Benin is a small West African country with a population of 11 million people, with one third living on less than $1.25 per day. Despite economic progress, Benin continues to struggle under pressures of underdevelopment, poverty and disease. The health sector in particular faces several challenges in delivering basic health services to the population.
PSI/Benin was created in 1992 to support the government of Benin in improving the health of the Beninese population. Established in 1994, the Association Béninoise pour le Marketing Social et la Communication pour la Santé (ABMS) works to continue PSI’s commitment to local, socially dedicated organizations capable of decentralized initiatives and decision-making. ABMS’s intervention in malaria, HIV/AIDS, family planning, child survival and water, sanitation and hygiene continues to have a significant health impact in Benin.
People We Serve
ABMS estimates that in 2015, its products and services helped avert 169,812 DALYs, including, by health area:
- 2,485 Malaria DALYs
- 21,121 HIV DALYs
- 122,293 FP DALYs
- 22,590 MNCH DALYs
- 1,008 WASH DALYs
- 309 Safe Abortion DALYs
- 6 NCD DALYs
ABMS’ family planning programs also provided 256,192 couple-years of protection.
Malaria is a major driver of child mortality in Benin. It places a significant burden on the country’s health systems and economy, with mortality and morbidity rates at 10%. In addition, anti-malarial products are not always available and are often illicitly overpriced in Benin. With USAID funding, ABMS launched its malaria program in 1998. The program’s goal was to equalize access and ensure a fair market price through the Super Moustiquaire, the first pre-treated insecticide-treated net (ITN) sold in urban areas.
In 2006, ABMS switched to a long-lasting insecticidal net (LLIN), Super Moustiquaire Longue Durée. It distributed LLINs to pregnant women and children under five through routine distribution in antenatal clinics, and to the general population through social marketing and commercial channels. ABMS also participated in a 2011 national campaign organized by the government of Benin to distribute free LLINs to households across Benin. As of 2012, ABMS had distributed more than 300,000 LLINs.
Since 2008, PSI has supported the National Malaria Program’s efforts to help pregnant women obtain artemisinin-based combination treatment (ACT) for malaria. ABMS also participates in ACTwatch, a research project focused on exploring methods to increase ACT availability and decrease the consumer price.
The adult HIV prevalence rate in Benin has been stable at 1.1% since 2006. Through peer education activities, mass media campaigns, and HIV and AIDS-specific activities funded by KfW (the German development bank), ABMS promotes healthy behavior and proper condom use among Benin’s high-risk groups: trucker drivers, commercial sex workers and both in-school and out-of-school youth.
ABMS also socially markets and distributes two brands of male condoms: Prudence Plus condoms for the general population and Koool condoms, a brand specifically targeting youth. Interventions in both the public and private health sectors promote and strengthen HIV and AIDS integrated services, including HIV testing, counseling and referral, STI testing and treatment, and prevention of mother to child transmission. Mobile clinics also provide HIV counseling and testing services in under-served areas.
To reach youth with key sexual health and HIV and AIDS prevention messages, ABMS created Amour & Vie (Love & Life) in 2003 with initial funding from the US Government and ongoing support from the Dutch government. Amour & Vie is a program that works to encourage responsible sexual behaviors with campaigns to increase condom use among youth, postpone sexual relations, and promote awareness of and prevention methods for HIV/AIDS and other STIs. Amour & Vie reaches youth through radio and TV shows, a bi-monthly magazine, and clubs for youth as well as community activities in partnership with the Peace Corps. The expansion of youth centers will increase access to sexual and reproductive health services.
ABMS and its local partners collaborated with the government of Benin in developing and implementing the government’s HIV and AIDS strategic plan through support for policy development. This included the coordination of a national response to HIV and the strengthening of a single national monitoring and evaluation system, building the capacity of NGOs and improving epidemiological surveillance.
ABMS offers a range of family planning products including oral contraceptives, injectables and cycle beads. With additional donor funding, ABMS expanded the affordable contraceptive options in the private sector to include implants and intrauterine devices (IUDs). In order to cost-effectively promote its family planning products, ABMS rebranded these options in 2012 under one umbrella brand, Laafia, which translates in a commonly spoken Beninese language as harmony, peace, and tranquility in the family. ABMS distributes its Laafia products through the pharmaceutical sector as well as its social franchise clinic network, ProFam with funding from the Women’s Health Project, Choices and Opportunities Fund (COF) and Kfw.
