Maverick Collective Report 2020

POWER IN HER HANDS AN INITIATIVE OF 1

2019 MAVERICK COLLECTIVE IMPACT REPORT

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BARB JONES DECEMBER 18, 1951 – JULY 13, 2019 This report is dedicated in loving memory of Founding Member, Barb Jones. May all the achievements of Maverick Collective – from the projects that are changing the lives of women and girls to the Members who are setting a bold example of philanthropy – live on through her legacy.

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Maverick Collective is a group of bold women who take part in the projects they fund to make a lasting difference for women and girls. As a groundbreaking initiative of Population Services International (PSI), Maverick Collective projects are amplified and guided by PSI’s 50 years of global health experience in over 50 developing countries.

Maverick Collective is what happens when smart, dedicated, compassionate women come together to make the change they want to see happen in the world.

MELINDA GATES Maverick Collective Co-Chair, 2016–2018

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THE MODEL We harness private capital to test promising innovations, unlock learning, and pioneer new approaches.

• Pilot and adapt innovative, consumer-powered healthcare solutions • Embrace risk to discover what works and what doesn’t • Share learning and scale agile and impactful solutions • Amplify impact by partnering deeply on projects

TURNING 50 A note from Karl Hofmann, President & CEO, PSI Dear Maverick Collective Members, In January 1970 — 50 years ago — Phil Harvey and Dr. Tim Black founded Population Services International.

Revenue from a condom catalog they started and an initial USAID grant allowed them to create their first social marketing campaign in Kenya: They sold subsidized condoms to underserved areas, giving people the power to control their destiny. This PSI was innovative, scrappy, and effective.

We are still that PSI. At 50, we’re bigger and more complex, but still innovative and hungry for impact. Maverick Collective helps keep us on the impactful edge of our work.

Since 2018, we have rededicated ourselves to putting our consumer, Sara, at the center of our thinking and design. We are committed to chipping away at the power imbalances that have frustrated global health progress and to removing the barriers so that Sara can exercise her own power. I’m proud of that.

As trusted partners and allies, you continue to push us – through your projects and your partnership – to question the status quo, fail fast, explore power constructs, and expand our worldview.

Thank you.

2020 will be an intense period of challenge and change for PSI. We need to reach for our roots of creativity and agility to maintain our momentum. We also need to continue collaborating with best-in-class partners like all of you.

For the next 12 months, through our 50Forward Campaign, we will celebrate your impact, the work of everyone who preceded us, and all that is to come for women and girls around the world.

Thank you for being a vital part of our 50-year history.

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NEW MEMBER SPOTLIGHT Please welcome our newest members to Maverick Collective. We can’t wait to see your passion realized into tangible impact through your projects and leadership.

AMY DORNBUSCH

“ Maverick Collective represents the future of philanthropy. I can apply a risk-tolerant approach and a ‘startup’ mentality to jumpstart important projects for scale that otherwise may not get funded.”

PROJECT: USING YOUTH-POWERED DESIGN TO REDUCE UNINTENDED PREGNANCY IN VIETNAM

SONJA PERKINS NATASHA JAMAL “ Maverick Collective allows me to implement my dreams. I dream of a safe, healthy water supply [in India] and a population that can grow, flourish, and implement their own dreams.”

PROJECT: AFTER THE FLUSH – SANITATION IN INDIA

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“ The Maverick [Members] are actively solving global problems facing women and girls. I joined Maverick Collective because I grew tired of waiting for the world to change and wanted to be part of this powerful women's network.”

MAVERICK COLLECTIVE MEMBERS DR. PRECIOUS MOLOI-MOTSEPE

AMY DORNBUSCH

ENGLISH SALL

NATASHA JAMAL

Co-Chair

ANA MORALES

ERIN SAMUELI

PAM SCOTT

H.R.H. THE CROWN PRINCESS METTE-MARIT

ANN MORRIS

HILARY HAMM

SARA OJJEH

Co-Founder & Co-Chair

ANU KHOSLA

JESS JACOBS

SHALINE GNANALINGAM

BARB JONES*

JULIA LOURIE

SONJA PERKINS

CAITLIN HEISING

KATHY VIZAS

STASIA OBREMSKEY

CAMILLA HAGEN SØRLI

KIM AGNEW

THERESA PRESTON-WERNER

CRISTINA LJUNGBERG

LINDSAY ABRAMS

VICTORIA SANT*

DIANE POWELL

MARTHA DARLING

MELINDA GATES Co-Founder & Former Co-Chair

KATE ROBERTS Co-Founder

*in memoriam

As young philanthropist[s]… we’re really oriented toward collaborative opportunities like [Maverick Collective].

