Toilets for All

Posted May 30, 2019

by John Sauer and Jennifer Marcy, Senior Technical Advisors for Water, Sanitation & Hygiene, PSI

Approximately 500 million people in Sub-Saharan Africa do not have access to a basic toilet, making them vulnerable to avoidable dangers like chronic disease, malnutrition and gender-based violence. We’re not doing enough to ensure they have access to the sanitation services they deserve. The World Bank predicts that at the current rate, it will take several hundred years to reach universal coverage of basic sanitation. In short, business-as- usual is not getting us there.

In an effort to reach the United Nations Sustainable Development Goal 6—availability and sustainable management of water and sanitation for all by 2030—PSI has partnered with Oxfam and Social Finance to create a global movement that will push forward progress for sanitation. This initiative aims to deliver sustained access to simple and affordable sanitation for 100 million people through the marketing, sales and installation of 20 million hygienic toilets.

This effort is built around three pillars of change: an approach built on inclusive markets, simple and affordable products and funding instruments that are fit-for-purpose. It will first be delivered in a small number of low-income countries, focusing on inclusive markets to ensure that consumers can access modern toilets at scale and pace.

This endeavor is complex, requiring upfront funding across donor communities. But with investment and cooperation across the development community, we aspire to deliver toilets for all.

This article appears in PSI’s Impact magazine, released in tandem with Women Deliver 2019, as part of an ongoing conversation about putting #PowerInHerHands.

Banner Image: ©PSI

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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.

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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.

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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

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“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.”

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Toilets for All

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The Consumer as CEO

Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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