Through its partner public clinics and social franchise clinics, ABMS provides women in Benin with comprehensive reproductive health services.These include family planning counseling and services, post-partum counseling for couples, fistula diagnosis and referral, safe childbirth through antenatal care, prevention of mother-to-child transmission of HIV, prevention of post-partum hemorrhage and active management of the third stage of labor. To facilitate these services, ABMS offers Laafia contraceptives to clinics at below-market cost and eases their access to central medical stores for other necessary medical supplies.
ABMS has been involved with various support platforms over the last decade that have helped advance its family planning goals. The Choice and Opportunities Fund has supported workshops, distribution of materials, and community lectures to promote effective family planning. It reached an estimated 140,000 Beninese people, including 60,000 men. The IMPACT (Project intégré d’appui à la santé familiale et à la prevention du VIH/SIDA) project supported promoting a national strategic plan to improve women’s health, reduce the impact of STIs and malaria, encouraging effective family planning methods and marketing oral rehydration salts. The IMPACT project also supported community programs to encourage family planning and responsible sexual behaviors as well as reduce HIV transmission from mothers to infants. The TRANSFORM (Translating Effective Practices from Research, Marketing and Design) project provided ABMS with technical assistance in behavior change and communication with particular focus on family planning and maternal and child health.
Although nearly half of Benin’s population does not have access to safe drinking water, the use of water treatment products among households in the country is low. ABMS continuously seeks to reduce morbidity and mortality in children due to diarrhea by expanding access to and demand for the household water treatment, Aquatabs, as well as the diarrhea treatment, OraselZinc, with funding from USAID. In 2016, ABMS started testing AquatabsFlo, which treats flowing water. Through mass media campaigns and peer education activities, ABMS’s interventions with local partners improve the use of household water treatment and diarrhea treatment practices in Benin. These activities focus on increasing knowledge of safe water storage and hand washing as well as self-efficacy on diarrhea prevention and treatment.
ABMS and the Beninese government promote routine vaccinations in public health centers in collaboration with local authorities, health agents and civic leaders. These activities also promote routine vaccinations in children under five in areas with low vaccination rates through mobile video activities, mass media activities and field supervision visits.
ABMS is also committed to fighting against child abuse and precocious marriages. Supported by UNICEF, ABMS is launching a nationwide dialogue to question the normalization of child abuse and precocious marriages. ABMS has further initiated dialogues in numerous communities, both rural and urban, to urge acceptance of a new Zero Tolerance culture against child abuse in all its forms at every level of society, no matter whether it is within a family’s home, in the classroom, in prison, in government or in media.
The program’s behavior change communications focus on three groups: parents of children ages 10 to 14, children ages 10 to 14, and traditional religious leaders.
Water, Sanitation and Hygiene
ABMS is the on-the-ground implementer of social marketing and hygiene promotion activities for WASHplus, a Global Health Initiative funded by USAID. The main goals of this project are:
- Applying small doable actions to build healthy households and communities through feasible and effective behavior change.
- Improving access to and innovation in sanitation for different geographies, marketplaces, personal needs, and preferences.
- Involving consumers, governments, and manufacturers to improve cooking stoves and develop clean cooking solutions.
- Integrating WASH with other development priorities—education, nutrition, maternal and child health, neglected tropical diseases, HIV/AIDS—for sustainability and scale.
ABMS will advance these goals via local media, household visits, and school and health center-based programs to raise awareness and foster better practices.
The Beninese population face poor choices in the sanitation market due to a broken supply chain and inadequate planning. As part of USAID’s Sanitation Services Delivery project, ABMS is catalyzing the private sector by introducing new latrine technologies, training local artisans to manufacture, promote and sell these latrines and working with the Beninese government to improve and enforce environmental standards. Additionally, ABMS is organizing a network of latrine emptiers to provide quality service to clients with safe waste disposal, diminishing exposure to fecal waste.
- U.S. Agency for International Development
- The Federal Republic of Germany through KfW Entwicklungsbank (the German development bank)
- The President’s Malaria Initiative
- Ministry of Foreign Affairs of the Netherlands
- Bill & Melinda Gates Foundation
- Government of Benin
- Benin Ministry of Health
- United Nations Population Fund (UNFPA)
- Joint United Nations Programme on HIV/AIDS (UNAIDS)
- Abt Associates
- Several more international and local NGOs
- Do anti‑malarials in Africa meet quality standards? The market penetration of non quality‑assured artemisinin combination therapy in eight African countries
This paper uses national and sub-national medicine outlet surveys conducted in eight study countries (Benin, Kinshasa and Kantanga [Democratic Republic of the Congo, DRC], Kenya, Madagascar, Nigeria, Tanzania, