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PSI INTERVENTIONS REACH CHILDRENPSI INTERVENTIONS REACH CHILDREN ––““The Power of CommunicationsThe Power of Communications””
Muna Shalita (Safe Water Program Manager) Nov 2005
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About PSIAbout PSIInternational nonInternational non‐‐profit founded in profit founded in 19701970Programs in more than 65 countriesPrograms in more than 65 countriesUses Uses social marketingsocial marketing of products of products and services to promote healthy and services to promote healthy behaviorsbehaviorsFocused on achieving Focused on achieving measurablemeasurablehealth impact at health impact at SCALESCALE
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PSI Health SectorsPSI Health Sectors•Safe Water/Oral Rehydration
•Malaria
•Nutrition/Micronutrients
•HIV/AIDS
•Family Planning
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Focus on Social Marketing.Focus on Social Marketing.PSI employs private sector business principles to PSI employs private sector business principles to marketmarket and and distribute distribute needed health interventionsneeded health interventions
Products and services are branded, attractively Products and services are branded, attractively packaged and marketed via multiple channelspackaged and marketed via multiple channels
Products/services are typically sold at affordable Products/services are typically sold at affordable prices, but not given away:prices, but not given away:
More highly valued and better used by consumersMore highly valued and better used by consumersProviding profit incentive to distributors and Providing profit incentive to distributors and retailers ensures availabilityretailers ensures availabilityCost recovery enhances program Cost recovery enhances program sustainabliltysustainablilty
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Global Burden of Unsafe WaterGlobal Burden of Unsafe WaterOver 1 billion persons Over 1 billion persons have no access to have no access to improved water improved water sources sources
Hundreds of millions Hundreds of millions more drink more drink unsafeunsafewater from water from ““improvedimproved””sourcessources
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What is Safe Water?What is Safe Water?
Water that does not cause morbidity Water that does not cause morbidity and/or mortalityand/or mortality
Especially in children under 5Especially in children under 5
Assumption that Assumption that ‘‘protected sourcesprotected sources’’ are are safe water safe water –– Often False!Often False!
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What Contaminates Water ?What Contaminates Water ?
Four types of organisms:Four types of organisms:BacteriaBacteriaVirusesVirusesProtozoaProtozoaHelminthsHelminths
Organic materials and heavy metals Organic materials and heavy metals including lead & arsenicincluding lead & arsenic
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PostPost‐‐Source ContaminationSource Contamination
Collection StorageTransportation
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““Disinfection of water at the Disinfection of water at the point of use is consistently the point of use is consistently the most costmost cost‐‐effective effective intervention.intervention.””
The United Nations The United Nations World Water Development World Water Development Report, 2003Report, 2003
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PSI POU Interventions PSI POU Interventions ‐‐ PuRPuRPuRPuR (P&G product)(P&G product)
Launched in Haiti, Uganda Launched in Haiti, Uganda and Pakistanand Pakistan
Soon launching in Malawi Soon launching in Malawi and Kenyaand Kenya
Powerful visual clue of Powerful visual clue of treatment treatment ‐‐ addresses addresses turbidity w/ flocculent (iron turbidity w/ flocculent (iron sulfate) & removes metalssulfate) & removes metals
PuRPuR vs. SWS: vs. SWS: a. More steps a. More steps
required for treatmentrequired for treatmentb. Cost higherb. Cost higher‐‐‐‐$0.10 $0.10 ‐‐ 0.20 0.20 USD per family per dayUSD per family per day
Over 500,000 sachets Over 500,000 sachets sold in less than one sold in less than one
year in Uganda.year in Uganda.
