Pathfinder programs champion the rights, health, and success of women and girls around the globe—for their own benefit, and for the good of their communities and the world. We collaborate with amazing women like Winnie Kimbe in India, Sharon Ayebale in Uganda, Hasna Akhter in Bangladesh, and Florence Ken in Kenya unlock their talent, skills, and energy to drive progress to:

• Make informed health decisions about their own bodies,
• Reach their full potential; and
• Develop solutions to advance sexual and reproductive health and rights strengthen health systems, lift people out of poverty and build resilience in the face of climate change.

Explore our digital 2023 Annual Report or view and download the PDF version.

TABLE OF CONTENTS

DEAR PARTNERS, SUPPORTERS, AND FRIENDS,

As three women living on different continents, we lead Pathfinder from diverse vantage points, and with a shared conviction: the way we can set our troubled world on a healthier and better path is by unlocking the incredible talent and inventiveness of women and girls. The more women and girls are engaged and empowered, the more the world finds peace and prosperity. There will be no progress in tackling the world’s most intractable crises—climate change, enduring conflicts, and gross inequities— without unlocking the immense potential of women and girls.

Every Pathfinder program contributes to advancing the rights, health, and prosperity of women and girls—for their own benefit, and for the good of their countries and the world. We work with women and girls so they can make informed decisions about their own bodies and reach their full potential in life. Women we engage develop locally led solutions to advance sexual and reproductive health and rights, lift people out of poverty, strengthen health systems, and build resilience in the face of climate change.

Today, millions of women struggle to meet the most fundamental needs of their families through childcare, water and fuel collection, and health care. Pathfinder makes it possible for women to care for themselves and their families, while freeing up their energy and resources to respond to the challenges their communities and countries face.

There is huge potential for communities, governments, and companies to tap into the wisdom, experience, and leadership of women to create system-wide solutions. Take climate change as an example. As farmers, health care providers, and disaster response and recovery workers, women play a critical role in mitigating the effects of climate change.

Like Felister Gideon in Tanzania—one of our role models. She uses excellent health and environmental practices at her household—energy-saving stoves, climate- smart agriculture, and sending girls to school—and encourages others to do the same.

Ainee Kohli in Pakistan has joined hundreds of women to strengthen their skills in climate adaptation, disaster risk reduction, and sexual and reproductive health and rights. Ainee and her husband, Dalpat, work on everything from recycling water projects to educating young girls.

With an education, strong female role models, and the basic resources to succeed, I developed confidence in myself and agency to make the most important decisions in my life—about my career, my relationships, my body, marriage, and childbearing. I now lead an organization that helps other women to do the same.

Lydia Saloucou Zoungrana, President, Africa

Florence Ken braved a local election normally dominated by men to become Chairperson of the Fish Traders Association in Kenya’s Kaksingri ward. In her current position, she ensures sustainable fishing practices are used while advancing opportunities for women in the fishing industry.

Through Pathfinder, I am able to channel my experience as a feminist and an activist and transform it to strengthen health and social systems that improve the lives of women and girls.

Tabinda Sarosh, President, South Asia, Middle East, and North Africa

At Pathfinder, we partner with women like Felister, Ainee, and Florence, unlocking their talent, skills, and energy to drive progress. The women you will read about in this report inspire us. We think they will do the same for you.

Your support makes all this possible: giving women and girls everywhere the chance to live their dreams and realize their potential. For their sake and all our sake.

Yours,
Lydia Saloucou Zungrana, President, Africa
Tabinda Sarosh, President, South Asia, Middle East, and North Africa
Lois Quam, Chief Executive Officer

MOMENTUM INTEGRATED HEALTH RESILIENCE
Tanzania | US Agency for International Development

NEEMA — Leading a savings club for women’s economic independence

MOMENTUM supports communities to develop savings and loans groups for women and men. These groups allow members to diversify their incomes through environmentally friendly businesses, such as beekeeping and soap making; provide information on sustainable natural resource management practices; and link members to information about sexual and reproductive health and maternal and child health services.

In Nafco Village, for example, the project is supporting a Community Conservation Microfinance Group, led by Maasai women, which has more than 30 members and a shared value of more than 4 million Tanzanian shillings (roughly $1,600). The project supports community health workers like Veronica Lazaro Peter with stipends and trainings.