You can watch these problems play out on the news every day or you can get involved now and do something while we still can. There are urgent problems around the world right now that are not going away if we don’t do something about it.

CAITLIN HEISING PROJECT: EXPANDING CONTRACEPTIVE ACCESS AND CHOICE FOR TEEN MOTHERS IN NICARAGUA

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OUR COLLECTIVE IMPACT IN 2019 Maverick Collective investments allow PSI to test new ideas and approaches, embrace and learn from failure, and create change at the local level with lessons for the global community.

Projects are designed for risk-tolerant philanthropists interested in testing an innovation in the field of global health.

We champion the incremental progress that is painstakingly won against some of the world’s toughest health challenges. Together—as a Collective and as a movement—we are building a future for women and girls that is healthier, happier, and ripe with potential.

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43K

People in Myanmar reached with health services and education including malnutrition assessments, malaria testing, and family planning

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First-ever Menstrual Health & Hygienefocused technical brief published at PSI, in partnership with The Case for Her

500K Consumers around the world reached with education and linked to nearby health facilities through a new mobile application

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Community Health Extension Workers—the first group in Kenya— trained to provide contraceptive implants at the community level

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Youth in Cote d’Ivoire reached with information on sexuality and reproductive health through a groundbreaking program highlighting the power of parent-child communication

800 2K “Restaveks”—Haitian children working as domestic servants— provided with family planning and education from a mobile clinic

South African men surveyed on their perceptions, barriers, and motivators to using Pre-Exposure Prophylaxis (PrEP) to prevent the transmission of HIV

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MAVERICK COLLECTIVE IS CHANGING THE WORLD ONE GIRL AT A TIME In Cote d’Ivoire, Jess Jacobs’ investment is helping PSI enlist parents as advocates for girls to access sexual and reproductive health education and services.

and become an informed advocate, Mama Bety gained his support for his daughters to try a new method: the contraceptive implant.

After an initial design workshop (collaborating and cocreating with youth), PSI launched a Parent Mobilizer program to respond to young people’s desire for safe spaces to discuss sexuality and reproductive health with their parents.

When asked why he’d changed his mind, he said that after talking to Mama Bety, he felt more confident knowing about the different methods, their potential side effects, and that none cause infertility. Mama Bety highlighted the importance of parent-child communication, encouraging him to continue talking to his daughters and listening to them. Both of the girls received the implant and felt confident knowing they had their father’s support.

“Mama Bety” is one such parent mobilizer. She’s working to ensure that parents are engaged and well equipped to support their daughters in decision making around modern contraception. Recently, a peer mobilizer introduced Mama Bety to a pair of sisters, aged 17 and 19, at a PSI mobile health service event. The girls had both been using the injectable contraceptive method, but after experiencing side effects, their worried father demanded that they stop receiving the injections.

Having been counseled by their healthcare provider, the girls knew the possibility of side effects and were not concerned, but their father was now hesitant about their using any method.

Mama Bety encouraged the girls to bring their father to a PSI event where she spoke with him, explaining the importance of modern contraception and the ways in which women and girls often experience each method.

By creating a safe space for their father to ask questions

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Maverick Collective projects are as diverse as the Members themselves, but coalesce around the following PSI strategic priorities: SEXUAL & REPRODUCTIVE HEALTH Help women and young people access contraception and lifesaving reproductive health services to lead the lives they desire.

Last year, PSI surpassed its Family Planning 2020 goal of reaching 10 million youth with voluntary modern contraception.

DIGITAL HEALTH TECHNOLOGY Use digital technology to connect people to on-demand health information and services, and to allow health workers to make decisions in real time.

PSI pledges to link 5 million clients to healthcare using digital technology by 2023.

SOCIAL ENTERPRISE Build social enterprises that provide sustainable healthcare to those who can and cannot afford it.

PSI operates the world’s largest social franchise network with 26 sub-networks in Asia, Africa, and Latin America.

SANITATION Improve access to safe, modern, and hygienic sanitation products and services for those who lack access.

This work has prevented more than 30 million cases of diarrhea—an illness that kills more children every day than AIDS, malaria, and measles combined.1

PRIMARY HEALTHCARE Facilitate delivery of community-driven primary healthcare services that are more accessible without the risk of financial hardship.

PSI deploys the latest market, consumer, and provider insights to help bring frontline healthcare to the 400 million people globally who lack access.

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Child Health Epidemiology Reference Group of WHO and UNICEF (2012).

