FRom HEaltH CENtER to HomE, polICy to pRaCtICE, FaCtoRy to pHaRmaCy

2011/ 2012 Biennial Report

V S I C O N N E C T S W O M E N W I T HL I F E - S AV I N G M E D I C I N E S A N D S E RV I C E S

REGISTRATION

I

Engaging governments and partners to achieve regulatory approval of quality,

essential medicines and supplies

II

INTRODUCTION

Strengthening national policies and practices to enable product access

III

AVAILABILITY

Applying practical solutions to ensure everyday availability for

communities in need

ConneCting Women With Care

these are exciting times for the field of global maternal health and VSI. In this report, we share our progress and proudest accomplishments over the past two years.

In 2011 and 2012, VSI remained dedicated to addressing the maternal health needs of communities and countries with everyday health solutions. In 15 countries, we providedour expertise in connecting women with life-saving medicines and services, such as misoprostol.

We are honored to share the stories of women like Comfort in Ghana who was protected from excessive bleeding after childbirth by medicine distributed in our innovative community-level program, and of nurses like yvonne in Rwanda, who for the first time in her career is now trained to treat women suffering from complications of unsafe abortion. you will read about VSI’s collaborative efforts with medical associations from Burundi to mozambique to strengthen the next generation of health professionals. and we will update you on newly developed national policies and protocols in our program countries that are expanding women’s access to medicines and services.

at the global level, we were encouraged by the establishment of the United Nations Commission on life-Saving Commodities for Women and Children in 2012. We were pleased to see misoprostol recognized as a priority medicine, which builds upon our successful collaborative effort to add misoprostol for postpartum hemorrhage prevention to the World Health organization’s model list of Essential medicines in 2011.

VSI’s programs continue to introduce this essential medicine in countries where the burden of maternal mortality is greatest, while growing our product portfolio

and collaborating with more governments and partners to introduce additional medicines and services for women and girls. looking ahead, VSI will be working to increase understanding and availability of commodities to address other significant causes of maternal morbidity and mortality the world over, such as pre-eclampsia and eclampsia.

While there have been important gains in reducing maternal mortality in recent years, our work is far from done. We are committed to making sure that pregnancyand childbirth remain times of joy, not suffering; that policies promote the highest quality of care for women and girls regardless of where they live, or their economic and social status; and that health care providers have the knowledge and supplies they need to save lives.

We are excited about applying our expertise and access model to new areas of care and are grateful for the opportunity to collaborate with so many talented, creative and motivated partners and donors to achieve our mission, every day. together, we can make lasting change in the lives of women and their families.

We invite you to connect with us so we can connect more women and girls with the life-saving medicines and services they need.

Sincerely,

Pamela m. norick President and CEO

nap hosang Chairman,

Board of Directors

DEAR FRIEnDS, CollEAGUES AnD SUPPoRtERS,

eaCh year 287,000 Women die in PregnanCy and Childbirth, nearly all in develoPing Countries.

a generation ago that figure was almost double. We have made gains, but women and girls continue to die unnecessarily because they lack access to

care when and where they need it. the solution to safe pregnancy and childbirth begins with everyday availability of essential medicines and health services.

VSI is connecting mothers and health care providers to life-saving medicines and services. When women are healthy, children survive and communities thrive for generations to come.

V S I C O N N E C T S W O M E N W I T HL I F E - S AV I N G M E D I C I N E S A N D S E RV I C E S

REGISTRATION

I

Engaging governments and partners to achieve regulatory approval of quality,

essential medicines and supplies

II

INTRODUCTION

Strengthening national policies and practices to enable product access

III

AVAILABILITY

Applying practical solutions to ensure everyday availability for

communities in need

VSI has developed and tested a model for health product access rooted in three fundamental components: Registration, Introduction and availability. VSI’s expertise ranges from gainingnational regulatory approval for essential medicines to updating health worker guidelines and designing product distribution strategies

with the goal of improving access for the hardest to reach populations. Working in partnership with governments and partners in the nGo and private sectors, VSI identifies and overcomes challenges to providing effective maternal and neonatal health products and services at the primary health care and community levels.

VSI ConnECtS WoMEn WItH lIFE-SAVInG MEDICInES AnD SERVICES

I II IIIREGIStRatIoNEngaging governments and partners to achieve regulatory approval of quality, essential medicines and supplies

INtRoDUCtIoNStrengthening national policies andpractices to enable access to products and services

aVaIlaBIlItyapplying practical solutions to ensure everyday availability for communities in need

mission: VSI is a nonprofit organization committed to improving women’s health in developing countries

by creating access to effective and affordable technologies on a large scale.

vision: VSI’s vision is to make lasting improvements in the health of women and girls in developing

countries by creating access to life-saving and affordable health solutions for all.

values: Equity • Respect • Collaboration • Expediency • accountability

on tHE ClInIC SHElVESyvonne dedicates her life to the health of others. a nurse for

many years in Rwanda, before VSI trained her to provide postabortion care, she had no way of treating women who came to her clinic suffering from complications of unsafe abortion and miscarriage. yvonne could only refer a woman to the hospital miles away, not knowing if her patient could afford the trip or would actually make it before her situation grew worse. Equipped with new skills and medicine on her clinic’s shelf, yvonne is now able to offer a critical service to the women of her community.

