To maximize impact, PSI puts disease burden evidence in the driver’s seat

Published March 14, 2014

Change isn’t always easy, but sometimes it’s essential to help you reach your goals.

Population Services International (PSI) is an international nonprofit organization that strives to improve health in developing countries around the world by providing healthcare, medical supplies, and services. For years, PSI tracked its impact by counting the number of medical supplies delivered to various communities, such as insecticide-treated bednets, family planning products, and rapid diagnostic tests for malaria.

But PSI knew that medical supplies don’t necessarily lead to improved health in equal measure. So PSI shifted its guiding measure of health. It chose the number of disability-adjusted life years (DALYs) averted. In other words, how was PSI preventing early death and disability?

“This switch resulted in more targeted strategies and greater program diversification,” wrote Kim Longfield, PSI’s Director of Research and Metrics, and her colleagues, in BMC Public Health.

And it led to specific results. They wrote:

By the end of 2011, PSI had doubled its health impact, averting 22.8 million DALYs in that year. From 2007-2011, 79.7 million total DALYs were averted, with a compound growth rate of 26.6% each year.

The shift in focus to DALYs averted resulted in substantial changes in PSI’s approach to global health challenges. For one, PSI expanded its portfolio to include interventions that targeted pneumonia, tuberculosis, and nutrition. In Asia and Eastern Europe, PSI started programs to reduce early death and disability from tuberculosis, hypertension, tobacco, and cervical cancer. In Laos, PSI succeeded in convincing donors through disease burden evidence to fund interventions focused on family planning, maternal health, nutrition, water and sanitation, and tuberculosis.

“As global health implementers, it is important that these metrics inform our work, define our impact and demonstrate our value to donors, and more importantly, to those we serve,” Karl Hofmann, President and CEO of PSI, wrote in Devex, an international development website and news outlet, upon the release of the GBD 2010 study in December 2012. “It’s important that the global health community embrace a new paradigm — relevance — that will require us to use burden of disease data as a decisive criterion to inform our choices about which health conditions to target, where, and with whom.”