“This group is composed of members who conduct agriculture and livestock activities,” says Neema Sirya, who leads the group in Nafco Village. “The group has members who are widowed and depend on agriculture and livestock [for their livelihoods].” Through the group’s work, the women have received financial support for health needs, education, and environmental adaptations. In the last year, not a single loan default was reported.

PROJECT SAUVER LA VIE
Burkina Faso | The Netherlands Ministry of Foreign Affairs

ALIMATA — Self-managing health through the women’s community health club

Alimata Zoungrana is a member of the women’s community health club of Singué (Central-North Region) in Burkina Faso. Pathfinder supports the Ministry of Health through Sauver La Vie to establish community health clubs, which bring together health technicians, health authorities, managers of social and municipal services, and leaders of local community groups. Community health clubs boost women’s self-management of their health, and, to date, Pathfinder has operationalized more than 150 health clubs in eight regions.

WOODABE PROJECT
Niger | Generous Individuals

GUITOL — Building resilience and economic opportunities in Niger

Guitol Limé and other women in her village were forced to migrate due to prolonged drought, which had depleted water supplies and natural resources. “There was a time when we weren’t interested in migrating. We had animals, and life was much easier,” she said. “But in recent years, things have changed, and the climate is no longer favorable. There’s not enough rainwater, so there’s not enough pasture for the animals. We don’t have enough water to drink, let alone give the animals, and the more time that went by, the more we lost our livestock. In addition, now there are more of us, we have many children, and there aren’t enough means to take care of everyone. So, we’re obliged to leave the children and the elderly at home and go to Nigeria to look for something to provide for everyone.”

But since the arrival of Pathfinder’s project, Guitol has been able to stay home. “We no longer leave our homes. We’ve received a lot of support. Today, we’ve become a real community, working together.”

The Woodabe project has offered information on health care, including contraception and maternal and newborn health. “Before, we didn’t know anything about health centers,” said Guitol. “Now, all pregnant women go to health centers from the beginning of pregnancy right through to delivery. In addition, we didn’t even know there were contraceptive methods, but now we know about it and use it.”

“Since we started working with the Woodabe project, we’ve achieved a lot. For the first time, we’ve formed a women’s group. Every two weeks, we each pay 500 CFA francs (US$ 0.83) into the fund, and the project has given us 100,000 CFA francs (US$ 166) to strengthen our fund. This fund enables each woman to take out a loan and carry out an income-generating activity. Some of the women among us borrowed money, and went on to fatten sheep, making a profit and returning the money they had borrowed. Personally, mine has given birth. We’ve also received goats for fattening.”

ADVANCING THE LEADERSHIP OF WOMEN AND GIRLS TOWARDS BETTER HEALTH AND CLIMATE CHANGE RESILIENCE
Bangladesh & Pakistan | Takeda Pharmaceuticals

HASNA — Delivering during a flood

The flooding was rapid, said Hasna Akhter, a Family Welfare Visitor at Badhaghat Dakhsin, Bangladesh. “At first, it was just a mild rain, and then one night I woke up and saw the water coming up the stairs. By 5:00 in the morning, the water had rushed in, and was up to our knees.” Water flooded all the roads leading to the Union Health and Family Welfare Center, the hospital where Hasna works and lives.

The hospital had a second floor, and people started showing up in boats. Together, they hauled rice and other goods to the upper level, and within the day, there were 15 families taking shelter. Along the way to get more supplies, a small boy on another boat cried out to Hasna. “He told me that his mother needed help and was in pain. I went to see the mother, who was on another boat.”

Soon after, a group of men brought the mother to the hospital. There was already a foot of water in the operating room, but the table was dry. Without electricity, and with the storm intensifying, Hasna managed to deliver a healthy baby boy.

“Everyone from her family was crying, asking me to do whatever I could—there was no other place for them to go.” After the birth, the family remained, as their home was under water. “I took the family upstairs and gave them a room, but after one day, they returned to their home.”

Building each community’s resilience to climate shocks takes the entire community. From using local schools as de-facto shelters, to preparing health workers to adapt and continue to serve through climate shocks, to engaging women in devising local solutions to climate change adaptation—Through the Advancing the Leadership of Women and Girls Towards Better Health and Climate Change Resilience project, Pathfinder is working across communities in flood-prone zones to comprehensively support resilience.

