2023 Annual Report

ELEVATING
OUR VOICES

Afro-Mexican youth from the Costa Chica region of Oaxaca, Mexico, participate in a “Right to Decide” event in the community of Mancuernas, Pinotepa Nacional. The girls showcase the outcomes of an engraving and printing workshop on fabric handkerchiefs, encouraging reflection on the Right to Decide and reproductive autonomy while fostering an artistic and creative process. This approach is a distinctive aspect of the community support provided by Mano Vuelta A.C.

Dear Friends,

Reflecting on 2023, we are filled with hope and resolve. This year, we have witnessed remarkable progress in partnership with courageous sexual and reproductive health and rights (SRHR) advocates across the United States and around the world. However, this progress has come with challenges.

Despite the renewed attacks on our rights, our resolve to protect and expand these rights has only grown stronger. In these challenging times, our collective voices have been crucial in expanding and amplifying our impact, ensuring that no one is denied the sexual and reproductive health (SRH) care they desire and deserve. Our work alongside local partners in over 30 countries has never been more vital.

Our efforts to navigate the shifting landscape of U.S. policies have been instrumental in safeguarding global access to reproductive health care. We have protected reproductive health care for millions of women and youth by advocating for stronger health systems and holding policymakers accountable. This impact is a testament to the power of our collective action.

This year, we have focused on supporting youth-focused and youth-led organizations. We have enhanced their advocacy skills and enabled their meaningful participation in shaping domestic policies and informing funding priorities to advance SRH priorities across Asia, Africa, Latin America and the Caribbean.

Accountability has also been at the heart of our work. In 2023, PAI and our partners made significant progress in holding governments accountable to deliver on their reproductive health commitments. When community-led accountability programs were implemented, domestic funding for SRH services across East and West Africa increased, as did the quality of care delivered. Our government accountability achievements reinforce that what gets demanded gets delivered, and communities’ health, well-being and vitality are strengthened.

As PAI looks ahead, we remain confident that with your support and the elevation of our voice, progress and impact, we can overcome the challenges before us and achieve the shared vision of a world where sexual and reproductive health and rights are a reality for all.

We are deeply grateful for your unwavering commitment and your significant role in enabling our impact.

In solidarity,

NABEEHA KAZI HUTCHINS

President and CEO

NEERAJA BHAVARAJU

Chair of the Board of Directors

Mixtec youth from the community of Tierra Caliente, in the municipality of Santiago Tlazoyaltepec, Oaxaca, Mexico, participate in a “Right to Decide” event. The purpose is to enhance knowledge of comprehensive sexual education (CSE), focusing on contraceptive methods and SRHR. In this image, the adolescents engage in an activity called “The Parachute,” designed to ask questions about SRH and contraceptive methods playfully and interactively. The first person touching the facilitator’s hand with the correct answer wins and receives recognition from the group. Mano Vuelta’s use of popular education and engaging, playful methodologies have been well received, as participants value the meaningful learning experiences.

In 2023, PAI provided close to $4.9M in flexible, trust-based funding, institutional development support and strategic and technical assistance to 70 local organizations in 35 countries. This past year, PAI strengthened its commitment to an equitable, inclusive and locally led movement to ensure universal SRHR.

Countries

Youth-Led or Youth-Focused Organizations

0 %

Independent,
Locally-Founded

0 %

Partners

DIRECTLY SUPPORTED WITH FLEXIBLE FUNDING, ADVOCACY TRAINING AND RESOURCES

Organizations In

0 +

Countries

PAI’S EXTENDED ECOSYSTEM REACH

Funded Partners

Extended Ecosystem

Funded Partners

Extended Ecosystem

Advocacy in Action

PAI was joined by its partners Abebe Kebede, Executive Director of the Consortium of Reproductive Health Associations (CORHA) in Ethiopia, and Amos Mwale, Executive Director of the Centre for Reproductive Health and Education (CRHE) in Zambia, for Spring Congressional briefings on the impact of U.S. funding and policy decisions on global family planning and reproductive health.

Elevating U.S. Government Commitments

Global access to contraceptives, trusted SRH information and safe abortion services constantly hang in the balance based on the decisions, funding and policy commitments of the United States government. In addition to PAI’s ongoing policy and budget analysis and advocacy, 2023 was also marked by efforts to mitigate global harm caused by U.S. domestic SRHR regressions.

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Amos Mwale visits Representative Sara Jacobs’ (D-CA) office to share how U.S. foreign policy extends beyond its borders to impact Zambian communities.

