Better health is out of reach for the majority of the world’s most vulnerable people because health products and services are inaccessible – often due to unaffordable prices and limited distribution.
How can we make health products and services accessible?
PSI uses a human-centered approach to understand what motivates someone to adopt a health solution, and then we get the product or service to them in a way they understand, at a price they can afford and in a place that is convenient.
How does this business approach benefit people with the greatest need?
Marketing products and services to improve health isn’t your standard nonprofit approach. PSI’s marketing approach includes both the sale and the free distribution of products and services. Sometimes giving products or services away for free provides greater health impact, and at other times, selling is best and provides a more sustainable solution.
Take the condom market in Cambodia, for example. To increase access to condoms for everyone, we need to look at the total market of condoms in the country, which includes:
- Condoms that are given for free for those with the greatest need.
- Commercial condoms (such as Durex or Trojans) that are sold at pharmacies at full price to people who can afford it.
- Donor-subsidized condoms for people who can only afford to pay a little.
We then market the right brand at the right price to the right people. When people who can afford to pay buy subsidized or commercial condom brands, the free condoms can be given exclusively to those with the greatest need ensuring limited resources are best spent.
Segmenting the total market for a health product or service in this way – based on price – maximizes development aid, so everyone accesses life-saving health solutions at a price they can afford.
How does marketing products and services strengthen health system?
A health market has various players – wholesalers, distributors, retailers, providers, consumers, etc — and a marketing approach to distributing health products and services benefits them all. For example, marketing a safe water solution at a subsidized price in the private sector provides economic benefits to the local manufacturer who produces the product, the local distributor who gets it where it needs to go and the local retailers who make a small profit off the product. It also frees up the availability of free safe water solution, through the public sector, for the people who need it but cannot afford to pay.
In many countries in developing world, most people access health products and services from the private sector, such as small kiosks or clinics. They rely on these private retailers and health providers to be capable, willing and motivated to provide these health solutions. We use our marketing acumen to gain insight on the biases, needs, obstacles and motivations of these market players to providing health products and services. We then:
|Address the needs of these market players.||Build intrinsic motivation to offer health products and services to those in need.|
|Demonstrate the direct benefits that doing so will have for them.||Equip them with the skills, tools and resources they need to offer the life-saving health products and services.|
Oftentimes, people who can afford to pay for a health solution do not have a product or service that best meets their needs in the market. They then over-burden the public sector for the free products that need to be dedicated exclusively to those with the greatest need. A marketing approach to distributing products and services creates an appealing and affordable product or service in the subsidized or commercial sector, thus alleviating the burden on the public sector.
When we use a marketing approach to distribute products and services based on peoples’ abilities to pay, each link along the distribution chain – such as wholesalers, distributors, and retailers – will receive a profit. This profit motivates the players to carry the product or service, making them more widely available for the people in need.
A marketing approach to distributing life-saving health products and services can create a market for a type of product that never existed. For example, we might be the first to introduce a condom to a market. By segmenting the condom market based on peoples’ abilities to pay, we create a space for a commercial entity, such as a Durex, to then enter the condom market and remain in the market long after donor subsidies deplete.
A stronger health system, bolstered by this marketing approach to distributing products and services, better serves the needs of its people, contributes to economic growth, and reduces dependency on development aid over time.
How do we use consumer insight to market products and services?
We use a human-centered approach to understand why individuals don’t use a life-saving health product or service and then figure out what can motivate them to use the health solution. We then reach them with these messages through all of the channels most appropriate to them – including peer-to-peer education, billboards, television, radio, social media tools and more.
See some examples of our TV ads from around the world.
Birth Spacing in Pakistan
Trust Condoms in Kenya
Vive condoms in Central America
Ngao mosquito nets in Tanzania
Orasel kit in Cambodia
Salama banana scented condoms in Tanzania
How do we gather and apply consumer insight?
In putting our beneficiary – or consumer – at the center of what we do, we create brands that inspire people to use the health products or services we promote. This is a dynamic process that needs to continuously respond to the ever-changing needs and desires of the people that we serve and the markets in which we work.
