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Linking Health Impact to the Business Decision-Making Process

This presentation at the Global Health and Innovation Conference discusses Population Services International's (PSI) use of DALYs (Disability-Adjusted Life Years) to inform business decisions and shift organizational focus from product sales to Burden of Disease (BOD). It highlights the impact and challenges of using DALYs, lessons learned, and the need for targeted strategies and diversification in interventions and program funding.

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Linking Health Impact to the Business Decision-Making Process

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  1. Linking Health Impact to the Business Decision-Making Process Kim Longfield Population Services International klongfield@psi.org Global Health and Innovation Conference Yale University April 13, 2014

  2. Background • 66 developing countries • More than 60 products and services

  3. PSI’s Mission PSI makes it easier for people in the developing world to lead healthier lives and plan the families they desire by marketing affordable products and services

  4. PSI Uses the DALY to Inform Business Decisions So, what is a DALY? A year of healthy life lost to death or illness Disability-Adjusted Life Year

  5. Methods Our modeling program (in a nutshell) Models developed to estimate impact of products and services Outputs from models are coefficients Coefficients multiplied by country-level sales, distribution, and service utilization figures DALYs averted routinely reported by program area, geographic region, and country Coefficients updated every year with most recent data

  6. Past Performance: Impact by Health Area 79.7million DALYs averted, 2007-2011 Actions Taken: Doubled health impact by 2011, averted 22.8 million DALYs Malaria 58% Recognized gains in health impact through free distribution HIV/AIDS 24% Expanded “relevance” to target new health conditions: acute respiratory infections (pneumonia), TB, nutrition Family Planning 15% Scaled up successful interventions

  7. PSI Strategic Plan 2012 - 2016 :: RELEVANCE :: SCALE :: VALUE

  8. Current Performance: Impact by Health Area 72.7 million DALYs averted, 2012-2013 PSI is 3% shy of Strategic Plan goal for DALYs averted Malaria 46% HIV/AIDS 27% Family Planning 23%

  9. What business decisions are we facing now? Identifying funding sources that allow us to focus on BOD Identifying appropriate responses to evolving markets Considering whether our “relevance” target is right Re-considering whether our cost/DALY metric is correct Identifying how new and impactful interventions fit within our portfolio Determining when it’s appropriate to attribute impact to our work, especially when strengthening markets and health systems Determining how to best integrate high BOD interventions into existing programs

  10. Lessons learned from using the DALY for business decision making Change management required for adopting a bottom-line metric and updating it Building and maintaining tailored measures can be resource intensive Data to inform decisions are sometimes limited Accounting for combined effects, competing risks, or trade-offs can be difficult Capturing everything we do is impossible; there’s a temptation to attribute everything

  11. Conclusions PSI’s adoption of DALYs Averted shifted the organizational focus from product sales to BOD and helped the organization double its health impact More targeted strategy – business decisions based on scale & relevance Greater diversification in interventions and country programs, but securing funding can be difficult More responsive to potential funding sources and alternative distribution strategies

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