The Best Buys in Global Health: Striking an Effective Balance

To have real and lasting impact, we must step back from the intervention level of analysis to understand how we can mold entire ecosystems to better serve the health of broad populations. Sometimes this is called ‘health systems strengthening’, and sometimes it might be seen under the even broader rubric of ‘capacity building’.

A Winning Strategy: Investing in Local Heroines

By Karl Hofmann, President & CEO, PSI

When you invest in local heroines, women win.

Despite all the systemic challenges women and children face around the world, we’ve learned that investing in local heroines who provide education and resources can help tear down barriers and save lives.

Here is an impact primer that shows how investing in local heroines helps PSI get results for women and children.

Local heroines trained in community health services save children’s lives.In many countries, mothers are unable to access health care for their children to treat preventable but deadly diseases like malaria, pneumonia, and diarrhea. We can shift that equation by deploying local health workers. In Cameroon, 48% of children received diarrhea treatment in areas served by community health workers vs. 7% of children in other areas with no community health workers.

Local heroines are effective champions for social change.There is often stigma associated with family planning activities. In Zimbabwe, where women are embarrassed to purchase female condoms, local heroines like hairdresser Tears Wenzira are distributing them in beauty salons. In fact, more than one million female condoms are distributed through this network of 2,500 hairdressers across the country.

Local heroines help keep mothers alive during childbirth.In the next 24 hours, 931 women will die worldwide from preventable pregnancy-related causes. In Pakistan, more than three-quarters of births take place at home, which is high-risk for maternal mortality. A pilot voucher program – where trained outreach workers recruit pregnant women from low-income households to receive subsidized reproductive health services from private health providers – increased prenatal clinic care by 16%, health care-facility based deliveries by 20% and postnatal care by 35%.

As you can see, PSI is committed to measuring our impact. And we’ve learned that investing in local heroines provides extraordinary returns on your investment.

Will you invest in a local heroine?

Handwashing with soap to help a child reach five years old

TV Asia USA covered the Help a Child Reach 5 campaign event featuring PSI, Unilever, Lifebouy soap and the Millennium Villages Project. Watch experts and advocates, including our CEO Karl Hofmann describe the importance of children reaching their fifth birthday and how handwashing with soap can make a difference.

Saving Lives Through the Power of Soap

photo(New York) - Handwashing with soap saves lives. It is really that simple agree leaders from the private, NGO and academic spheres at an event this morning. As a child dies every fifteen seconds around the world, the time is now to bring solutions that save lives to scale.

“The cost of inaction is higher than the cost of action,” said Paul Polman, CEO of Unilever.

Polman was joined by economist Jeffrey Sachs of Columbia University, PSI CEO Karl Hofmann and Indian actress Kajol. The four called attention to the way that partnerships can accelerate programs like handwashing so that more lives are saved.

Unilever’s Lifebouy soap brand partners with PSI to run handwashing education programs in Kenya. A similar partnership with Sachs’s Millennium Villages Program further increases the reach and impact of handwashing.

“The 2008 crisis showed that while many people improved their lives, many were still left behind,” said Polman.

Lifebuoy’s Help A Child Reach 5 campaign aims to eradicate preventable deaths from diseases like diarrhea one village at a time, by teaching lifesaving handwashing habits. Hofmann praised the marketing abilities and reach of Unilever. He said that PSI was initially interested in learning from Unilever to improve PSI’s social marketing. The formal partnership that later developed showed just how NOGs can work with the private sector.

“As we look at the burden of disease, there’s naturally an overlap with the consumer goods marketing done by Unilever,” he said.

The idea was put into action when Lifebuoy launched its Help a Child Reach 5 handwashing campaign in Thesgora, a village in Madhya Pradesh with one of the highest rates of diarrhea in India. Lifebuoy has committed to teach Thesgora and the surrounding five villages the importance of handwashing at the five key occasions – and to help them sustain this habit. The initiative will increase the practice of handwashing with soap among children and therefore reduce the disease burden of child diarrhea.

Unilever Panel

Early results are exciting. The 6,000 people reached helped decrease the diarrhea incidence rate from 42% to 11% in a matter of six months. The next step will be to bring the program to the rest of the state and eventually all of India. Achieving that can be done through partnerships.

“Governments can find it hard to engage with programs that involve behavior change. Hygiene is an area which has been often overlooked. No business, government or UN agency can achieve the agreed reduction of child mortality alone, but by working together we can combine the expertise, resources and policy needed to achieve real change,” said Polman at the UN yesterday.

By working with Indian actress Kajol, Lifebouy hopes to reach more people. She described how simple it is for people to wash soap with their hands. Being a mother, she described a motivation to ensure that all children in India are able to survive and thrive.

Handwashing is working, they all agreed. Fewer kids are getting sick and fewer kids are dying. With the expiration of the MDGs around the corner, we must keep pressure up to include Water Sanitation and Hygiene in the post 2015 Sustainable Development Goals. Polman said he did not believe that handwashing will be a goal itself Post-2015, but was optimistic that it can be a key part of improving health and ensuring that fewer children die each year.

How health impact metrics contribute to global health program decisions

By Karl Hofmann, President and CEO of PSI

Measurement and accountability for programmatic results are increasingly important in the work that we and other publicly funded organizations do.  We love measurement, so we welcome this.