In HER oWn HAnDSComfort is the proud mother of baby Joseph. thanks toprenatal care from nurses in Ghana, she had medicine in her hands that prevented life-threatening bleeding after childbirth when her labor came on quickly at home

and she could not reach a facility to deliver. Comfort recognizes the risks of pregnancy and childbirth as well as the

value of trained health care providers, so much so that she hopes Joseph grows up to become a doctor. She wants VSI’s safe motherhood

program to continue so more women can enjoy a safer childbirth.

V S I C O N N E C T S W O M E N W I T HL I F E - S AV I N G M E D I C I N E S A N D S E RV I C E S

REGISTRATION

I

Engaging governments and partners to achieve regulatory approval of quality,

essential medicines and supplies

II

INTRODUCTION

Strengthening national policies and practices to enable product access

III

AVAILABILITY

Applying practical solutions to ensure everyday availability for

communities in need

EthiopiaFollowing the completion of a successful comprehensive abortion care pilot, VSI brought over 1, 000 women together to discuss reproductive health concerns and barriers to access at traditional coffee ceremonies. Women offered devastating and eye-opening testimony:

“Previously we used detergents and local herbs to end unwanted pregnancy and many mothers faced severe complications. Now we have all themethods to prevent unwanted pregnancy and safe abortionservices nearby.” —mother, adi-Ha health post

Burundito train the next generation of front-line health professionals,

in December 2012, VSI convened maternal health providersfrom all 17 provinces to educate on misoprostol in obstetricsand family planning, the first gathering of its kind in the country.

ZimbabweVSI’s operation research introducedthe use of misoprostol for treatment ofincomplete abortion and miscarriage to

51 rural health centersthat were not equipped to offer the service until now.

to engage community leaders as valuable allies in VSI’s programs, we involve leadership at all levels, from law enforcement officers in Rwanda to Queen mothers in Ghana.

GhanaIn VSI’s program introducing misoprostol,

93 % of the women whodelivered at home were protected from life-threatening postpartum hemorrhage. Without this program, they would have had nothing to prevent this leading causeof maternal death. Rwanda

VSI educated 1, 000 community-level animatrices de santé maternelle (aSms) to connect women to health centers, ensuring they are protected from excessive bleeding after childbirth:

“A woman was going to the health center and coming from far away. I called for others to carry her and when they were on the way, she delivered. I gave her misoprostol and she did not bleed.”

—Denise, aSm

VSI supported the development of a postabortion care protocol and training tools for use in the national expansion of this critical maternal health program.

NatIoNal

Kenya and mozambiqueVSI hosted meetings to introduce the misoprostol Use inpostabortion Care Service Delivery toolkit developed withIpas to providers and program planners. endorsed by 27 organizations globally and translated into three languages, this tool is equipping program implementers to address a leading cause of maternal mortality.

REGIoNalto build regional capacityand collaboration, VSI gathered

35 medical leadersfrom 12 african countriesin July 2012 for a week-long Regional Experts’Summit. the experts are leading effortsto accelerate the reduction of maternal mortality throughout africa.

tanzania and Zanzibarto understand the factors influencing availability of maternal health medicines in the health system, VSI collected district-, regional- and national-level data, and made recommendations on how training, ordering practices and demand generation would improve product availability in the near term.

angola and South SudanWith approval of the essential medicine misoprostolin angola and South Sudan in 2012, VSI has achievedproduct registration in 17 developing countries.

GloBalVSI is lending expertise to

multiple global initiatives that increase access to essential maternal health commodities: • United Nations Commission on life-Saving Commodities for Women and Children • Reproductive Health Supplies Coalition • maternal Health Supplies Working Group

In may 2011, the World Health organization approved VSI and Gynuity Health projects’ joint application to include misoprostol for prevention of postpartum hemorrhage on its model list of Essential medicines, a policy step that influences government prioritization of this maternal health medicine.

CommUNIty

FRoM HEAltH CEntER to HoME,PolICy to PRACtICE, FACtoRy to PHARMACy... VSI IS ConnECtInG WoMEn WItH CARE.

FInAnCIAl StAtEMEntIn 2011 and 2012, VSI continued to demonstrate strong

fiscal discipline over our program portfolio and to maintain the highest financial standards in our management of valued donor funds. this year, as in all past years, we received the highest possible rating, a standard unqualified opinion, on our 2012 financial statements from an independent auditing firm.

