PSI ANNUAL
REPORT

2023

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Letter From
the CEO

The story of human health progress over the last century is amazing. The right policies, investments, partners, and political commitment have saved and improved the lives of hundreds of millions of people, perhaps even billions. 

 

The COVID-19 pandemic slowed progress, we know, and in some cases sent lifespans into reverse. We are still recovering. And the challenges of health equity coupled with mega threats such as climate change have put our remaining health gaps on clear display. 

 

We know that fresh thinking and new and deeper partnering is needed if we are to close gaps, recover our momentum, and continue to make progress toward health for all. 

 

To transform health, we must do it together.  

Together, we can tackle the root causes preventing people and their communities from achieving and maintaining good, quality, and affordable health. We can develop transformative solutions for people and communities, markets, and health systems. And we can forge the deep synergies needed to unleash solutions that last.

 

Together, we can make it easier for people to choose quality, affordable healthcare, wherever and whenever they need. At Population Services International (PSI), that starts by prioritizing strategic partnerships. The challenges that consumers face are not happening in isolation, they are interconnected. To respond, we must partner more deeply and collaborate more widely.  

 

In 2023, the PSI global network laid the foundation for transforming health together by: 

 

  • Leading locally and connecting globally to decentralize decision-making and shift power to consumers. 
  • Building upon innovations like self-care and digital health to strengthen health systems to respond to crises more effectively. 
  • Breaking binaries and fostering holistic, integrated solutions to the world’s greatest health challenges. 

 

The world is sending us so many reasons to divide, but we achieve more when we work together. 

Looking ahead, PSI will continue to work alongside consumers, governments, donors, and strategic partners to achieve Universal Health Coverage and make it easier for all people to lead healthier lives.

Karl Hofmann

Psi’s impact in 2023

In 2023, the PSI (Population Services International) Network captured its health impact in three ways, by measuring:

 

  • what we deliver
  • what we catalyze others to deliver, and
  • what we deliver through Viya Health, PSI’s sustainable social business model.

 

These three measures capture the millions of people reached with sexual and reproductive health and rights (SRHR), malaria, HIV/tuberculosis, and sanitation products and services.

 

As we work to transform health, an increasing share of the PSI Network’s impact is and will be achieved by catalyzing others to deliver products and services, sustainably, and at scale.

 

Together with other leading NGOs, we will mainstream catalytic impact as a central tenet of how programs are designed, delivered, and evaluated.

 

The numbers represent only one small piece of the impact that these interventions have on people’s lives and the barriers overcome to deliver them. Each person has their own story and intersectional identities advantage and disadvantage people unevenly. Much of the PSI Network’s programming seeks to reach those who are left behind.

people reached with healthcare products and services, for family planning, malaria, HIV, TB, and sanitation services.
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people reached through accelerated market growth and system change.
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people reached through our social business, Viya Health
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About PSI

PSI is a network of locally-led, globally-connected organizations that are passionate about making it easier for people to lead healthier lives. Together with partners, we transform health by tackling the root causes preventing people and their communities from achieving and maintaining good, quality, and affordable health

where we work

Stories from our network

At PSI we center the voices of people and communities, grow robust markets for health products and services, and support governments to build resilient health systems. Our integrated program design makes it easier to serve more people’s holistic needs for the long term.

People and Communities

We center the voices of people and communities to connect them with the information, products, and services to make it easier to lead healthier lives.

Benin – Malaria prevention helps children thrive

By Malia Skjefte, Technical Advisor, PSI; and Luc Bankole, Communications Advisor, Plus Project Benin 

Mother Assohoto Mahuna Dame (left) and her aunt (right) receiving information on PMC from Plus Project team member Luc Bankole.

At the heart of Benin, near the Zogbodome Health Center, a young mother named Assohoto Mahuna Dame lives with her daughter, Naomie. Assohoto, a 24-year-old bread seller, was going about her daily routine when a community health worker approached her with crucial information about Perennial Malaria Chemoprevention (PMC) for children under two. This preventative treatment, administered alongside routine vaccinations and vitamin A supplementation, is a key measure in the fight against malaria.