EMPOWERED CHOICES
Nigeria | Generous Individuals

TREASURE — Learning life skills and earning money

“We conducted a total of three skill acquisition sessions for the [Empowered Choices] project,” said Hauwa Usman, Program Coordinator with Pathfinder Nigeria. These skill- building sessions were held so young people could make small economic gains in their communities. “We did the sessions in partnership with local organizations. The [sessions] included making reusable sanitary pads, shoe making, and liquid soap making. We ensured that the participants were given starter packs to practice in their own time, as well as start making materials for commercial purposes.”

Said Treasure Otene, who attended the sessions, “The shoe making and the soap, and some skills that they taught us… I wasn’t thinking of doing all these things! I was thinking that when I finish school, I’ll find a job, and I’ll just become what I want to become… just like that. But when they came, they gave us the idea that, even when you’re in school, you have to do some work so that you can make money, so you can help your parents in what they are doing.”

Adds Hauwa, “We had a total of five modules in the curriculum… the very first module was focused on life skills, which included topics on goal setting, decision- making, self-esteem, negotiation, and refusal skills to enable them to plan their lives and reach their full potential.”

UGANDA FAMILY PLANNING ACTIVITY
Uganda | US Agency for International Development

SHARON — Talking to peers about pregnancy prevention

Sharon Ayebale is a 20-year-old youth champion and community health worker. She uses her experience as a teenage mom to educate and promote awareness among fellow youth in Kyenjojo district, western Uganda.

Sharon got pregnant at the age of 14, which forced her to drop out of school. “I never knew how to use contraceptives,” said Sharon. “I thought that family planning was only meant for married couples. I also feared that I would not give birth (later on) if I used family planning at that age.”

According to Sharon, she would not have gotten pregnant if she had access to comprehensive and accurate information about pregnancy prevention. Sharon’s decision not to use family planning was driven by different myths and misconceptions about how contraception would impact her body and the belief that she could not get pregnant at 14 Sharon’s childhood dream was to become a doctor, but she dropped out of school when she became pregnant. This frustrated her, and she never wished the same to happen to other girls in
her village.

Pathfinder’s USAID/Uganda Family Planning Activity recruited and trained Sharon to become a youth champion and work with young people. “I learned about various family planning methods, side effects, and how to manage them, as well as HIV prevention measures,” says Sharon. To date, Sharon has reached more than 700 young people, ages 15 to 24, in her community. She equips them with comprehensive information on pregnancy prevention and refers them to health facilities for more specialized reproductive health services.

Sharon uses an injectable contraceptive. With this method in place, concerns about unplanned pregnancy no longer trouble her. Presently, she has enrolled in a local institute to pursue a certificate in social work and social administration, while simultaneously delving into poultry farming to secure a steady income.

Through her poultry venture, she generates funds to provide for her child’s needs and fulfill her day-to-day expenses. “Today, many things have changed in my life. I am aware of family planning and its benefits. I would have fallen pregnant and couldn’t have been able to take care of another child if I didn’t [get this information].”

SCALING UP FAMILY PLANNING
Tanzania | United Kingdom Government

WINIFRIDA — Bringing contraceptive choice to her community

“Before, I was judgmental,” says nurse Winifrida Mbawile. “When I saw adolescents, I thought they had bad behavior… but now I provide good services, especially education on STIs [sexually transmitted infections], family planning, and HIV prevention and testing.”

Winifrida is a nurse based in Arusha, Tanzania, working with the Scaling up Family Planning program. She has practiced for 10 years, and 4 years ago, started focusing her work on youth- friendly services. Through the program, Winifrida attended a Pathfinder training on working with adolescents, and supporting their specific needs and circumstances. Now, she works across her region with adolescents, sharing reproductive health information and services.

“I also do outreach to local schools and colleges,” she says. “We make appointments with their teachers, then we make a special weekend where we can provide services.” What do the students ask her?

“Today, for example, they asked about female condoms… some of them ask about STIs, their symptoms, prevention, and complications.” After a training, she says around 75 percent of the attendees will come to her with questions, or for services. “We have a WhatsApp group,” she says. “These are continuous services. We continue to provide education. Some come in the inbox, some text me.”

And what’s her favorite thing about this work?