I want to highlight a recent special supplement in the journal BMC Public Health that PSI sponsored and published with Pathfinder, MSI, and UCSF, Use of Health Impact Metrics for Programmatic Decision Making in Global Health.

The supplement includes articles by all four organizations, which describe approaches for estimating the health impact of programs, and the equity and breadth of our reach. Featured metrics are used at the programmatic level for accountability, decision-making, priority setting and intervention design.

Patricia H David, Director of Research and Metrics at Pathfinder International, explains the importance of metrics and the motivation for the supplement in an introduction for the supplement.

Click here to read the supplement or see the list of articles with links at the end of the post.

Please share your thoughts by commenting on the supplement and articles below or, even better, contacting metrics@psi.org to schedule a meeting or presentation at your agency, and engage with our authors in person.

PBS on the Consequences of Unintended Pregnancies

The PBS series To the Contrary shows how increased access to reproductive health services can save the lives of women and children around the world. Viewers meet some of the people who see their lives changed by healthcare access and features the May Women Deliver Conference held in Malaysia.

One section (~15 min mark) highlights the work of PSI and our ambassador, Mandy Moore. She says that people should challenge themselves to drive the conversation about reproductive health forward by making allies, meeting people and starting discussions about the issue.

“The majority of the young people I talk to really are advocates and passionate about sexual health and reproductive rights,” says Moore.

Give the video a watch and also see PSI board member Barbara Bush talk about her organization’s, the Global Health Corps, impact on family planning in Malawi.

What’s the Big Idea? Investing in a Comprehensive Approach to Women’s Health

By Amy Lieberman

There are still two years left before the United Nations’ eight poverty, health and gender Millennium Development Goals expire and lapse into a new international development agenda. Yet MDG 5 remains one of the most off-track targets, potentially too derailed to meet the benchmarks on time.

Every year, more than 1 million children are left motherless as a result of complications during pregnancy and childbirth. In sub-Saharan Africa, a woman’s maternal mortality risk is 1 in 30, compared to 1 in 5,600 in developed regions. And more than 200 million women lack access to critical family planning services.

The situation is dire, but signs of progress are emerging. Increased advocacy in recent years has spurred a wide array of new commitments from donors, government leaders and corporations. Many advocates, health experts and supporters are looking at new models for improving the health of women and girls in the world’s poorest countries.

But what strategies will ensure that those regional and global commitments – in policies, partnerships and dollars – will be maintained during this decade and beyond? And what models for health service delivery can successfully reverse the abysmal health outcomes facing millions of girls and women?

Putting an End to the World’s Leading Killers of Children

Leading global health organizations are joining with the WHO and UNICEF to take on the diseases that cause 2 million child deaths a year. The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) provides a blueprint for deploying the strategies that will prevent deaths caused by diarrhea and pneumonia.

“Simple, affordable solutions exist to save children’s lives,” said Karl Hofmann, President and CEO, PSI.  “I’m very happy to see that the new Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea prioritizes these proven strategies and ensures that we tackle these critical diseases in an integrated and coordinated way to reach the most vulnerable children.”

The plan sets out steps for key partners, namely governments, the private sector and the two UN organizations. Private sector recommendations include:

- Committing to producing quality, affordable treatments and vaccines in child-friendly formulations that are easy-to-administer and to improving distribution to ensure these products reach the most vulnerable children;
- Developing and delivering improved water treatment, sanitation products and clean-cooking technologies and supporting accessible and affordable service delivery for all; and
- Conducting communications campaigns to reach families and health providers about best practices.

What Male Circumcision Taught Us About the Future of Funding for Global Health

By Karl Hofmann, President and CEO, PSI

Private capital is needed to test and develop proof that existing health solutions can be adapted to a developing world context. Once this proof is established, the solution has the power to unlock the large-scale government funding needed to dramatically improve health across the developing world.

As demonstrated in a new report released this week by PSI’s Impact magazine and Devex, in partnership with Fenton Communications, the landscape for global health financing has changed dramatically. High-income governments that provide foreign aid for health have steadily increased their support over the last decade. That support is now leveling or shrinking due to budget constraints. Governments are under increased pressure to reduce risk and ensure that all public funds for foreign aid are invested in solutions that guarantee results.

As a result, corporations, foundations and philanthropists are now taking an active role to help protect the progress already made against serious threats to health and economies like HIV, malaria, tuberculosis, pneumonia, and lack of access to family planning, which remain as urgent as ever. They are providing private capital to fund the type of innovation that governments cannot afford to advance on their own.

Karl Hofmann Elected President of TB Alliance’s Stakeholders Association

PSI CEO Karl Hofmann both joined the board and was elected to the position of President of the TB Alliance‘s Stakeholders Association (SHA) this week. The SHA is made up of representatives from  developing nations, government, non-governmental organizations, professional organizations, academia, foundations and industry. It represents a support mechanism for the TB Alliance, where Karl will also serve as a board member.

“I’ve seen how today’s suboptimal TB therapies contribute to a cycle of disease and poverty in some of the least developed countries in the world,” said Mr. Hofmann in a press release. “Now with improved TB drugs on the horizon, I look forward to working with the TB Alliance through my role on the Board and in leading the SHA, to help speed the delivery of promising new regimens to those who need them most.”