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228 CHAPTER 10 ■ “Safe Water Saves Lives”
SWO T ANALY S I S
Since 1998, PSI has worked in partnership with the government of Madagascar
to develop social marketing components in their national health programs.
Registered as a local NGO, it implements a comprehensive social marketing pro-
gram to address major public health issues such as family planning, HIV/AIDS,
malaria, and diarrheal disease as identified by the government of Madagascar.
Diverse financial support from government, multilateral, and private founda-
tion donors has resulted in a nationwide program that reaches all 22 regions
throughout the country, with more than 200 employees trained in public health,
marketing, research, and communications. PSI Madagascar designs and man-
ages large-scale behavior change programs that include the provision of a wide
range of high-quality reproductive and maternal and child health products and
services at affordable prices through commercial and community-based distri-
bution channels.
PA ST A ND S IMIL A R EF F O R T S
In early 2000, PSI launched its first two large-scale safe water programs in
Madagascar and Zambia in the midst of public health emergencies—cholera
epidemics in both countries followed by cyclone emergencies in Madagascar.
Due to ongoing demand for safe water programs in both countries after the
emergencies were addressed, SWS initiatives were scaled up into successful na-
tional programs—still vibrant and growing today—promoting safe drinking
water for everyday use.
PSI saw the early success of the two SWS programs in Madagascar and
Zambia as an exciting new opportunity to apply social marketing techniques to
a global public health challenge: morbidity and mortality related to diarrheal
disease. At that time, it had offices in more than 50 countries and, in partnership
with the CDC, embarked on a global initiative to launch the SWS in countries
where social marketing techniques could potentially create large-scale behavior
change related to improved home water treatment. PSI’s expertise and experi-
ence had previously resided in the intervention areas of HIV/AIDS, family plan-
ning, and malaria. In the absence of donor funding and presented with the
opportunity to create significant new health impact with a global SWS pro-
gram, PSI decided to invest substantial levels of its funds to launch and scale up
household water treatment programs. It hoped that in doing so, successful pro-
grams would subsequently attract long-term donor funding. By 2008, PSI was
leading SWS programs in 25 developing countries using its unique style of social