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PROJECT SPOTLIGHT

MEMBER: KIM AGNEW PROJECT: EMPOWERING HAITI’S MOST VULNERABLE GIRLS TO LIVE HEALTHY LIVES FREE FROM VIOLENCE

This map highlights select Maverick Collective projects and all the countries reached

DOMINICAN REPUBLIC

HONDURAS MEMBER: SHALINE GNANALINGAM PROJECT: DELIVERING QUALITY, AFFORDABLE HEALTHCARE PRODUCTS GLOBALLY BY DEVELOPING SUSTAINABLE AND REPLICABLE CONSUMER-DRIVEN SOCIAL ENTERPRISE MODEL

NICARAGUA

MEMBER: ANA MORALES PROJECT: EMPOWERING TEEN MOTHERS AND FATHERS IN EL SALVADOR TO LIVE HEALTHY AND PRODUCTIVE LIVES

MEMBER: JULIA LOURIE PROJECT: INTERGENERATIONAL APPROACHES TO PREVENT AND TREAT CERVICAL CANCER IN THE CARIBBEAN

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MEMBER: HILARY HAMM

MEMBER: MARTHA DARLING

PROJECT: BUILDING NEW BUSINESS MODELS TO IMPROVE HEALTHCARE IN EAST AFRICA

MEMBER: DIANE POWELL

PROJECT: USING MOBILE TECHNOLOGY TO DELIVER MATERNAL AND CHILD HEALTHCARE IN INDIA

MEMBER: CAMILLA HAGEN SØRLI

NEPAL

PROJECT: ENSURING DIGNITY AND HEALTH FOR WOMEN AND GIRLS

BY IMPROVING SANITATION IN RURAL VIETNAM

PROJECT: BUILDING A SCALABLE MODEL FOR MOBILE MATERNAL HEALTHCARE IN RURAL SENEGAL MYANMAR

UGANDA MEMBER: ANN MORRIS

COTE D'IVOIRE

TANZANIA

PROJECT: EXPANDING CONTRACEPTIVE OPTIONS FOR WOMEN IN KENYA THROUGH COMMUNITY HEALTH WORKERS

MEMBER: ANU KHOSLA

MOZAMBIQUE

PROJECT: TESTING PrEP FOR HIV/AIDS PREVENTION IN SOUTH AFRICA MEMBER: ENGLISH SALL PROJECT: TRANSFORMING COMMUNITY HEALTH SYSTEMS TO IMPROVE HEALTH OUTCOMES IN ZIMBABWE

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THE MEMBER EXPERIENCE Over the course of their journey with Maverick Collective, Members become informed advocates for the women and girls their projects serve; build strong connections with PSI’s consumers and teams; and use their curiosity, leadership, and lived expertise to help us solve hard problems.

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PHASE 1: LEARN Members gain pivotal knowledge about PSI, their project, and the larger global health context. Learning is amplified through trips to the field, attendance at global technical meetings, and fostering deep connections with health experts around the world.

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PHASE 2: CONNECT & GROW Working closely with their PSI team, Members witness their project come to life, evolve, and gain momentum. Through retreats, networking events, and virtual connection, they form bonds and build platforms for future collaboration.

2 PHASE 3: SHAPE As Members learn, connect, and grow – both as philanthropists and as informed advocates for their projects – they begin to join and shape the larger conversation taking place about women’s leadership, innovation, and the role of philanthropy in creating lasting change.

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PHASE 1: LEARN

AMY'S LEARNING JOURNEY IN VIETNAM WITH YOUTH-POWERED DESIGN MEMBER: AMY DORNBUSCH

PROJECT: U SING YOUTH-POWERED DESIGN TO REDUCE UNINTENDED PREGNANCY AMONG YOUTH IN VIETNAM 16

In Vietnam, 40% of all pregnancies end in abortion.2 This startling statistic is what drew Maverick Collective Member, Amy Dornbusch, to invest in a human-centered design project to discover how we might reduce unintended pregnancies amongst Vietnamese youth.

Upon launching her project in December 2019, Amy, her husband, and her two young daughters flew to Hanoi, Vietnam to spend a month immersing in the culture, learning about the history, and working hand-in-hand with the PSI Vietnam team and youth participants.

Working alongside youth facilitators recruited and trained by PSI to conduct the “insights gathering” phase of this research, Amy was able to hear from the youth themselves what barriers exist to accessing contraception in Hanoi. “ I was mostly surprised by the cultural attitude amongst youth toward what it means to be sexually active. While youth are largely active by age 18, sex is a sporadic activity until they get married. With sex being ‘occasional,’ most of these young women do not consider themselves to be ‘sexually active’ and thus injections or daily pills that require advance planning are largely unused amongst unmarried women.”

