A Paradigm Shift for Tackling Extreme Poverty

By Karl Hofmann, President and CEO, Population Services International

When girls and women earn, they spend 90% of their income on their families, while men spend between 30-40%.

According to the Guttmacher Institute, if we were to meet the unmet need for contraception, we’d reduce unintended pregnancies by 70%, unsafe abortions by 74%, and reduce maternal deaths by 25%.

Education, participation in the labor force and earning potential would increase.

By investing in the health and rights of girls and women in the developing world, we can end extreme poverty in our lifetime.

This we know.

But up until now, we’ve been mainly investing in single health solutions in the developing world because this is how donor governments have funded them. To achieve the bold goal of ending extreme poverty requires us to make a very simple, yet important, paradigm shift to how we have been operating.

We must shift from addressing single health issues to an approach that integrates solutions to solve the complexity of her needs — because her needs are not vertical – they are horizontal, and they are connected.

We must shift from addressing single health issues to an approach that integrates solutions to solve the complexity of her needs…

We learned much and saw great successes with the Millenium Development Goals in the last 15 years.

Since 1990, extreme poverty has been cut in half. 17,000 fewer children die each day than in 2000 . Maternal mortality has fallen by nearly half. 3.3 million malaria deaths have been prevented, while 2.3 billion people gained access to clean drinking water.

But we know there’s so much more to be done.

In order to fast track solutions to some of the world’s most vexing health challenges, we must look closely at the Sustainable Development Goals (SDGs). The complexity of 17 goals, 169 targets, and an undetermined number of indicators — which address increasing health outcomes, but also environmental impact, access to education and economic growth for all countries — points much more sharply to integration and working among sectors, rather than spending resources to find a single or vertical solution. And those solutions will come from a new era of greater collaboration among partners in the public and private sector.

This is good news for girls and women. The SDGs oblige us to look at everything that stands in the way of girls and women thriving and to approach the challenge from all sectors of society.

In the health context, we simply aren’t doing our best when we test a woman for HIV but don’t address her family planning needs or her child’s fever at the same time. Addressing girls and women by individual health areas is like playing a perverse game of whack a mole.

Addressing girls and women by individual health areas is like playing a perverse game of whack a mole.

Instead, at Population Services International (PSI), we try and understand what is possible by looking at the totality of what she needs, versus simply what disease or health area is being funded.

The private sector plays an important role in providing health care to many in the developing world. But private health providers may often be unregulated or of questionable quality. PSI’s answer to this challenge is a model borrowed from our modern economy:  franchising.  PSI operates more than 10,000 franchised health facilities in 33 countries and serves 10 million people a year.

PSI’s franchising model offers business owners quality assurance, training, lower cost medical supplies, and business support like marketing and branding. Consumers can access low-cost, quality health services in a single convenient location.

So when a mother comes in for her child’s vaccinations, the health worker may also talk with her about family planning, malaria prevention, HIV prevention or treatment, screening for cervical cancer and looks for signs of violence or abuse.


Integrated Service

The result is a more sustainable solution, that better integrates the services and products she needs while building the business skills of entrepreneurs and relieving pressure from an overtaxed public health system.

The challenge for all of us — whether we work with NGOs, governments, donors, philanthropists, the corporate sector or social enterprises — is to take a step back and look at the bigger picture. Integrated solutions, with a focus on the holsitic needs of girls and women, are the imperative set by the SDGs. What can all of us do to live up to that challenge?

Photo Credit: Sala Lewis