 

Upon learning that Naomie had not yet received the necessary malaria prevention interventions, Assohoto took immediate action. She brought her daughter to the health center, ensuring that Naomie received her first round of PMC treatment, along with routine vaccinations. This seemingly simple act underscores the vital role community engagement plays in health awareness and malaria prevention, supporting mothers like Assohoto to make informed decisions for their children’s well-being.

 

The Plus Project, spearheaded by PSI and funded by Unitaid, is instrumental in promoting and scaling up PMC in Benin, Cameroon, Côte d’Ivoire, and Mozambique. This initiative is pivotal in reducing the burden of malaria and anemia among children in malaria-endemic regions of sub-Saharan Africa.

 

However, challenges persist. Vaccination rates tend to drop as children grow older, and many women in Benin face difficulties in tracking follow-up appointments or deciphering the handwriting in child health cards. The often significant distances between health centers and communities further complicate efforts to ensure children receive timely follow-up care.

In October 2023, the project team conducted visits to various health facilities across Benin to enhance awareness of PMC through community engagement. Utilizing mobile video units (MVUs) as a dynamic platform, the team delivered interactive presentations on the benefits of PMC, its dosing schedule, and broader malaria prevention strategies. These sessions also served as a critical opportunity to understand and address the barriers that community members encounter in preventing malaria.

 

The impact of these efforts is evident. Over 2,200 people participated in the MVU sessions, reflecting the community’s engagement and enthusiasm for the project in Zogbodome. Since its inception in 2022, the Plus Project has supported the Ministry of Health in Benin in distributing more than 104,000 doses of sulfadoxine-pyrimethamine (SP), the drug used for PMC.

 

Through the Plus Project and similar initiatives, we are making strides toward a world where every child can access their fundamental right to health. Together, we can continue to champion child health and well-being, ensuring a future where every child not only survives but thrives.

Cambodia – It takes two: Engaging men in family planning
By Michelle Priya Sahai, Monitoring, Evaluation, Learning and Communications Fellow, PSI Cambodia
A “Heart Protector” participant poses in front of a banner depicting contraceptive product samples.

“Learning about contraception helps eliminate misunderstandings [about contraception] between men and women,” said Chhorn Srieng, a resident of Cambodia’s Battambang Province. “And it encourages us to discuss both the traditional and modern methods of family planning.”

 

Because most modern family planning methods are primarily designed for women to use and reproductive health programs typically engage women, the responsibility of family planning too often falls to women alone.

With the USAID-funded Promoting Healthy Behaviors (PHB) project in Cambodia, we are bringing men into the conversation. In collaboration with the Royal Government of Cambodia, PSI and partner 17-Triggers used social and behavior change (SBC) techniques, including human-centered design, to understand the needs of rural couples and co-develop the following programs:

 

 

Heart Protector – Also known as the “Men’s Session,” Heart Protector is named after men’s traditional roles as protectors of their families. It includes engaging, participatory activities and materials through which groups of men learn and discuss, many for the first time, about modern methods of family planning and how to discuss the topic with their partners or wives. Through the sessions, men are encouraged to consult with trained health providers, have informed, open discussions with their partners about contraception, and support their partner to use family planning.

 

Loving Relationship – The Loving Relationship program works with couples to help them communicate openly about family planning. Alongside an interpersonal communication agent, partners talk about fears and misconceptions of modern methods, see real contraception product samples, and play games to have fun and build trust as well as ease the discomfort many couples feel talking about taboo topics, such as family planning.

These programs were crafted to increase the uptake of modern family planning methods, promote joint decision-making among couples, and equip Cambodian men with the knowledge and tools to make informed choices about family planning. This initiative is strengthened through partnerships with community-based organizations such as Partners in Compassion, Khemara, and Action for Health Development (AHEAD).