The U.S. is the most substantial global health funder in the world, including reproductive health. Preserving and expanding the essential reproductive health services that U.S. funding enables is a human rights imperative. Bringing our voice and the perspectives of our global partners forward as we engage with U.S. lawmakers and international development leaders has enabled the protection of U.S. foreign assistance for quality reproductive health services, ongoing support for the United Nations Population Fund (UNFPA) and financing for health systems and contraceptive commodities that change lives.

Throughout the year, PAI organized and co-facilitated briefings with more than a dozen congressional offices and closely engaged with Representatives Chrissy Houlahan (D-PA), Barbara Lee (D-CA), Grace Meng (D-NY), Jan Schakowsky (D-IL), Senator Jeanne Shaheen (D-NH) and other leaders to advance pro-SRHR legislation. In addition, PAI conducted meetings and briefings with the leadership of the National Security Council, Health and Human Services, the U.S. State Department and the U.S. Agency for International Development (USAID). Our role as founders and co-chairs of the International Family Planning Coalition also continues to position us as a go-to resource for members of Congress who champion choice, rights and the well-being of communities worldwide.

PAI and partners from Ethiopia and Zambia speak with D.C. lawmakers about the international effect of U.S. SRHR policies

While it’s common for congressional representatives to travel abroad to learn about foreign assistance, PAI flipped the script.

In March 2023, leaders representing SRHR advocacy coalitions in Ethiopia and Zambia joined PAI for meetings with Congressional staffers to share the importance of supportive policies and funding for global SRH. As champions in Congress take their asks to the House and Senate floors, being armed with first-hand insights from communities deeply affected by U.S. actions reinforces why U.S. commitment to global SRHR is vital.

Congresswoman Jan Schakowsky (D-IL) joins PAI and fellow SRHR advocates to assess progress and recommit to advancing SRHR for all.

In anticipation of the troubling anniversary of the day the U.S. Supreme Court reversed Roe v. Wade, PAI hosted a critical dialogue with Representative Jan Schakowsky, one of the longeststanding congressional champions of reproductive health and rights, about the state of reproductive health in the U.S. and its impact abroad.

Serving in Congress since 1999, Rep. Schakowsky is a staunch advocate for reproductive rights and has long championed bills that seek to strengthen and expand access to contraception, protect providers of women’s health care and safeguard people’s right to make their own reproductive decisions. This includes leading the Abortion is Health Care Everywhere Act, which seeks to repeal the Helms amendment so that U.S. foreign assistance can be used to fund safe and legal abortion services in other countries.

While the immense damage caused by the reversal of Roe quickly became apparent domestically, less attention has been paid to the negative global ramifications — enabling increasingly anti-SRHR policies, bolstering anti-choice movements and ultimately, harming communities throughout the world. Rep. Schakowsky summed it up nicely: “We are such a small world, and what happens anywhere happens everywhere.” The Congresswoman also shared stories of her activism and her vision of a future where all can access the SRH care they need and deserve.

“During my visit to Capitol Hill in Washington, D.C., I spoke with lawmakers about the critical landscape of SRHR in Ethiopia, highlighting the challenges faced and the urgent need to strengthen strategic partnerships and interventions to support and uplift the segment of communities that need it most. A lot has been done, but much remains.”

"I think so many people are becoming more and more enlightened, with the help of organizations like PAI and brave advocates speaking out and organizing. I think this is a moment of opportunity that we have to take.”

PAI’s President and CEO, Nabeeha Kazi Hutchins, met with staffers from Representative Chrissy Houlahan’s (D‑PA) office to discuss legislation to support funding for UNFPA, the U.N. agency dedicated to SRHR.

Rep. Schakowsky spoke to a room of PAI supporters about the interconnectedness of our world and the strong influence U.S. policies have on global communities.

In addition to hundreds of engagements with congressional staff, PAI’s advocacy in Washington, D.C., included:

letters signed to U.S. policymakers

policy briefs and analyses published

In Addis Ababa, Ethiopia, a youth leader from PAI partner Future Hopes Integrated Development Organization (FHIDO) shares reproductive health and rights information to combat stigma, reduce gender-based violence and promote youth access to SRH services.

A girl participating in PAI partner Mano Vuelta’s Summer Artistic Camp for Menstrual Health, holding a menstrual cup and a cloth pad she made herself. The camp is designed for Indigenous girls from the community of Villa de Zaachila, Oaxaca, Mexico.