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Over the course of two weeks, 15 youth facilitators shared findings they had discovered through one-onone and group interviews; conducted thematic analyses to synthesize insights; and designed prototypes to help youth access affordable, comfortable, and appropriate contraception options. “ The youth facilitators on-the-ground were the perfect way to seek understanding and insights into a young population on a sensitive topic.“ By designing family planning projects with the youth we aim to serve, the project ensures solutions are locallygrown, relevant, and appropriate. In the next stage, we will rapidly test three solutions before bringing them to scale in a pilot. We can’t wait to see what develops!

According to a report from doctors from Hanoi's Central Obstetrics Hospital (2014).

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CASE STUDY: PHASE 2: CONNECT 2 & GROW

PIVOTING TOWARD GREATER HEALTH IMPACT IN MYANMAR MEMBER: THERESA PRESTON-WERNER

PROJECT: T ESTING A SOCIAL ENTREPRENEURSHIP MODEL TO DELIVER FAMILY PLANNING IN MYANMAR 18

Maverick Collective Members are agile partners who understand that the business of global health is tough work. Innovative ideas can fail to produce results, political strife can delay progress or upend a project altogether, and pilot findings can lead a project down a different path than originally anticipated.

Theresa Preston-Werner discovered this firsthand when, half-way through her project in Myanmar, the team decided to make a strategic shift in the project’s measure of success. Working in partnership with Living Goods, PSI Myanmar has been piloting a network of community-based sales agents who sell health products and services.

In this model, PSI acts as wholesaler to the entrepreneurs, retaining a small margin to cover the costs of recruitment, marketing, training, and managing the network. One goal of the project was to build on the purchasing power of consumers to create a financially sustainable and scalable model.

After launching in several townships, the PSI Myanmar team realized that, despite achieving significant health impact, the goal of financial sustainability was proving less successful. In communications with Theresa, the team decided to hold a “pause and reflect” workshop

to take stock of successes, build off learned lessons to create an optimized project model, and align on objectives.

Theresa joined the PSI Myanmar team to understand the progress to date and to build a new vision for the model going forward. Together, it was agreed that the project would shift focus from financial sustainability to the health impact of bringing needed care to remote Myanmar villages.

The project team is now implementing the realigned model as Theresa plans her next trip to Myanmar in 2020.

She will have the opportunity to visit the townships and see the model in action. Through flexible and supportive members like Theresa, who trust the expertise of local staff on-the-ground, projects like this one are able to realign toward a stronger vision of success.

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PHASE 3: SHAPE

SHIFTING NATIONAL POLICY TO SAVE MOTHERS' LIVES IN UGANDA MEMBER: SARA OJJEH

PROJECT: S AVING THE LIVES OF MOTHERS AND NEWBORNS WITH CLEAN DELIVERY KITS IN UGANDA 20

One in three maternal deaths in Uganda is due to postpartum hemorrhaging.3 These deaths are entirely preventable, especially when Ugandan mothers use a Maama Kit: a World Health Organization (WHO) recommended kit containing tools a mother needs for safe delivery.

In 2016, however, these kits were missing two crucial medications recognized by the United Nations as essential life-saving commodities: chlorhexidine to sterilize the baby’s umbilical cord and misoprostol, which the mother can take to prevent or treat heavy bleeding.

Despite being registered in Uganda for over nine years, misoprostol had not been accessible to mothers for deliveries at clinics, or to the 27% of Ugandan mothers who give birth at home.

With an investment from Maverick Collective Founding Member, Sara Ojjeh, PSI Uganda advocated to change the Ministry of Health guidelines to include misoprostol and chlorhexidine in Maama kits and to make the kits available for distribution at the community level.

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Beginning in 2016, PSI Uganda piloted the addition of chlorhexidine and misoprostol to Maama kits in five districts, with much success. The project found a significant increase in the use of hygienic birthing practices and a decline in postpartum hemorrhaging occurrences.

Given the strength of these results, in 2019 PSI Uganda successfully advocated for changes to government guidelines. Misoprostol and chlorhexidine were added to the list of safe delivery guidelines and misoprostol was added to community distribution guidelines.

Soon, every one of these convenient Maama kits will be even more effective in saving mothers’ and babies’ lives.

Estimates from the Uganda Demographic Health Survey.

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REMARKABLE MOMENTS IN 2019 JANUARY

PARTNERSHIP WITH THE WORLD ECONOMIC FORUM’S YOUNG GLOBAL LEADERS Partnership announced to transform the urban Indian sanitation ecosystem by creating a sustainable waste management system, with support from Member Natasha Jamal.