 

The impact has been substantial. Community events hosted through these programs have reached over 120,000 individuals, including 76,642 men. A post-assessment revealed that 60 percent of participants, most of whom were men, had meaningful conversations with their partners about family planning.

By involving men in family planning decisions, we are helping to build stronger, healthier families. Addressing the contextual barriers to modern family planning for Khmer men and their partners has supported couples in Cambodia to take control of their health and make informed decisions about their families’ futures. This initiative serves as a model for how couples worldwide can choose whether, when, and how they build their families.

Markets

We grow robust markets for health products and services to ensure people can access the resources they need when and where is best for their health, lives, and futures.

Shaping the Global Market
for Self-Care
By Dr. Karin Hatzold, Global Director HIV, Tuberculosis and Viral Hepatitis
Randburg Taxirank Johannesburg, HIV self-test user testing himself at self-testing booth. Credit: Ndoro film, South Africa for Unitaid

Eight years ago, the concept of HIV self-testing (HIVST) was still emerging, with global guidelines absent and only a few countries, such as the United States, the United Kingdom, and France, having policies that allowed for it. In low- and middle-income countries, where the burden of HIV is high, there was a significant gap in diagnosis, compounded by the lack of evidence and guidance for HIV self-testing.

 

Our journey to impact

PSI led the Unitaid-funded HIV Self-Testing Africa (STAR) Initiative to evaluate the feasibility, acceptability, and scalability of HIVST in resource-limited settings and address market barriers to self-testing rollout. From the beginning, the STAR Initiative aimed to generate crucial information about delivering self-testing products effectively, ethically, and efficiently. Through different distribution models — including facility-based, community-based, private sector, community pharmacy, workplace, and virtual models using both oral-fluid and blood-based kits — the project investigated for cost, client preferences, linkage to care and prevention, and the impact of HIVST in increasing access to services faster. STAR generated critical evidence demonstrating that HIV self-testing is not only safe and acceptable but also cost-effective for reaching high-risk populations with limited access to conventional HIV testing.

 

Evidence from STAR informed the pre-qualification process of six self-testing kits by the World Health Organization and was instrumental in informing normative guidance and influencing national policies and regulatory frameworks. STAR also informed demand and supply needs for HIVST, enticing manufacturers to invest in new product development and market entry, increasing the availability of diverse products and choice while simultaneously generating competition. Today, over 108 countries have reported HIV self-testing policies, with many scaling up to complement and, in some cases, partially replace conventional testing services. This progress became even more critical as countries worked to maintain HIV services amid the disruptions caused by the COVID-19 pandemic.

 

 

Expanding the horizons of self-testing

Leveraging our expertise in HIV self-testing implementation, PSI expanded its efforts to explore how self-testing for Hepatitis C and COVID-19 can enhance testing uptake and coverage. This research focused on identifying specific areas and populations where self-testing can make the most significant impact. STAR developed targeted strategies to expand access to self-testing, ensuring individuals have convenient, timely options for testing, and are effectively linked to care, treatment, and prevention services through differentiated test-and-treat approaches.

 

By pioneering the expansion of self-testing beyond HIV, PSI is helping to decentralize health services, bringing care closer to those who need it most. By enabling individuals to take control of their health, PSI’s approach also strengthens health systems, enabling them to continue providing essential services even in the face of challenges and crises. This model builds more resilient and adaptable health systems worldwide.

Ethiopia – A market-based approach to scale sanitation

By Dr. Dorothy Balaba, Country Representative, PSI Ethiopia   

Safiya Ahmed, from Oromia region of Ethiopia, is seen immersed in transformative technical training on floor solutions and SATO pan installation

Traditional efforts to eliminate open defecation have often relied on the distribution of free or heavily subsidized sanitation products. While these methods have provided immediate relief, they often lack sustainability. To foster lasting change, a more durable solution is required: that’s where market-based sanitation comes in.

