Our year in one page

Health is the first step out of poverty

Simavi realises structural improvement to the health conditions of people in marginalised communities in Africa and Asia. By tackling WASH and SRHR issues we can stop preventable diseases and boost social and economic development.

WASH logo

Water, Sanitation and Hygiene

SRHR logo

Sexual & Reproductive Health and Rights

In 2014 we further implemented our Theory of Change.

All our programmes are based on its three integrated pillars, which we work on simultaneously in order to realise long-lasting change.

These are the three pillars.

Empowered communities

We empower communities to ensure they will demand quality services and engage in healthy behaviour.

Enabling environment

We create an environment where everybody from the local communities to the private sector to local, regional and national government level is actively involved in a community’s health situation.

Sustainable services

We ensure that good quality Water, Sanitation and Hygiene (WASH) as well as Sexual and Reproductive Health and Rights (SRHR) services are available, affordable, sustainable and accessed by the people who need them.

By working simultaneously on the three pillars, we are able to change health and WASH systems and realise sustainable improvement to the health conditions of people in marginalised communities in Africa and Asia.

Empowered communities

People understand what is important for the health situation in their villages. People take care of their health, for example by washing hands or using antenatal care services.



target: 2,893,799

people were directly reached with WASH and/or SRHR education.

More results

Enabling environment

We ensure that every party involved works together towards realising sustainable, long-lasting improvement of basic health.


target: 74

recommendations or advocacy issues were adopted by authorities.

More results

Sustainable services

We realise significant growth in the effective and sustainable use of WASH and SRHR services.


target: 4,310,673

people got access to WASH or SRHR services.

More results

We want to show that our Theory of Change works. That is why we developed a new Results Monitoring Framework to define how we measure progress on all levels of our Theory of Change.

Within the Empowered Communities pillar we measure for example the impact of education.

  • Input


    We raise awareness and organise training and education sessions about WASH and SRHR themes.

  • Output

    Immediate result

    We record the number of people who participated in these sessions and events.

  • Outcome

    Result after 2 years

    We assess if people have increased knowledge (for example if they can mention five ways to prevent diseases spreading, like washing hands or using a condom).

  • Long term outcome

    Sustainable result

    We can measure how many people have changed their behaviour and demonstrate healthy behaviour, like washing hands before eating or using antenatal care services during pregnancy.

Within the Enabling Environment pillar we measure for example the impact of training people on social accountability. Social accountability is a way for people from the community to influence policy and decision makers.

  • Input


    We train people from the communities we work with on policy influencing and social accountability.

  • Output

    Immediate result

    We record the number of people trained.

  • Outcome

    Result after two years

    We record the number of times a social accountability tool has been applied.

  • Long term outcome

    Sustainable result

    We can measure how many recommendations or lobby issues have been definitively adopted by the government and how many laws or policies have been adapted.

Within the Sustainable Services pillar we measure for example the impact of improving services.

  • Input


    We train health workers to make services in health centres more youth and female friendly.

  • Output

    Immediate result

    We record the number of people trained and specific training topics.

  • Outcome

    Result after two years

    We record the number of health centres that have improved the access and quality of their services.

  • Long term outcome

    Sustainable result

    We can measure how many people are actively using the services, for example by going to the clinic to give birth,instead of delivering at home with a traditional birth attendant. The fact that services are being used shows that clients are aware, and that the services are affordable and accessible.

The Theory of Change in Practice: 12 programmes, within which we implemented 126 projects in 9 countries, reaching over 5 million people together with 93 partners.

Project highlights

In India, by organising training sessions specifically designed for men, couple communication improved, domestic violence was reduced and men became more involved in the choice of contraceptive methods.

  • 2,146,487

    people directly reached through SRHR education (target 902,943)

  • 13

    partner organisations adopted an advocacy plan (target 15)

  • 2,514,512

    people with access to SRHR services (target 1,031,213)

In remote areas in Kenya, health workers use their mobile phones to send health results to a medical doctor, who diagnoses the clients.