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PSI POU Interventions PSI POU Interventions ‐‐ SWSSWSSafe Water System (SWS)Safe Water System (SWS)Dilute sodium hypochlorite solution in Dilute sodium hypochlorite solution in bottle bottle –– branded branded WaterGuardWaterGuard
Sometimes paired with 20 liter vesselSometimes paired with 20 liter vessel
PSI first launched in Zambia 1998 PSI first launched in Zambia 1998 (involved prior w/CDC pilot in Bolivia in 1997)(involved prior w/CDC pilot in Bolivia in 1997)
Now implemented by PSI in 15 countriesNow implemented by PSI in 15 countries
>16 million bottles sold to date>16 million bottles sold to date
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Benefits of SWS & PURBenefits of SWS & PUREvidenceEvidence‐‐based interventionbased intervention
Prevents diarrhea (studies show at least 50% reductions)Prevents diarrhea (studies show at least 50% reductions)Provides protection in vulnerable zone between water collection Provides protection in vulnerable zone between water collection and consumptionand consumption
Low cost, portable, rapidly implementedLow cost, portable, rapidly implemented
Readily accepted and effectively marketedReadily accepted and effectively marketed
MultiMulti‐‐sectoralsectoral community mobilization facilitates community mobilization facilitates adoptionadoption
Benefits the poor, those not served by current Benefits the poor, those not served by current infrastructure and last in line for future installationsinfrastructure and last in line for future installations
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Safe Water System
Treat drinking water at the point‐of‐use
Dilute sodium hypochlorite bleach
Store treated drinking water safely
Narrow‐mouthed, lidded vessels with spigots
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Communications Interventions to Communications Interventions to Reach Children Reach Children –– PSI/UPSI/U
PSI/U formed partnerships with selected organizations to reach tPSI/U formed partnerships with selected organizations to reach target audiencesarget audiencesUPMA: UPMA: -- Communication through registered private Midwives Communication through registered private Midwives clinics nationwide targeting pregnant women and clinics nationwide targeting pregnant women and caretakers of children < 5yrs. Key messages focus on caretakers of children < 5yrs. Key messages focus on Safe Water, Hygiene, Sanitation and Malaria prevention Safe Water, Hygiene, Sanitation and Malaria prevention and controland controlUNANM:UNANM:-- Communication through nurses and midwives at Communication through nurses and midwives at public health institutions nationwide focusing on Safe public health institutions nationwide focusing on Safe Water, Hygiene, Sanitation and Malaria prevention and Water, Hygiene, Sanitation and Malaria prevention and controlcontrol
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Communications Interventions to Communications Interventions to Reach Children Reach Children –– PSI/UPSI/U
Organized WomenOrganized Women’’s Groups:s Groups:-- To enhance community led interventions on Safe To enhance community led interventions on Safe Water, Hygiene, Sanitation and Malaria prevention and Water, Hygiene, Sanitation and Malaria prevention and control. control. ((ieie::HomapakHomapak –– Home Based Management of Fever)Home Based Management of Fever)
Community Based Organizations (Community Based Organizations (CBOCBO’’ss):):-- Training of peer educators to sensitize communities Training of peer educators to sensitize communities on good health practices and distribution of health on good health practices and distribution of health products at grassroots level.products at grassroots level.
* Target distribution (* Target distribution (ieie: PLWHA): PLWHA)* General distribution* General distribution
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Communications Interventions to Communications Interventions to Reach Children Reach Children –– PSI/UPSI/U
Disadvantaged ChildrenDisadvantaged Children’’s Homes:s Homes:-- Health Sensitization and Provision of health Health Sensitization and Provision of health products (products (ieie ITNITN’’ss & PUR) and communication & PUR) and communication materials (materials (ieie: Brochures, Instructional Posters : Brochures, Instructional Posters etc.)etc.)
* Sunrise Children* Sunrise Children’’s Village (Entebbe & Lira)s Village (Entebbe & Lira)* Toro babies Home (Fort Portal)* Toro babies Home (Fort Portal)* * Moyo Moyo ChildrenChildren’’s Home (s Home (MoyoMoyo))* Gertrude* Gertrude’’s Childrens Children’’s Home (s Home (JinjaJinja))
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Communications Interventions to Communications Interventions to Reach Children Reach Children –– PSI/UPSI/U
PUR SCHOOLS PROGRAM:PUR SCHOOLS PROGRAM:
-- PSI/U together with P&G aims at reducing the PSI/U together with P&G aims at reducing the occurrence of occurrence of diarrhoealdiarrhoeal disease among school disease among school going children (primary schools).going children (primary schools).-- BCC techniques to promote correct and BCC techniques to promote correct and consistent treatment of water using P&Gconsistent treatment of water using P&G’’s PUR s PUR pointpoint--ofof--use water treatment product.use water treatment product.