 

In Ethiopia, the PSI-led USAID Transform WASH (T/WASH) project, in collaboration with consortium partners SNV and IRC WASH, is using this market-driven approach. The project aims to build robust markets for underutilized sanitation products, enhancing household access to affordable, high-quality sanitation solutions. By integrating market forces, supporting business growth, creating demand at the household level, and providing clear pathways for purchasing WASH products, T/WASH is driving considerable progress in Ethiopia’s sanitation sector.

In partnership with Ethiopia’s Ministry of Health, Ministry of Water and Energy, and Ministry of Labor and Skills, T/WASH has achieved promising results:

  • 158,000+ households have invested in upgraded sanitation solutions, with rapid expansion expected as the initiative scales and market growth accelerate.
  • 500+ small businesses have been trained, including community masons and construction-related enterprises, equipping them with the technical skills for sanitation product installation, as well as the operational capacities, marketing, and sales skills necessary to run successful, growing businesses.


Nationwide scaling

The project has supported the Ethiopian government in scaling this market-based approach across the country. Furthermore, T/WASH has collaborated with the One WASH National Program and various government ministries to examine and influence policies that encourage increased household uptake of basic WASH services. These efforts include advocating for targeted sanitation subsidies, tax reductions to boost affordability, and improved access to loan capital for businesses seeking expansion and households needing assistance to upgrade their facilities.

 

As Michael Negash, Deputy Chief of Party of T/WASH, aptly noted,

“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.”

Health
Systems

We support governments to build resilient health systems that can efficiently respond to changing population needs and adapt to new environmental contexts.

Somalia - How holistic care makes health systems stronger

By Zamzam Arale Hassan, Research, Learning & Documentation Specialist, Eden Issak, Senior M&E Specialist, Abdiwahit Jama, Senior community Health Specialist, PSI SOM 

Bulsho Kaab nurse, a member of PSI’s social franchise network, checks an infant patient in her pharmacy in Hargeisa, Somaliland.
Bulsho Kaab nurse, a member of PSI’s social franchise network, checks an infant patient in her pharmacy in Hargeisa, SOM.

In Somalia, the Marwo Caafimaad Program has emerged as a promising initiative, transforming community health while also strengthening the country’s health systems. Over the past year, this initiative has equipped female health workers with the training, resources, and ongoing support to deliver essential healthcare services directly to the homes of those in need. This holistic approach ensures that healthcare is not only accessible and affordable but also deeply attuned to the specific needs of each community.

 

The program’s impact is vividly illustrated through the story of Hidaya, a female health worker in the heart of Hamar Bile Village, Warta Nabada district of Mogadishu. Hidaya’s unwavering commitment to her community and the Marwo Caafimaad Program’s support have led to transformative outcomes, particularly in the case of Ali Dahir, a 10-year-old boy suffering from a severe skin disease on his scalp.

 

During one of her routine visits, Hidaya encountered Ali, whose condition had left him in daily pain and discomfort. With her keen observational skills, empathy, and the training provided by the program, Hidaya took immediate action. She referred Ali to a health facility for comprehensive treatment, diligently cleaned his wounds with antiseptic, and ensured he adhered to a prescribed regimen of antibiotics and painkillers.
Hidaya’s care extended beyond medical intervention; she became a pillar of support for Ali and his family. Understanding the importance of holistic care, she went the extra mile by purchasing anti-dandruff shampoo to maintain Ali’s hygiene and closely monitored his recovery process. Her dedication not only alleviated Ali’s suffering but also brought relief to his family, who were spared the burden of travel and hospital expenses.
Ali’s father noted,

 

“My child experienced daily pain and discomfort. Now, thanks to Allah and the efforts of Hidaya, my child has fully recovered and is healthy. The Marwo Caafimaad program and Hidaya have alleviated this burden.”