“I like to teach,” she laughs. “I like to provide education, to teach, and to show how to use!”

BUILDING HEALTHY FAMILIES ACTIVITY
Pakistan | US Agency for International Development

HAWA & MUJHTIARAN — Helping women explore their options

Like many women in her community of Khairpuir in Pakistan’s Sindh province, Hawa had children year after year, with no spacing in between. After having her fourth child within just seven years of marriage, she found herself exhausted.

Hawa found a solution when she crossed paths with Lady Health Worker Mujhtiaran during one of her rounds. The Lady Health Worker Program, one of the largest community health programs in the world, provides health services to the doorsteps of underserved communities in Pakistan. Mujhtiaran recognized the challenges Hawa faced and counseled her on the availability and use of contraceptives and pregnancy spacing.

The road to change, however, was not without obstacles. Pakistan had been hit hard by the 2022 floods, which left homes destroyed and many people below the poverty line. Mujhtiaran herself was among those affected, with her home clinic reduced to rubble.

In June 2023, the Building Healthy Families Activity provided essential kits and support to 25,000 Lady Health Workers, including Mujhtiaran, enabling them to continue their crucial work and serve clients such as Hawa in Sindh. The kits contained delivery sets, infection prevention supplies, and basic furniture.

With Mujhtiaran’s unwavering support and guidance, Hawa switched from short-term pills to a long-term contraceptive impant inserted at Kausar Hospital to ensure no unwanted pregnancies occur.

YOUTH VOICES FOR AGENCY AND ACCESS (YUVAA)
India | Bill & Melinda Gates Foundation

WINNIE — Mentoring nurses

“Initially, my job was to map [health] facilities for YUVAA,” said Winnie. “We started mapping each block. We mapped a block a day, four or five facilities a day. I then filled out a checklist, noted if contraceptives were available. Then, we selected facilities to work with, approached doctors, and brought a letter of intent about the project.”

“I trained nursing staff, trained them in counseling. Initially, the mentees didn’t have a lot of experience with counseling or interacting with clients. But I started working with them, and then as they started to see more referrals, they realized how important family planning counseling was.”

Winnie helped establish family planning corners in the facilities, giving family planning clients increased privacy.

Over time, Winnie saw real changes. “At first, doctors were really biased against a variety of contraceptives. Few doctors, for example, would use injections. They wouldn’t suggest these options. But over time, we saw changes, with repeated visits, and we worked to shift the biases.”

“There was one client who came in for an abortion. A mentee of mine went and talked to her. Her mother-in-law was there and didn’t like talking about contraception. She listened to the family. She engaged with the mother-in-law, and ultimately, she discussed the fact that if the wife got pregnant right away again, the child might not be healthy. That you need to plan, you need to think about the health of your children. The husband and wife, they wanted to take contraception moving forward.”

“I am in love with this job,” said Winnie. “It gives me real satisfaction.”

UZAZI SALAMA
Kenya | MPESA Foundation

RACHAEL — Transforming community health

Rachael Obago, a community health volunteer, works in Ndhiwa, Kenya, where many people have trouble accessing health care due to distance and cost. Rachael bridges the gap between communities and essential health care by providing health services at their doorsteps. Rachael visits nearly 100 households each month, focusing on reaching mothers with prenatal and postnatal care, information on childhood nutrition, and guiding expectant mothers through pregnancies.

In addition to providing essential care, Rachael is a formidable health advocate. She has convinced numerous women, for example, to deliver their babies safely at health facilities, often accompanying them when they go into labor, despite local customs and beliefs that favor home deliveries. Her advocacy for childhood immunizations has reduced the number of unvaccinated children. Through community dialogues and health outreaches, she has raised awareness about the availability of health services and dispelled myths and misconceptions hindering people from seeking care.

M-MAMA
Tanzania | Vodafone

CONSOLATA — Taking a taxi ride that saved my life

When Consolata went into labor at 28 years old, something felt wrong. She was exhausted and afraid. “I was in bad shape,” she said. In her rural district of Tanzania, there were only 10 ambulances for more than 1.5 million people—and she needed help.

That’s when Pathfinder’s Mobilizing Maternal Health Project, or m-mama for short, stepped in. A local driver was called to take Consolata to the nearest clinic. There, she gave birth to a healthy baby boy, Kurwa—and learned that she wasn’t finished! “The doctors examined me, and there was another baby.”