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Communications Interventions to Communications Interventions to Reach Children Reach Children –– PSI/UPSI/U
PUR SCHOOLS PROGRAM:PUR SCHOOLS PROGRAM:
-- ACTIVITIES:ACTIVITIES:* Training sessions for Teachers, Student * Training sessions for Teachers, Student
peer educators and District Health Educatorspeer educators and District Health Educators* Drama & Music competitive sessions* Drama & Music competitive sessions* Education: use of IEC materials * Education: use of IEC materials
wooden tree boards.wooden tree boards.* M&E* M&E
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PSI/U Joint Safe Water & PSI/U Joint Safe Water & Malaria Campaigns: UTMTMalaria Campaigns: UTMT
PSI Uganda developed and adopted the PSI Uganda developed and adopted the ““Under the Under the Mango TreeMango Tree”” (UTMT) concept to communicate joint Safe (UTMT) concept to communicate joint Safe Water and Malaria BCC messages to similar target Water and Malaria BCC messages to similar target audiences:audiences:
‐‐ Primary Target GroupPrimary Target Groupoo Pregnant Women & Caretakers of children <5Pregnant Women & Caretakers of children <5∙∙ Secondary Target GroupsSecondary Target Groupsoo Men with children <5Men with children <5oo Schools/school childrenSchools/school childrenoo Community Health providers (CORPS)Community Health providers (CORPS)∙∙ Selected High Risk GroupsSelected High Risk Groupsoo People Living with HIV/AIDSPeople Living with HIV/AIDSoo IDPsIDPs/Refugees/Refugeesoo Informal Urban Settlement ResidentsInformal Urban Settlement Residents
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PSI/U Joint Safe Water & PSI/U Joint Safe Water & Malaria Campaigns Malaria Campaigns -- UTMTUTMT
ACTIVITIES:ACTIVITIES:
-- Sensitization of rural communitiesSensitization of rural communities-- Distribution of IEC materials including film Distribution of IEC materials including film showsshows-- Pre & Post evaluation of community membersPre & Post evaluation of community members-- Sales of health products (Sales of health products (ieie: : ITNITN’’s s & PUR)& PUR)
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PSI/U Joint Safe Water & PSI/U Joint Safe Water & Malaria Campaigns Malaria Campaigns -- UTMTUTMT
Safe Water ActivitiesSafe Water Activities Malaria ActivitiesMalaria Activities
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PSI/U Joint Safe Water & PSI/U Joint Safe Water & Malaria Campaigns Malaria Campaigns -- UTMTUTMT
ACHIEVEMENTS OF ACHIEVEMENTS OF ““UTMTUTMT””::
-- Activations in 8 districts nationwide, covering Activations in 8 districts nationwide, covering 760 villages760 villages-- People reached: Over 60,000 People reached: Over 60,000 (59% Women & Children)(59% Women & Children)
-- Established Sales Outlets (Market priming)Established Sales Outlets (Market priming)-- Sales: PUR = Over 20,000 sachetsSales: PUR = Over 20,000 sachets
ITNITN’’s s = Over 2,000= Over 2,000
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PSI/U Joint Safe Water & PSI/U Joint Safe Water & Malaria Campaigns Malaria Campaigns -- UTMTUTMT
““UTMTUTMT”” PARTNERS:PARTNERS:-- Ministry of Health (DDHS)Ministry of Health (DDHS)-- Local Government Officials (Local Government Officials (LCLC’’ss))-- Faith Based Faith Based Organisations Organisations ((FBOFBO’’ss))-- Community Drug Distributors (CORPS)Community Drug Distributors (CORPS)
DURATION of DURATION of ““UTMTUTMT””::-- Phase I = 8 monthsPhase I = 8 months
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Key Key LearningsLearnings from Experiences from Experiences ( PSI/U)( PSI/U)
Health Sensitization: Health Sensitization: achieves greater impact achieves greater impact if issues pertaining to Malaria and Safe Water if issues pertaining to Malaria and Safe Water are addressed in unison. are addressed in unison. (Fever)(Fever)
Partnerships: Partnerships: -- Public Public –– Govt. bodies, Hospital, SchoolsGovt. bodies, Hospital, Schools-- Private Private –– NGONGO’’s, Private Commercial s, Private Commercial
OrganisationsOrganisations, , FBOFBO’’ssCommunity Led InterventionsCommunity Led Interventions: Through : Through CBOCBO’’ss
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KeyKey LearningsLearnings from Experiences from Experiences (PSI/U)(PSI/U)
AccessibilityAccessibility: Hard to reach areas are usually those : Hard to reach areas are usually those with the most needs. Increased costs compromise with the most needs. Increased costs compromise equity, (Fewer populations reached)equity, (Fewer populations reached)MobilisationMobilisation:: Minimum facilitation for public officials Minimum facilitation for public officials required due to required due to ““volunteer fatiguevolunteer fatigue””. (. (ieie: cars without fuel): cars without fuel)
Pricing:Pricing: Increased direct subsidies on commodities Increased direct subsidies on commodities requiredrequired
-- ITNITN’’ss: Subsidized nets in : Subsidized nets in Kaberamaido Kaberamaido generated increased sales (1,000 nets) as opposed generated increased sales (1,000 nets) as opposed to low sales for to low sales for unsusidizedunsusidized nets (180 nets)nets (180 nets)
Population Services Population Services InternationalInternationalMeasurableMeasurable
HealthHealthImpactImpact
Drives Drives EverythingEverythingWe DoWe Do
790,000HIV infections prevented
6.1 millionpregnancies averted
78,000child deaths from malaria averted
8.7 milliondiarrhea cases avoided
8.4 millionmultivitamin pills marketed
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PSIʹs Liters of Treated Water 1999‐2005
‐
1,000,000,000
2,000,000,000
3,000,000,000
4,000,000,000
5,000,000,000
6,000,000,000
7,000,000,000
1999 2000 2001 2002 2003 2004 Thru Q32005Year
Liters of Treated Water
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ConclusionConclusion
We have affordable technologies that work.We have affordable technologies that work.We know how to do it at scale.We know how to do it at scale.
Funding is critical for the Funding is critical for the success of our programs.success of our programs.
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Thank youThank you