 

This story underscores the Marwo Caafimaad Program’s role in strengthening health systems in several critical ways. By building the capacity of female health workers like Hidaya, the program enhances the overall quality and effectiveness of healthcare delivery. The decentralized model of bringing healthcare services directly to communities—particularly in remote and underserved areas—addresses significant gaps in access and equity, ensuring that even the most vulnerable populations receive the care they need.

 

Moreover, by reducing financial barriers and providing care within the community, the program prevents families from facing catastrophic health expenditures, thereby contributing to the sustainability of the healthcare system. The strong referral system, as demonstrated by Ali’s case, ensures that patients receive appropriate levels of care, optimizing healthcare resources and improving patient outcomes.

India – Superwomen of Indore changing lives one tap at a time

By Ankita Gambhir, Assistant Manager of Communications, and Suma Pathy, Chief of Party, Samagra, PSI 

Seema-interacting-with-Hemlata

Hemlata’s son has liver damage – and she wants private sector care.

 

The catch: it is pricey and Hemlata needs guidance on where to get government-funded subsidies for private health services.


Through the USAID-funded project Samagra, PSI and Haqdarshak are building out digital health platforms to make it easier for people like Hemlata to access the tools and resources to get the care they need. In partnership with Haqdarshak, who offers a digital platform originally built to help rural populations navigate government support programs, we tailored the platform to fit the unique needs of marginalized urban populations – which are typically more diverse, have less permanent housing, and sometimes have less reliable social and family networks than their rural counterparts.

 

Living in Indore City, India, Hemlata met Seema, who is a “Haqdarshika” – a community-level entrepreneur for Haqdarshak. PSI and Haqdarshak identified and trained local women like Seema to act as digital facilitators for government services. The Haqdarshikas are deeply rooted in their communities; they are the superwomen connecting people to relevant government support systems and supporting them to not just access but navigate their journey to care.

 

Seema worked with Hemlata and her son to access an Ayushman Bharat ID, needed to access government funding for private care, and choose a health insurance that they were eligible for. After navigating this process together, Hemlata’s son received treatment for liver damage at a private hospital, free of cost.

 

Haqdarshikas like Seema work across Indore city, India aiming to bridge the digital divide and bring crucial government support programs directly to people’s doorsteps, especially for women. Samagra’s Haqdarshak initiative in Indore City supported over 226,000 individuals, unlocking access to 315,000 government-funded health grants. As designed, 70 percent of these individuals were women. By making information and services accessible, Samagra is igniting a sense of independence and agency in marginalized communities. Through partnerships with local governments and healthcare institutions, Samagra lays the foundation for a sustainable future.

Program Spotlight MOMENTUM

Private Healthcare Delivery

Health challenges are complex and intersectional, and to find solutions, we can’t operate in silos. MOMENTUM’s impact highlights how integrated program design makes it easier to serve more people’s holistic needs in the long term. 

By Mariela Rodriguez, Senior Learning and Communications Advisor, MPHD and Salamatou Mamane Sani Issa, Manager of Communications and Knowledge Management, MPHD Niger

Aichatou Sidi with midwife at clinic. Photo credit Salamatou M Sani, MPHD Niger

In low- and middle-income countries, the private sector plays a crucial role in healthcare, providing over 40 percent of health services. Recognizing this, the USAID-funded MOMENTUM Private Healthcare Delivery (MPHD) project uses integrated program design to strengthen every level of the private sector. 

MOMENTUM creates and sustains the health markets and systems necessary for individuals and communities to access high-quality, person-centered reproductive, maternal, and child health services. By engaging people and communities, markets, and health systems, MOMENTUM ensures the sustainability and quality of private sector healthcare to serve people’s holistic health needs. 

 
People and Communities – Partnering with the private sector to deliver person-centered care in Niger 

Aichatou Sidi’s visit to the Aida clinic in Zinder, Niger, during an open day exemplifies the impact of MOMENTUM’s initiatives. She received a free prenatal consultation, an experience that left her both surprised and pleased.

