Beyond Condoms COMMERCIAL MARKET STRATEGIES NEW DIRECTIONS IN REPRODUCTIVE HEALTH Should social marketing programs do more to promote abstinence and partner reduction in Africa? IN PARTNERSHIP WITH Abt Associates Inc. Population Services International

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health What is Social marketing?  The use of commercial marketing techniques to promote behavior change and achieve a social goal  Adaptation of the “marketing mix” or 4Ps to a public health context: Product (+ services, behaviors) Pricing (tangible, psychological) Place (product and service outlets) Promotion (advertising, BCC, IEC) Other Ps (people, policy, etc.)

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health In the developed world, social marketing is  Communication-based  Driven by behavioral goals  Highly segmented

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health In developing countries, social marketing has been:  Product-based, supply driven  Based on commercial strategies  Focused on population at large  Evaluated on sales

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health But things are changing in many countries…  Increased focus on HIV/AIDS  Improved access to products  Emphasis of Behavior Change Communication (BCC)  More population-based behavioral research  More targeted interventions  Dissemination of Lessons learned and best practices

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health Lessons learned in changing youth behavior  Findings from US and developing country research* Programs focusing on A and B and C can improve reproductive health outcomes The promotion of only one behavior can potentially undercut other behaviors. These behaviors should be promoted simultaneously * Source: (Doug Kirby, ETR associates, 2003)

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health The case of Uganda  One of the few countries where HIV/AIDS prevalence has declined since the late 1980s (UNAIDS 2002)  Decline in HIV/AIDS coincided with the following changes:

 Ugandans who engage in high or potentially high risk behavior  90% of respondents who did something to avoid HIV/AIDS BehaviorPercent Fidelity Abstinence Condom use Other Age groupPercent High risk vs. preventive behavior

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health Social marketing in Uganda  Historically focused on product distribution and promotion  HIV/AIDS prevention campaigns emphasized condom use  Use of lifestyle ads for mainstream audiences aged 15-29

Program Impact

Condom use in Uganda

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health Lessons learned  Condom brands tend to compete for the same user group  Suppliers likely to focus on sales and market share instead of health impact  High-risk groups are not appropriately targeted  Non-product based behaviors are not promoted

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health Implications  Social marketing should promote a range of safe behaviors  Segment population according to sexual history, health risk and likely behavioral choices  Make full use of social marketing behavior change capability  Establish performance indicators based on behavioral data

COMMERCIAL MARKET STRATEGIES New Directions in Reproductive Health Social marketing is about promoting safe behaviors