Marketing Health for Social Good
Social marketing utilizes commercial advertising and marketing techniques to influence health behavior change. This approach works well in encouraging health product sales, and perhaps the largest and best established social marketing campaigns advertise contraceptives and oral re-hydration therapies. Social marketing has more recently been used to influence health behaviors such as seeking voluntary counseling and testing for HIV, practicing safe sex, or encouraging hand-washing. Because of the focus on researching and evaluating the needs and desires of the target population with a market-driven focus, social marketing is often described as a bottom-up public health approach.
Social marketing organizations also engage in the manufacturing, distribution, and sales of health products and services to meet the demand they create. Oftentimes, social marketing programs have their own subsidized brand of the product being promoted (e.g., Trust Condoms).
The Private Sector and Social Marketing
Social marketing programs are subsidized by donors or national governments and are almost always run by NGOs or for-profit marketing agencies. Historically, social marketing has focused on integrated commodity branding, distribution, and promotion. Behavior Change focused social marketing initiatives do not link to specific products or services. As knowledge and experience with social marketing has grown, there has been a movement among some donors and some implementing agencies to separate commodity or service provision from the marketing and communication activities. Many traditional social marketing groups argue that brand creation and brand control are critically linked, and have concerns about the effectiveness of fragmented social marketing initiatives.
Commodity based social marketing is best suited for developing markets, with low levels of commodity production, import, and distribution. A concern is that in countries with strong commodity markets, social marketing may undermine the ability of the unsubsidized private sector to thrive. Studies on this are inconclusive.
- Increased access
- Health behavior change
- Fast scale-up
- Over 75% of funds go to local private sector
- Compatible with OBA/vouchers
- Compatible with social franchising programs
- Directly acts to reduce stigma
- Decreases burden on public sector
- Can lead to overall market growth
- Cross-subsidizing potential
- Unit costs decrease as programs mature
- Payment for products correlates to usage
- Coordination with public sector is difficult
- Many stakeholders and competing interests
- Some NGOs reluctant to charge for services
- Crowding out domestic competitors
- Sustainability depends on subsidy
- Rarely reach the very poor
- Many confounders in assessing health impact
Social Marketing Today
About $350 million is invested in social marketing programs each year. One billion condoms a year — one of every five condoms used world wide — are delivered through a social marketing program. Major donors include KfW, USAID, DFID, and the Netherlands. Social marketing programs are increasingly focusing on delivering integrated programs and addressing overall market segmentation. This requires greater collaboration with the local private and public sectors.
Social marketing programs have recently been included in national and regional poverty reduction and health strategies, although few take a fully comprehensive approach.
A current theoretical approach is to prime the market with a social marketing program, and then withdraw the social marketing brand as local manufacturers and importers enter the market. As the social marketing brand is withdrawn, the social marketing program engages in technical assistance to the local private and public sectors (see box).
Due to leakage problems and market undermining, free social marketing products and services are now more frequently being distributed with voucher programs to ensure access by the poorest. Brand ownership remains an ongoing issue for commodity social marketing as large donors argue for their retention of brands, which would allow re-bidding of ongoing projects.
Measurements for success are changing. Family planning metrics such as cost per Couple Year of Protection need to be revised to address other areas of health promotion, and programs with broader market influence.
Another Point of View
Ordinary social marketing programs may not address weak wholesale coordination, lack of retail credit systems, low retail margins, leakage of fully subsidized products, or lack of product transport and storage systems--all important considerations in helping to stimulate the local private sector. Northern NGOs which build, own, and manage a social marketing brand are delivering a social good, but creating dependence rather than supporting development toward independence.
The Total Market Approach (TMA) aims to address some of these issues, and provides not only for a thorough analysis of the overall market, but also an assessment of comparative advantages of different supply-side entities in offering a range of prices to specific market segments. This aids in designing more appropriate segmentation strategies, assuring supply chain security, and exploring potential for combinations of social marketing and private brands.
Note: TMA was introduced in the “Review of DFID Approach to Social Marketing”, 2003; it is currently being applied in some form by Futures/Constella, Chemonics, and PSI, among others