOT, PROVE, LEVERAGE, SCALE

The Maverick Collective model begins with a team of global health experts and the development of pilot projects in the areas of HIV prevention; reproductive health; maternal and child health; water, sanitation and hygiene; non-communicable diseases; and the prevention of gender-based violence. Maverick Collective members commit their time, skills and financial resources. They work closely with technical teams in each country to identify issues and develop solutions that if proven effective can help improve the way health is delivered to girls and women. These projects have the potential to unlock additional funding to reach even more women. At the same time, members begin their education to become informed advocates with intensive training from a range of health and communications experts.

RESULTS

In three years, Maverick Collective has helped unlock $60 million in funding and impacted the lives of close to 300,000 girls and women. With 14 founding members — all women — and pilot projects in 13 countries, the group is showing promise as a new model of philanthropic partnership. On the advocacy front, Maverick Collective members have taken their message to the press, to the United Nations, the Institute of Design at Stanford, Social Innovation Summit, Cavendish Global Forum, Harvard Business School, Women Moving Millions Summit, Nexus Summit, TEDx and Women Deliver, to name just a few.

All of Maverick Collective’s founding members are women. But Roberts says the effort is open to men as well. “It’s important to engage men as champions, and we are looking forward to our first male member. The world certainly needs more men advocating for girls and women.”

A DESIGN THINKER PUTS HER FIRST

In Tanzania, San Francisco-based design thinker and founding member Pam Scott is working with PSI’s
local staff to better understand unintended teen pregnancy from the girl’s perspective. They’ve partnered with teen girls and are using human- centered design to develop and test solutions that give girls access to the contraceptive services they need and want. The ideas they generate with teens will be rolled-out throughout Tanzania. Scott believes integrating human-centered design into health programs for teen girls has far reaching potential across countries and organizations.

“The reason that so much philanthropy has failed and people have put billions of dollars into solutions that don’t actually solve anything is hubris,” says Scott. “Who am I to ever say what someone in the developing world needs? I want to hear from them. We have started experimenting with what it looks like when we bring a radically collaborative form of human-centered design to the issue of teen pregnancy and when girls are at the very center and part of that conversation.”

The design approach piloted in this project influenced a PSI-led $30 million initiative funded by the Bill and Melinda Gates Foundation and the Children’s Investment Fund Foundation called Adolescents 360. The goal of the project is to increase contraceptive use among adolescent girls in three countries. PSI credits Scott’s approach as a factor that helped best position the organization to develop the winning concept.

A SURVIVOR EMBRACES HER POWER

Following one of India’s most recent, horrific and high-profile incidents of violence against women — the brutal rape and torture of Jyoti Singh on a New Delhi bus — Maverick Collective founding member and violence survivor Indrani Goradia joined forces with PSI India to test a novel approach to preventing gender-based violence and supporting survivors. The approach brings together local organizations, engages boys and men, and connects community leaders and policymakers in a coordinated response.

As a survivor, speaker and certified life coach, Goradia helped PSI think differently about how to approach negative gender norms, stereotypes and stigma both programmatically and among PSI’s 9,000 staff worldwide. She regularly conducts trainings to improve gender equality across programs and within teams.

Two years after the start of the project, USAID joined Goradia and PSI to create a $10 million program, now the largest and most far-reaching of its kind in India. The USAID partnership will expand program activities, reach more girls and women, and amplify its impact in preventing and addressing violence across India.

WITH A NEW MODEL COMES HARD LESSONS

PSI faced its fair share of challenges in creating Maverick Collective. “One of our goals is to serve as a model for other organizations, so we feel particularly responsible to share the lessons we learn,” says Colleen Gregerson, director of Maverick Collective and PSI’s vice president of Corporate Partnerships and Philanthropy.

“Inviting members to truly be part of the team is difficult and uncomfortable and completely necessary.”

What are her three most important lessons?

“First, plan for a culture shift. This takes time, training and development of a new language of collaboration.

Talk about it. Build structures that can support this culture shift, get buy-in from senior leadership at headquarters and country level, and set expectations early with internal and external partners.”

“Second, transparency builds trust. Openness, honesty and a willingness to admit when things don’t go as planned are essential to building an effective partnership. We learned to approach problems and develop solutions together — and set meaningful targets from the outset. Sometimes we get that right, other times we stumble. A partnership charter or similar agreement is a useful framework to ensure everyone is on the same page.” “Third, one size doesn’t fit all. It was important for us to learn how to balance the need for bespoke member experiences and to build the right structures so we could properly staff the work with limited resources. We settled on a core package of services we offer to members knowing we’ll need to maintain the flexibility to meet evolving member needs.”