VSI continued to direct the overwhelming majority of our resources in support of programs, with minimal expenditure on administration and business development: an average of 87 cents of every dollar was spent in support of VSI’s programs to connect women with life-saving medicines and services across 15 country programs. VSI spent $12.7 million to deliver on our promise to our contributors and to program beneficiaries.

VSI’s programs and product portfolio continue to evolve and grow with valued support from long-standing contributors and new funding sources. as VSI grows, we will continue to enhance our financial management capacities in order to maintain sound fiscal policies and procedures.

Contributions to VSI are precious. It is incumbent upon us to be responsible stewards of donor funds, ensure these funds are well spent, and efficiently reach the women and girls who stand to benefit the most from this generosity.

We thank our donors and partners for their significant contributions as we work toward a shared mission of improved health for women and girls.

oPERAtInG SUPPoRtAnD REVEnUE SoURCESGrants and contractsother investment income

total operating support and revenue

totAl

$11,097,766$ 1,324,805$ 262,092$12,684,663$ 3,155,396$ 3,301,008Find VSI’s financial statements on www.guidestar.com

PRoGRAM AnDoPERAtInG ExPEnSESProgram servicesGeneral and administrativeBusiness developmenttotal operating expensesnet assets, beginning of year 2011net assets, end of year 2012

totAl

$12,853,530$ ($23,255)

$12,830,275

With the contributions of Vsi and other partners, ZanZibar reduced maternal deaths from 528 per 100,000 liVe births in 2004 to 261 in 2010.”

—Dr. Khadija Said, obstetrician Gynecologist, ministry of health’s mnazi mmoja hospital, Zanzibar

2011 and 2012opERatING ExpENSES

$12.7 million

2.1 %BUSINESS DEVElopmENt

10.4 %GENERal aNDaDmINIStRatIVE

87.5 %pRoGRam SERVICES

VSI lEADERSHIPVSI’s leadership combines backgrounds in clinical medicine, demography, program design, epidemiology, monitoring and evaluation, social marketing, finance, international relations and public policy.

Pamela m. norickPresident and CEO

ndola PrataMedical Director

shannon bledsoe Vice President, Global Programs

Wasim KhanVice President, Finance and Administration

BoaRD oF DIRECtoRS

nap hosangChairmanCenter for Global public Health - University of California, Berkeley School of public Health

Kari gothieTreasurerVice president, Finance - think Big analytics

Pamela m. norickpresident and CEo - VSI

Friday e. okonofuaprofessor, obstetrics and Gynecology - University of Benin, Nigeria

J. Joseph speidelprofessor - University of California, San FranciscoBixby Center for Global Reproductive Health

ruchi varshneyaSecretaryDirector, Global market Research and Competitive Intelligence - abbott laboratories

In my career In nIgerIa and throughout afrIca, I have seen countless women and gIrls suffer from the dangers of pregnancy and chIldbIrth. sInce Its InceptIon, vsI has demonstrated technIcal expertIse In maternal health and a steadfast commItment to practIcal and hIgh-Impact solutIons to Improve the health of women and theIr famIlIes. havIng worked alongsIde vsI for years, I am honored to advIse thIs group of dedIcated professIonals as we brIng about lastIng change In communItIes lIke my own.”

—Professor Friday E. Okonofua

university of benin, nigeria

ConnECt WItH USso we can connect more women with life-saving medicines and services

get interaCtive Encourage your family, friends and colleagues to lend their voices in support of women worldwide by following VSI (VSInnovations):

get inFormed Visit the VSI website for the latest news, resources and publications on VSI’s programs: www.vsinnovations.org

get insPired Gain a fresh perspective by reading VSI’s Field Journal: www.vsinnovations.org/field-journal

get invested Give to VSI and invest in women so that communities can thrive for generations to come: www.vsinnovations.org/donate-now.html

VSI Northern California 2115 Milvia Street, Suite 4aBerkeley, California 94704 USA

VSI RwandaGrand Pension Plaza, 3rd FloorKiyovu, Kigali, Rwanda

VSI EthiopiaKirkos Sub City 01/19Addis Ababa, Ethiopia VSI Zimbabwe20 Cleveland Road, Milton ParkHarare, Zimbabwe

PhotograPhy: Emma NEsPEr holm (CovEr, P.4/rwaNda, ghaNa) ©2012; marko BalENoviC (P.2, P.9/taNzaNia) ©2012; kEviN rozNowski (P.3) ©2013; hugh wright (P.3) ©2012; kora imagE ©2010 (P.11/EthioPia).

VSI is a tax-exempt 501(c)(3) nonprofit organization incorporated in the State of California.

ContACt InFoRMAtIon www.vsinnovations.org

VSI Southern California (HQ)19200 Von Karman Avenue, Suite 400 • Irvine, California 92612 USAtel +1 949 622 5515 • Fax +1 949 622 5516