Elevating Youth Power

Campaign promotes non-judgmental SRHR information for Indigenous and Afro-Mexican youth in Oaxaca

Of the 31 Mexican states, Oaxaca is in the top five of those with the highest rates of adolescent and unintended pregnancy. In response, PAI partner Mano Vuelta works in Oaxaca’s eight regions to research and promote contraceptive access, choice and youth SRH and rights among Indigenous and Afro-Mexican youth and women.

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This includes collaboration with ‘Red de Jóvenes Indígenas y Afromexicanas por el Derecho a Decidir’ (Network of Indigenous and Afro-Mexican Youth for the Right to Decide) to promote and monitor young people’s access to contraceptives. Together, they launched the campaign, ‘Te acompaño a decider’ (I accompany you to decide). The campaign created visual materials in a range of Indigenous languages that enable adolescents to make responsible and autonomous decisions on SRH, aided by accurate and judgment-free information. In 2023, campaign events were organized for students at schools in Oaxaca’s Costa and Mixteca regions to advance knowledge and inspire young people to embrace and demand their rights.

Simultaneously, Mano Vuelta began collecting and analyzing local and national data to effectively advocate for contraceptive methods. Mano Vuelta will continue building youth capacity so they can lead dialogues with health workers about the barriers to contraceptive information and access in Oaxaca and the need to develop non-discriminatory contraceptive services for young people.

“Through artistic workshops and participatory methodologies, we share information on topics that are not easily accessible in our communities, such as access to menstrual health and resources that help us experience menstruation with dignity. Knowing that we can access methods to take care of ourselves and fully enjoy our sexuality is empowering.”

Andrea Hernández

Youth Coordinator, Mano Vuelta

Securing meaningful youth engagement with global initiatives to advance SRH.

The World Bank’s Global Financial Facility (GFF) partnered with PAI to strengthen the engagement of youth-led organizations to inform sexual, reproductive, maternal, newborn, child and adolescent health and nutrition across 36 countries in Asia, Africa, Latin America and the Caribbean.

PAI’s stewardship of youth advocates and networks as the GFF’s NGO Host has elevated and improved the influence of youth in civic space and enhanced their organizations’ technical and strategic capacities. Through a network approach, more than 25 youth-led and youth-focused organizations have shared experiences and knowledge, tackled stigma and misinformation, built relationships with policymakers and decision-makers and influenced SRH policies and programs to better meet the needs of youth.

The collective contributions have enabled the inclusion of menstrual health and modern contraceptive commodities in public health services, accountability of local health systems to provide comprehensive SRH information and support to youth as well as budget and policy changes to sustain youth-friendly and youth-focused health care.

Our GFF partners are making an impact. Paz Joven is tackling stigma and combating skyrocketing adolescent pregnancy rates in Guatemala. Young and Alive Initiative is implementing accountability programs to better shape subnational health policies in Tanzania. GEM Initiative is working in hot spots with high rates of adolescent pregnancy and maternal mortality to advance urgent policy conversations and changes to support the SRH needs of Nigerians. This work requires supporting and centering youth advocates for accelerated change through data and experience and on their own terms.

"People think about youth at the national stage as the most important or influential. If you go down to the community level, you not only get better results, but also the issues they raise are unique to the local context. There are a lot of strategy documents at the national level that do not trickle down. You need to be there physically, engaging with youth to create strong leadership.”

Andrea Hernández

Youth Coordinator, Mano Vuelta

Health services that serve youth are best improved when young people themselves are consulted about their experiences and enabled to lead discussions to improve their peers' SRH.

In addition to attending the 2023 World Bank Spring Meeting in Washington, D.C., PAI invited international youth leader Christina Chilimba to share her inspiring journey as a young advocate in Malawi with a wide array of SRHR stakeholders. The conversation underscored that an integral component in youth SRHR is knowing not only their SRH needs but also what contraceptives and programs they want and will use.

Health services that serve youth are best improved when young people themselves are consulted about their experiences and enabled to lead discussions to improve their peers' SRH.

A participant in the Center for Supporting Community Development Initiatives (CSCDI) Vietnam’s communication session on maternal health care before, during and after birth. These sessions, which reached 794 people, brought together outreach workers and at-risk groups to learn about how and when to seek services and document the challenges they face in accessing services.

In Balochistan, Pakistan, participants in Youth Association for Development’s Policy Consultation and Advocacy Forum share SRHR challenges, gaps, needs and recommendations to inform the creation of policy and advocacy materials encouraging the provincial government to improve policies and services. Across four sessions, more than 120 stakeholders, including community members, advocates and local government officials, shared their experiences and perspectives.