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MAY

MAVERICK COLLECTIVE ANNUAL RETREAT 12 Members gathered in Vancouver Island, British Columbia, Canada for the annual event.

The goals of this retreat were to more deeply connect and build trust amongst Maverick Collective Members and staff, map our assets, and identify points of interest and commitments to action.

JUNE

WOMEN DELIVER CONFERENCE The PSI delegation organized more than 20 events including: Roundtable discussion, “Youth-Powered Investments” in Francophone West and Central Africa, featuring Jess Jacobs.

Dr. Precious MoloiMotsepe provided opening remarks for a plenary session, “The Power of Money: Driving equitable economic growth by investing in women.”

SEPTEMBER

CO-CHAIR DR. PRECIOUS MOLOI-MOTSEPE NAMED CHANCELLOR OF UNIVERSITY OF CAPE TOWN Co-Chair Dr. Precious Moloi-Motsepe named Chancellor of University of Cape Town. This is a 10year term as leader of the university that officially starts January 2020.

In making the announcement, UCT’s Chair of Council, Mr Sipho Pityana commented: “The university is privileged to have Dr. Moloi-Motsepe serve as the Chancellor of one of the leading institutions in the country and on the African continent.”

SEPTEMBER

OCTOBER

LAUNCH OF CERVICAL CANCER TREATMENT AND PREVENTION ADS

SIGNED MOU WITH THE TIGRE REGIONAL GOVERNMENT

In Trinidad, which has some of the highest rates of deaths from cervical cancer in the world, PSI launched a multi-channel messaging campaign to drive increased uptake of the HPV vaccine and awareness of the importance of testing for cervical cancer. This work was supported by Member, Julia Lourie.

This agreement allows for the piloting of a comprehensive sex education program (the first of its kind) in Ethiopia, thanks in large part to Erin Samueli’s investment.

This achievement came after significant project delays as the regional government revoked their initial approval forcing PSI Ethiopia to revise the curriculum and find a different pilot region.

NOVEMBER

POWER, TOGETHER Founding Member Cristina Ljungberg and The Case for Her received the POWER, TOGETHER Award for its work to end period poverty.

The Reykjavík Global Forum presents the POWER, TOGETHER award to outstanding initiatives, where people join forces to effect great change.

DECEMBER

LAUNCHED FIRSTEVER CAMPAIGN With support from member Lindsay Abrams, PSI Dominican Republic launched the first-ever campaign for mental health awareness in coordination with the Ministry of Health, helping shift government policy and start the conversation on mental health services integration.

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MEMBER RETREAT: MAY 31 – JUNE 2 The annual Maverick Collective retreat took place in Vancouver Island, British Columbia, where Members gathered to learn, reflect, and connect.

The retreat included training sessions on storytelling, an exercise to map individual Member skills and resources, discussions on power and how it relates to the role of influence in philanthropy, and activities to deepen relationships between Members.

The three-day schedule encouraged Members to connect on their experience in the Collective, as philanthropists at-large, and as powerful leaders.

It was very useful for me to be able to connect with other Members' and staff members' motivations for joining Maverick. [‌] I was able to see WHY everyone actually wants to do this work, beyond high level ethical reasons.

ANONYMOUS

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LOOKING FORWARD T0 2020 Here’s what we are excited about for the upcoming year: PSI turns 50! To celebrate 50 years in global health, PSI will be launching a social media campaign, a crowd-sourced history project, a new video, convenings with partners at conferences around the world, and Healthy Futures Fund.

The 2020–2021 MaverickNext cohort launches in February and will be co-investing in a burst of innovation, embedded into Maverick Collective Member Ann Morris’ project in Kilifi County, Kenya. The investment will help the PS Kenya team take the early success of Ann’s investment and expand access to community-based contraception to adolescent girls and young women.

After the Flush, a sanitation project in India supported by Natasha Jamal, will expand into four cities, providing fecal sludge management services to over 1 million people.

Jess Jacobs’ project in Cote d'Ivoire will be presented at the 2020 International Social and Behavior Change Communication Summit. The presentation will highlight how the project has used the theme of sexuality as a powerful entry point to redefine the traditional roles of parents and adolescents.

In May, Members will travel to Guatemala for a Learning Journey on PSI’s social enterprise and sexual and reproductive health programs in Latin America.

In November, Members will gather for the annual Member Retreat. This is the biggest Member gathering of the year and a meaningful time for reflecting on progress, deepening learning, and forging connections for the future.

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THANK YOU

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