CREATING A PARADIGM SHIFT

Maverick Collective is one effort working to ensure girls and women reach their full potential. Its co-chairs see it as part of a bigger picture solution that’s needed to lift girls and women and to better engage philanthropists and advocates.

“My hope is that we’ll see Maverick Collective members acting as catalysts for others to use their resources, everything from their voice to their ideas to their money, to empower women and girls around the world,” says Gates. “I hope we’ll see other organizations replicating the model to help people get involved in tackling other important issues.”

MEET THE FOUNDING MEMBERS

Maverick Collective

NON-COMMUNICABLE DISEASE

1. Kathryn Vizas is helping save women’s lives through early detection and treatment of cervical cancer. Her project in India trains doctors to provide screening and treatment in a single visit and increases awareness of this deadly disease.

WATER, SANITATION, AND HYGIENE

2. Camilla Hagen Sorli is working to improve the dignity and health of women and girls in Vietnam. Her project will create a sustainable commercial market for quality, hygienic toilets with the unique needs of women in mind.

REPRODUCTIVE HEALTH

3. Cristina Ljungberg is working to improve sexual, reproductive and menstrual health for teen girls. Her project in Nepal will create girl-centered solutions to tackle barriers, especially to menstrual hygiene, in the adolescent health landscape.

4. Victoria Sant is working to empower girls to reach their full potential. Her project in Honduras is providing girls with safe spaces to learn, trained mentors and sexual and reproductive health education and services.

5. Ana Morales is working to empower teen mothers and fathers in El Salvador to break the cycle of poverty. Her project aims to postpone second pregnancies in teen girls and engage male partners in tackling harmful cultural norms.

6. Caitlin Heising is working to give teen mothers contraceptive choice to decide their futures. Her project in Nicaragua will address the sexual and reproductive health needs of teens through a sustainable clinic model.

7. Pam Scott, a design thinker by profession, is using human-centered design to find a sustainable way to address unintended teen pregnancy in Tanzania.

8. Stasia Obremskey is helping bring greater contraceptive choice to women. Through a mobile phone system, her project in Mozambique will link rural women to health services and products, as well as test delivery of a new injectable contraceptive.

Maverick Collective

GENDER-BASED VIOLENCE

9. Indrani Goradia is on a mission to end gender-based violence. Her projects in India and Trinidad and Tobago will work to transform cultural norms, engage local communities and policy-makers and expand support services for survivors.

10. Barbara Jones is working to bring gender-based violence to light. Her project in Myanmar will engage the private health sector, challenge entrenched norms and provide services to survivors.

11. Kimberly Agnew is working to empower Haiti’s most vulnerable girls to live healthy lives free of violence. Her project will create a network of support for girls to holistically address their psychosocial, legal and health needs.

MATERNAL AND CHILD HEALTH

12. Diane Powell is piloting mobile clinics to reach rural women where they are. Her project in Senegal will bring ante- and post-natal health services to expectant and new mothers and link them with the existing public health network.

13. Martha Darling is championing the use of mobile technology to deliver maternal and child health care. Her project in India will link pregnant women and new mothers with health products and services through community-based female entrepreneurs.

14. Sara Ojjeh is helping to save the lives of mothers and newborns through clean delivery kits. Her project in Uganda will distribute simple tools and two medicines – chlorhexidine and misoprostol – to ensure women give birth safely and hygienically.

Follow @Mav_Collective on Twitter.


Photo Credit(s): Courtesy of PSI

IMPACT21-masthead_d2-01-01

Sign up to
Receive Updates

Donate to
Support Our Work

Related

04

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.

CAN DIGITAL LOCATOR TOOLS IMPROVE ACCESS TO HIGH-QUALITY HEALTH SERVICES AND PRODUCTS IN LOW-RESOURCE SETTINGS?

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.

03

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.

02

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. 

01

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. 

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?

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.

OUR COMMITMENTS

WHISTLEBLOWER AND ANTI-RETALIATION

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.

OUR COMMITMENTS

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.

OUR COMMITMENTS

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.

OUR COMMITMENTS

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.

OUR COMMITMENTS

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.

OUR COMMITMENTS

UNITED NATIONS GLOBAL COMPACT

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.

OUR COMMITMENTS

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.

OUR COMMITMENTS

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.

OUR COMMITMENTS

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.

OUR FOCUS

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.

OUR COMMITMENTS

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.

Cover

01 #PeoplePowered

02 Breaking Taboos

03 Moving Care Closer to Consumers

04 Innovating on Investments

ICFP Q&A:
Let's Talk About Sex

icons8-linkedin-circled-240
icons8-twitter-circled-240