Members of youth-led organizations share their innovation to address SRH challenges as part of Indonesia’s Health in All Policies initiative to integrate health issues in all sectors. The Center for Indonesia’s Strategic Development Initiatives (CISDI) worked with 34 civil society organization and youth-led organizations and government institutions to develop unique proposals for social innovation and selected the top five to present to experts and donors during CISDI’s Primary Health Care Forum.

Elevating Accountability for Access

It is estimated that globally, 257 million women who want to avoid pregnancy are not using safe, modern contraception.¹ To close the access gap, the availability of preferred contraceptive methods, reliable, resilient and trusted health services, an enabling policy and funding environment and communities that are aware of their rights, are all critical. PAI partners have worked with national governments to inform and shape national family planning commitments—in national strategies and regional and international initiatives, such as the Ouagadougou Partnership and Family Planning 2030 (FP2030). However, shaping policy and securing government commitments are only one part of the journey. What matters is whether commitments are acted upon and communities can access the family planning needs they desire.

1 UNFPA. State of World Population 2022 Report: United Nations Population Fund, New York, NY, USA, 2022. https://reliefweb.int/node/3832519.

CRHE in Zambia conducted a SMART Advocacy training for SRH champions, during which they gained knowledge and skills to effectively communicate the importance of SRH and advocate for evidence-based policies and practices.

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As part of our Government Accountability for Family Planning Budgets project, PAI supported civil society organizations in Bénin (Groupe de Recherche, d’Action et de Formation en Epidémiologie et en Développement and Social Watch Bénin), Burkina Faso (Centre pour la Gouvernance Démocratique and SOS Jeunesse et Défis), Côte d’Ivoire (Mission des jeunes pour l’Education, la Santé, la Solidarité et l’Inclusion and Initiative pour la Justice Sociale, la Transparence et la Bonne Gouvernance en Côte d’Ivoire), Malawi (Malawi Network of AIDS Service Organisations), Tanzania ( Tanzania Communication and Development Center), Uganda (Samasha) and Zambia (CRHE) to ensure governments have met their commitments to fund family planning supplies and services by spending their domestic family planning allocations and improving the transparency of family planning budget data. Partners across these seven countries implemented the Common Framework for Tracking Government Spending on Family Planning, an accountability approach developed by civil society advocates and PAI. This approach and its tools measure, on an annual basis, the performance of governments investing in family planning resources. Comprised of a standard set of indicators that can be used across country contexts, the Common Framework follows the planning and budgeting cycle and tracks government resource flow from allocation and disbursement to actual spending, using six budget indicators and five transparency indicators.

Civil society organizations have stepped up to lead accountability efforts around their governments’ financial commitments to family planning. Strengthened through budget tracking and advocacy, civil society’s efforts can, over time, build sustained domestic resource mobilization and government ownership of family planning. They have also demonstrated that what gets demanded, gets delivered.

Together, PAI and its partners produced family planning budget scorecards to advocate for the allocation, disbursement and, most importantly, spending of government funds for family planning programs and contraceptives. Each scorecard provides a snapshot of the government’s performance over one fiscal year in meeting its financial commitments to family planning and assesses the transparency of the budget data required to track those commitments.

Change Enabled in Bénin, Côte d’Ivoire, Malawi and Zambia

Our partners’ advocacy efforts resulted in wins across the project’s focus countries:

In Bénin, Groupe de Recherche, d’Action et de Formation en Epidémiologie et en Développement and Social Watch Bénin played a leading role in advocacy that led to the national assembly increasing the contraceptive commodities budget by 500% from FCFA 50 million to FCFA 300 million between fiscal years 2021 and 2022.
In Côte d’Ivoire, advocacy led by SOCIAL JUSTICE resulted in two government commitments being included in the Open Government Partnership National Action Plan 2020-2022: create a specific budget line for the purchase of contraceptive products and regularly publish family planning budget data on the Ministry of Health’s website. Due to continuous follow-up by SOCIAL JUSTICE, the Ministry of Health included a budget line for contraceptive commodities in its FY 2022 budget.
In Malawi, MANASO’s joint advocacy with a civil society coalition resulted in the government increasing its family planning commodities allocation by 126% from MWK 82.7 million in FY 2018/19 to MWK 187 million in FY 2019/20. The government also spent 100% of the family planning commodities allocation in FY 2019/20 and supported many health system wide costs contributing to improved family planning service delivery.
In Zambia, CRHE’s monitoring and advocacy led to an increase in the number of health grant disbursements (including family planning funds) from the Ministry of Finance to all 116 districts—from three monthly grants in FY 2017 to full disbursement in FY 2021. In addition, in FY 2021, the government allocated ZWK 15.7 million for family planning commodities, over 100% of the ZWK 13.8 million total funding need.