“I was consulted free of charge, even though it’s a private clinic,” Aichatou shared. “I’m delighted because I was welcomed and treated well by the staff.”

These open days, organized by private sector facilities partnering with MOMENTUM in Niger, are designed to help underserved communities access quality care and become familiar with the reproductive, maternal, and child health services available. In 2023, MOMENTUM Niger facilitated over 100 such events, significantly enhancing awareness and access to family planning and reproductive health services. 

At the core of MOMENTUM’s work is the promotion of person-centered care, a pioneering effort to integrate this approach across reproductive, maternal, and child health services in the private sector. MOMENTUM has developed a comprehensive training program for private sector providers, offering user-friendly tools and strategies to promote holistic, person-centered care. This training focuses on adolescent and youth-responsive care, gender-transformative care, respectful maternity and childcare, client-centered family planning counseling, and empathetic communication. By equipping providers with these tools, MOMENTUM ensures that care is tailored to the values, preferences, and needs of individuals, thus strengthening the capacity for person-centered care in the private sector. 

Hormonal IUD simulation training. SFH- Society for Family Health, 2023
Markets – Expanding access to contraceptives in Nigeria and Mali 

Access to contraceptives, particularly hormonal IUDs, a type of birth control that’s placed in the uterus and uses hormones to give long-term birth control, remains limited in many low- and middle-income countries. This is primarily due to the prohibitive cost of hormonal IUDs as well as the specialized provider training required to insert them. MOMENTUM is addressing this challenge by training and certifying private healthcare providers to deliver hormonal IUDs (brand name: Avibela) in Nigeria, equipping over 250 providers across 11 states. From April to December 2023, over 1,000 hormonal IUD units were sold through the private sector, illustrating the growing capacity of local providers to offer this essential contraceptive method affordably. 

 

In Mali, MOMENTUM collaborates with national partner JIGI to ensure the availability of high-quality, socially marketed contraceptives in the private sector. MOMENTUM’s support has significantly improved the supply chain for contraceptives, leading to the sale of over 353,000 oral contraceptive packs, 410,000 injectables, 2,800 implants, 1,600 IUDs, and 1.6 million condoms between 2022 and 2023. These efforts are strengthening markets for affordable contraceptive products, ensuring sustainable access for individuals in need. 

Digital-Health-Solutions-Project
Health Systems – Enhancing data-based decision-making for health in Uganda 

In Uganda ongoing challenges related to limited government oversight and resource constraints have hindered the effectiveness of healthcare delivery. Recognizing the need for improved collaboration and data-driven decision-making, MOMENTUM has taken significant strides to bridge these gaps. 

 

Working in partnership with Uganda’s Ministry of Health, the MOMENTUM project is focused on enhancing the exchange of data between public and private digital health platforms. This initiative is not only fostering greater collaboration between sectors but also is empowering healthcare providers with the information they need to make informed decisions. 

“With support from USAID’s Momentum Private Healthcare Delivery,” says Dennis Chemonges of PSI Uganda, “we are aiding the government in transforming these fragmented systems into a cohesive framework. By integrating public and private sector data, we are generating the evidence necessary to support everyday decision-making for health service providers.”

 

This effort underscores the importance of collaboration in overcoming healthcare challenges in Uganda, ensuring that both public and private sectors can work together to deliver quality health services to all. 

Theresa. Garu Presby Health Center
Integrated Program Design – Supporting women’s health choices in Ghana

“Prior to adopting the Counseling for Choice (C4C) approach, I really did not know I was overloading my clients with information,” said Theresa, a midwife trained by MPHD “This time around, when the clients come, we give them the exact information they need and they leave here satisfied.”

 

We know supporting women’s health choices is important, but when it comes to contraceptive counseling, the question is how. Recognizing the gap in how contraceptive information was being delivered, MOMENTUM designed C4C as an evidence-based counseling method that equips clients to make informed decisions about their contraceptive options, focusing on what matters most to them. 