Consolata’s doctors decided they needed to send her to the nearest hospital, but once again, no ambulances were available. “I was so afraid… I had given birth to Kurwa, but his brother hadn’t been delivered.” An m-mama community taxi driver showed up to take Consolata to Shinyanga Regional Referral Hospital… but she couldn’t wait. Kurwa’s brother was born in the taxi, and by the time she reached the hospital, she was bleeding heavily. There, she received the critical care she needed, and today, is the mother of two healthy twins.

“I don’t know what I would have done without this transportation. Maybe I would have traveled on a bicycle,” she said, laughing. “If this service wasn’t available, I might be dead.”

THE ADVOCACY WIN:
Since m-mama’s inception, Pathfinder has worked to ensure the financial sustainability of the program through a staged approach, where the government contribution increased over a period of three years, starting at 20% in 2017 and reaching 100% by the end of 2020. Today, the Tanzanian government considers m-mama one of its key strategies for coordination of emergency referrals and reduction of maternal and newborn deaths. The government has already identified areas where the model will be expanded.

THE DARWIN INITIATIVE
Kenya | United Kingdom Government via The Darwin Initiative

FLORENCE — Making conservation decisions

Florence Ken now serves as Chairperson of Fish Traders in Kaksingri Ward. With support from the Darwin Initiative and the women in her community, Florence braved the beach management unit election, vying for a role traditionally held by men—and won. In her current position, Florence governs the local fish traders in her community near Lake Victoria, governing conservation decisions made by the beach management units and how resources from fishing are used.

THE ADVOCACY WIN:
More than 150 women joined beach management units across Homabay County, Kenya, after Pathfinder conducted advocacy visits with beach management unit leaders and lobbied for more women being in leadership positions.

DEAR PATHFINDER COMMUNITY,

I recently traveled to Tanzania to attend Pathfinder’s most recent board of directors meeting. It was exciting to travel back to a country I lived in as a teenager and Pathfinder has worked in for decades.

At the board meeting, we welcomed two new board members, Livhuwani Shirley Machaba, from South Africa, and Fiona Dias, originally from Kenya. We also welcomed back Biniam Gebre, who grew up in Eritrea. I am particularly proud of how professionally and geographically diverse our board has become, with many members who have lived experience in the countries where Pathfinder operates. Having these diverse perspectives and in-depth knowledge of the contexts in which Pathfinder works is particularly important as delivering on our mission becomes more complex.

Many of the communities Pathfinder serves continue to face enduring challenges—the impacts of climate change, political instability, regional and national conflicts, and economic crises. Yet I continue to be filled with hope.

Africa, where Pathfinder works in 16 countries, has the largest youth population on the planet. The median age across African countries is 19, and by 2050, 25 percent of the world’s population will be African. All our futures, to some extent, depend on how well we engage and empower Africa’s young people with education, quality health care, jobs, and leadership opportunities. They need to be involved in driving solutions to the continent’s most pressing challenges— and Pathfinder is working to make that happen.

The women and girls Pathfinder reaches through its programs also make me optimistic. Thousands, with Pathfinder support, have been able to stay in school, contribute to the resilience of their communities, and

drive policy changes that allow more women and girls to live the lives they choose. They are the health workers, mothers, doctors, community leaders, farmers, teachers, and politicians their families, friends, and nations rely on.

While I was in Tanzania, I was extremely moved when hearing about m-mama, a Pathfinder program supported by the Vodafone Foundation. M-mama includes an emergency transportation and communication system for mothers and newborns in distress. A mother can call a dispatcher who connects her to “taxi ambulance.” Her ride is tracked on an app to ensure she arrives safely. At the same time, the program strengthens health systems to offer safe, respectful, quality services for mothers and their newborns.

M-mama has reduced maternal deaths by as much as 38 percent. Impressed by the number of lives saved, the Tanzanian government has invested fully in the program, making it a sustainable solution to saving lives. Pathfinder will now help roll out the program in Kenya.

Pathfinder’s programs like m-mama, led by local teams with in-depth knowledge of the contexts, cultures, and histories of the places we operate, have infinite potential to save lives and build a brighter future.

Thank you for supporting Pathfinder and walking this path with us.

Yours,
Collin Mothupi, Board Chair