Thank you for standing with PAI on our nearly 60-year journey to secure universal sexual and reproductive health and rights for all.

Join our Movement

When you donate to PAI, you are supporting an extended ecosystem of partners across more than 65 countries. Together, we power a bold, diverse movement that is expanding the right to bodily autonomy and access to essential sexual and reproductive healthcare for all. Every contribution, no matter how big or small, helps us move closer to this goal. Thank you.

Young actors in a community theater group (Eagle Vision) in a populous neighborhood of Kinshasa in the Democratic Republic of the Congo.

Financials

This annual report gives us the opportunity to share how we use the resources provided by our donors to make our work possible. Accountability and transparency are important at PAI.

We value the trust and commitment of our donors, and we strive every day to maximize the impact of your support.

To see the PAI 2023 Audited Financial Statements, please visit pai.org/about/financials.

Leadership

Board of Directors

Neeraja Bhavaraju

Board Chair

Tammy Palmer

Vice Chair

Luis Guardia

Treasurer

Nancy Deck

Secretary

Nabeeha Kazi Hutchins

President and CEO

Angela Bruce-Raeburn

Barbara Camens, J.D.

Barbara Sapin, J.D.

Karla Berdichevsky Feldman, M.D.

Kimberly C. Brooks

through June 2023

Patricia Fairfield, Ph.D.

Suellen Lambert Lazarus

Sujata Lamba

Emeritus Members

Pouru Bhiwandi, M.D.

Sharon L. Camp, Ph.D.

The Honorable William H. Draper III

Thomas E. Lovejoy, Ph.D.

deceased

Phyllis Tilson Piotrow, Ph.D.

Nafis Sadik, M.D.

deceased

Vicki Sant

deceased

Executive Leadership

Nabeeha Kazi Hutchins

President and CEO

Mustafa Kudrati

Senior Vice President of Program Strategy & Growth

Kadeem Brown

Vice President of Finance

Christine Meehan

Senior Director, Individual Giving

Katie Unthank

Director, Strategic Communications

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2023 Annual Report

ELEVATINGOUR VOICES

NABEEHA KAZI HUTCHINS

NEERAJA BHAVARAJU

Advocacy in Action

Elevating U.S. Government Commitments

PAI and partners from Ethiopia and Zambia speak with D.C. lawmakers about the international effect of U.S. SRHR policies

Congresswoman Jan Schakowsky (D-IL) joins PAI and fellow SRHR advocates to assess progress and recommit to advancing SRHR for all.

In addition to hundreds of engagements with congressional staff, PAI’s advocacy in Washington, D.C., included:

Elevating Youth Power

Campaign promotes non-judgmental SRHR information for Indigenous and Afro-Mexican youth in Oaxaca

Securing meaningful youth engagement with global initiatives to advance SRH.

Health services that serve youth are best improved when young people themselves are consulted about their experiences and enabled to lead discussions to improve their peers' SRH.

Health services that serve youth are best improved when young people themselves are consulted about their experiences and enabled to lead discussions to improve their peers' SRH.

Elevating Accountability for Access

Change Enabled in Bénin, Côte d’Ivoire, Malawi and Zambia

Thank you for standing with PAI on our nearly 60-year journey to secure universal sexual and reproductive health and rights for all.

Join our Movement

Financials

Leadership

Board of Directors

Neeraja Bhavaraju

Tammy Palmer​

Luis Guardia

Nancy Deck

Nabeeha Kazi Hutchins

Angela Bruce-Raeburn

Barbara Camens, J.D.

Barbara Sapin, J.D.

Karla Berdichevsky Feldman, M.D.

Kimberly C. Brooks

Patricia Fairfield, Ph.D.

Suellen Lambert Lazarus

Sujata Lamba

Emeritus Members

Pouru Bhiwandi, M.D.

Sharon L. Camp, Ph.D.

The Honorable William H. Draper III

Thomas E. Lovejoy, Ph.D.

Phyllis Tilson Piotrow, Ph.D.

Nafis Sadik, M.D.

Vicki Sant

Executive Leadership

Nabeeha Kazi Hutchins

Mustafa Kudrati

Kadeem Brown

Christine Meehan

Katie Unthank

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powering activism

Speaking truth to Power Power In Washington D.C.

In addition to hundreds of engagements with congressional staff, PAI’s advocacy in Washington, D.C., included:

ELEVATING
OUR VOICES

Tammy Palmer