To see it in action, watch the videos below that show how we rebranded our Jeito condoms in Mozambique.
|The Jeito re-branding process||The TV advertisement for the Jeito rebrand|
- Women’s Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.
- From Innovation to Scale: Advancing the Sexual and Reproductive Health and Rights of Young People
This brief reviews components of the approach PSI recommends to reach young people (15-24 years old) with programs that ensure their improved sexual and reproductive health and rights.
- Towards Subsidized Malaria Rapid Diagnostic Tests. Lessons Learned from Programmes to Subsidise Artemisinin-Based Combination Therapies in the Private Sector: a Review
Private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. A subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.
- Expanding Access to Long-acting Reversible Contraceptives and Permanent Methods through Task Sharing
PSI hosted a meeting with USAID and its partners, with the LARC and PM Community of Practice (CoP) to discuss current progress and future opportunities for task sharing.
- Private Sector Readiness and Performance for Malaria Case Management in Uganda
In a nationally-representative 2015 outlet survey, 1 in 4 private sector outlets had both confirmatory testing and QA ACT treatment available. Among outlets with testing and treatment available, study results suggest positive private sector performance with respect to testing all fever patients, particularly in health facilities and drug stores, however testing was very low in pharmacies. However, not all patients seeking treatment in the private sector can or will be tested for malaria. There is need to further promote confirmatory testing and first-line ACT treatment among patients and private sector providers, as well as discourage the use of non-artemisinin therapies and inappropriate use of injectable artemisinin monotherapies for uncomplicated cases.
- What Happened to the Malaria Market in Nigeria after the AMFm?
AMFm continuation under the private sector co-payment mechanism (CPM) has been successful in further improving access to quality assured ACTs in the private sector, where the majority of antimalarials are distributed in Nigeria. High QA ACT price relative to nonartemisinin therapies including SP and chloroquine is likely still a barrier to uptake. Furthermore, the very low availability of confirmatory testing in the private sector suggests that presumptive treatment remains common.
- ￼Trends in Public and Private Sector Readiness to Manage Malaria in Madagascar, 2010-2015
Stronger private sector strategies are needed to improve malaria case management in Madagascar. In the vast majority of cases, people seeking malaria treatment
in both public and private sectors of Madagascar are treated with non-artemisinin therapies including SP and chloroquine. The majority of antimalarials in Madagascar are distributed in the private sector. 2015 findings also highlight widening gaps in public sector readiness and performance for appropriate malaria treatment.
- Malaria Testing and Treatment Markets on the Thai-Myanmar and Thai-Cambodia Borders
A 2016 outlet survey was conducted in Thailand with 2 study domains: Thai-Myanmar and Thai-Cambodia border areas. Availability of malaria blood testing was high in the public sector, but antimalarial availability was variable. Overall, over half of malaria clinics/posts and hospitals had ASMQ or DHA PPQ, CQ, PQ and malaria blood testing available, indicating moderate readiness to test for and treat both P. falciparum and P. vivax malaria. The gap in readiness in the public sector suggests that patients may need to be referred to a different facility to receive appropriate care.
- The Malaria Testing and Treatment Landscape in Benin
Readiness to test and treat malaria is high in Benin's public health facilities, but with gaps in readiness for IPTp. However, the private sector is responsible for the majority of antimalarial distribution in the country, and general retail outlets are the most common distributor of anitmalarial medicines. Strategies to improve malaria case management in the private sector are critical to improve overall coverage of appropriate malaria case management in Benin.
- The Public Private Mix Program and Antimalarial and Malaria Rapid Diagnostic Test Availability and Market Share in the Southern Lao PDR Private Sector
Access to first-line ACT and mRDT was higher in PPM district antimalarial stocking private sector outlets compared with non-PPM outlets. However, CQ availability and distribution was high in both PPM and non-PPM districts. Expansion of the PPM program could increase availability of mRDT and ACT, as well as improve provider treatment and dosing knowledge, all of which are paramount in the context of national malaria elimination goals in Lao PDR. However, interventions aimed at provider preference and consumer demand may also be necessary to reduce CQ availability and market share in the private sector.