 

MOMENTUM’s efforts have not only transformed individual practices but are also influencing national health systems. In partnership with Total Family Health Ghana and Ghana Health Services, MOMENTUM successfully integrated the C4C approach into Ghana’s National Family Planning Protocol. This inclusion allows the C4C method to be implemented across the country, reaching a broad spectrum of health providers and ensuring that person-centered care is accessible to all. 

 

By prioritizing informed choice and respecting clients’ voices, C4C is changing the landscape of family planning counseling in mixed health systems, where individuals depend on both public and private sectors for their healthcare needs. MOMENTUM and its partners are making significant strides in ensuring that everyone receives the respectful, effective, and personalized care they deserve.

 

To transform health, we can’t work in silos. MOMENTUM’s impact in strengthening the private sector to meet people’s holistic health needs is powered by partnerships at every level of local health systems and the global health community. Together, we can leverage integrated program design to tackle barriers to health and achieve Universal Health Coverage. 

A WAY FORWARD

Looking ahead to 2024 – A new strategic direction 

In 2024, we will introduce a new strategic vision – Transforming Health Together. This strategy is designed to create transformative solutions for people, communities, markets, and health systems, recognizing the deep synergies between these elements as the key to lasting impact.

Broadening our focus and leaning on partnerships 

Over the past five decades, we have consistently pushed boundaries, challenged taboos and crafted innovative solutions to some of the world's most complex health challenges. In coming years, we will continue to look beyond healthcare and tackle a wider range of issues that influence health and well-being – from the effects of climate change to urbanization, and limited livelihood opportunities. We will lean on new and existing partnerships to reach people in new, impactful ways.

Building on digital transformation

We aim to unlock the potential of emerging digital technologies by working with global and in-country partnerships to adapt, test and build an evidence base on the use of these innovations to power health outcomes. In addition, we will work closely with governments and relevant partners to support scaling and sustainability of proven digital innovations in a manner that adopts common standards and reduces fragmentation – ultimately supporting stronger health systems.

Sustaining impact through Viya Health

PSI remains committed to delivering impact at scale through donor-supported programming, but increasingly this impact is also being delivered by our social business, Viya Health. This year, Viya Health became a wholly owned, independently incorporated business, granting it greater autonomy to differentiate its offerings, finance expansion, and continue delivering sustainable results.

Leveraging our Global Network 

Although PSI has long championed locally-led development, this approach has gained momentum as the capacity of donor recipient countries has strengthened. National governments, USAID, and other leading donors are prioritizing partnerships that align with national plans and strengthen local organizations. We will continue to evolve our locally-rooted, globally-connected network to maximize flexibility and agility, improve accountability and shift power closer to our consumers.

2023 Financial
Summary

PSI is proud of the growth we experienced over the past year. The financial support we receive helps us address growing health challenges thought the wold. Visit PSI’s consolidated financial statement  

Revenue

million
$ 1

Expenses by Year

Revenue by Donor Type

partners

Governments and
International Organizations

  • AusAid
  • CDC – Centers for Disease Control and Prevention
  • CIDA Canadian International Development Agency
  • DANIDA Danish International Development Agency
  • FCDO – Foreign Commonwealth and Development Office – ADD
  • Global Affairs Canada
  • Global Fund
  • Government of Flanders
  • Government of Lesotho
  • Government of Tanzania
  • Government of Uganda
  • KFW
  • Ministry of Foreign Affairs Netherlands
  • Sida
  • UNFPA
  • UNICEF
  • UNITAID
  • UNOPS
  • USAID
  • US Department of Defense
  • West Africa Health Organization
  • World Bank
  • World Health Organization

Foundations

  • Children’s Investment Fund Foundation CIFF
  • Conrad N Hilton Foundation
  • David and Lucile Packard Foundation
  • Erik E and Edith H Bergstrom Foundation
  • High Tide Foundation
  • Merck Foundation
  • Patrick J McGovern Foundation 
  • Stone Family Foundation
  • William and Flora Hewlett Foundation
  • Wallace Genetic Foundation