  • 614,115

    people directly reached through SRHR education (target 625,837)

  • 253

    community groups organising SRHR activities (target 243)

  • 2,176,480

    people with access to SRHR services (target 2,989,496)

In Southern Mzimba, Malawi, community chiefs highlighted the need to change local bylaws. Only then could they enforce the minimum age of marriage.

In Indonesia, more than one million people have changed their WASH behaviour. They now use a toilet, wash their hands, treat household water and manage their waste. As a consequence incidence of diarrhoea and worm infections have decreased, while, less malaria and skin diseases have been reported.

  • 1,482,009

    people reached with education on WASH (target 760,740)

  • 9

    recommendations taken over by authorities (target 9)

  • 1,431,372

    people using WASH facilities (target 750,000)

In Bangladesh, thanks to our budget tracking system we managed to gain an increased government budget for WASH of 14%.

  • 409,701

    people reached with education (target 418,558)

  • 3

    recommendations taken over by authorities (target 5)

  • 15,906

    people with access to WASH services (target 13,285)

Thanks to a special combination of football and life skills training, plus increased access to WASH facilities, pupils in Ghana, Kenya and Mozambique are changing their hygiene behaviour.

  • 18,706

    18,706 people directly reached with WASH education (target 42,859)

  • 10

    policy influencing tools applied (target 18)

  • 9,952

    people with access to WASH (target 16,800)

These are our results. What do you think? Which pillar of our Theory of Change is most important to achieve results?

It's not as simple as voting for the best

Our theory is based on the interaction between the three pillars. Simply constructing services is not sustainable. But if people are made aware of the issue and raise their voices, they will demand and use services. And if an enabling environment is created at the same time, stakeholders will be more receptive towards the community's demands. It is only when people are working simultaneously on the three pillars, that change happens. No one pillar is more important than another – we want to make that clear, so we tricked you, sorry!

Read more about our theory

Behind the Theory of Change is an international organisation working with partners around the world to improve the health of marginalised communities in Africa and Asia. The figures below provide an insight into the financial side of the organisation.

Income and expenditure

Income 2014

  • Government grants
  • Income from investments
  • Other income
  • Direct fundraising
  • Share of 3rd party campaigns

Expenditure 2014


From every euro

  • 92 cents is spent on our main objective: basic health for all
  • 4 cents is spent on fundraising activities
  • 4 cents is spent on organisational management

Our stakeholders

  • 16,225

    private donors


  • 15



  • 35



  • 6

    institutional funds
    & governments


  • 50



  • 12,600



  • 93



  • 9

    alliances and



  • Dopper


    Social enterprise Dopper provided substantial and long term support for our WASH projects in Nepal.

    Congratulate Dopper
  • Nationale Postcode Loterij

    The Dutch Postcode Lottery

    With the support of the Dutch Postcode Lottery we started a new programme Making Periods Normal to enhance full participation of women in India.

    Congratulate Postcode Lottery
  • CSA

    The Centre for the Study of Adolescence (CSA)

    CSA improved the sexual and reproductive health of young Kenyans by providing information and making health services youth friendly.

    Congratulate CSA

Campaigns and events in the Netherlands


Walking for Water

During our Walking for Water campaign, 15,783 pupils from 210 Dutch primary schools walked 6 kilometres while carrying 6 litres of water in their backpack. Together they raised €324,000, a fantastic amount!

more about this event »


World Toilet Day

During World Toilet Day we ran a campaign called Let’s give a shit! to raise awareness about the lack of sanitation and its consequences. We reached over 48,000 Facebook users.

more about this campaign»

These are our goals for 2015

We would love to hear what you think about them!

Objectives 2015

  • In 2015 we will develop several proposals for new WASH and SRHR programmes and partnerships in order to reach our goal to structurally improve 10 million people’s health by 2020.
  • In 2015 Simavi will celebrate its 90th anniversary. To mark the occasion we will conduct a retrospective study assessing the sustainability of our past work. We plan to investigate the long-term effects of interventions that were completed during the course of our history.
  • In 2015 we will launch a new Dutch and English website to better communicate about our work and involve more people.
  • Submit your idea Miss something? Submit your idea.

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