Private Sector

  • Abbott
  • Afaxys
  • Astrazeneca
  • Audere
  • Bayer
  • Boston Scientific
  • Babylon Health
  • Exxon Mobile
  • Johnson and Johnson
  • META
  • Microsoft
  • Pfizer
  • Procter and Gamble
  • Lixil
  • Unilever
  • Twilio

Our work is also made possible by the contributions of Maverick Collective members and hundreds of individual donors.

quotes from
our team

 ERIN SAMUELI
Maverick Collective
Maverick was my first foray into philanthropy and it was transformative in my life and how I engage with others philanthropically and personally. Maverick really puts gusto behind the phrase "trust-based philanthropy" by putting local leaders at the center of their work globally and really putting authentic trust and faith in their decision making through the human-centered design process. Being able to see that play out in real time reframed my perspective on risk, philanthropy, and activism.
 Alison Malmqvist & Christopher Lourenco
Acting VP, Global Fundraising & Communications, PSI
Director, Malaria & Neglected Tropical Diseases (NTDs), PSI
We recognize that investing in girls and women for our common future is more important than ever before; our work at the intersection of agency and economic empowerment offers an entry point for relevant cross-sectoral partnerships. The challenge is to develop coherent solutions across sectors so that all people, and girls and women especially, can thrive in vibrant, healthy, and biodiverse communities.
Imran Rasheed
Director Global Policy, AstraZeneca
PSI in Nigeria leads one of AstraZeneca’s biggest Healthy Hearts Africa programs, underscoring PSI’s value in shaping impactful health systems for non-communicable disease across East and West Africa
Mosima Mabunda
Board Member
When I think of Transforming Health, it is being human-centered. This is where systems and services are centered around individuals and communities with the goals of keeping them in good health.
DR. REBECCA KINNEY
Maverick Collective
I traveled to Eswatini for a project-related visit last year, and we had lunch with the Principal Secretary to the Minister of Health, who was very invested in PSI's work. I realized at that meeting the incredible convening power that PSI holds with the Ministry of Health and how this nurtured relationship can help PSI's work on behalf of women and girls to become integrated into policy and practice at the highest levels of government.
Abhijit Dutta
Board Member
PSI's network of global offices and branches give it a unique insight, depth, and perspective on what local ecosystems and what local needs looks like so that they can tailor solutions.
Marcie Cook
Vice President, Social Business and Global Operations
With its relentless dedication to breaking taboos, dispelling misinformation, and enhancing the quality of health delivery, Viya health is an example of how social business not only creates ripples of change but also illuminates a transformative path forward
Mary Adebola Adebisi
Former, Youth Information Officer, SFH Nigeria
A standout moment in my experience with the 9ja Girls' program was receiving a Facebook message from a girl. She shared her success in preventing unplanned pregnancy using information from the 9ja Girls' page. Her comfort discussing sexual and reproductive health via direct messaging highlighted the program's positive impact
Noah Taruberera
Executive Director, Population Solutions for Health
This week we landed our strategy with the PSI and PSH teams. This is value! PSH exports technical competencies in defined health areas and business functions. And the PSI network presents opportunities. Together we can and should grow this network.

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ACCELERATING UPTAKE OF HEALTH INSURANCE

Governments in LMICs that have opted for a pathway toward UHC involving health insurance are implementing various measures to increase health insurance coverage. However, these efforts do not automatically translate into high uptake of health insurance or, among those enrolled, into increased utilization of services, as several barriers may still prevent individuals from enrolling or from utilizing the available services provided under insurance schemes. How can governments navigate the complexities of health insurance to accelerate uptake in LMICs?

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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?

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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?

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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?

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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.

Safiya Ahmed, from Oromia region of Ethiopia, is seen immersed in transformative technical training on floor solutions and SATO pan installation

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

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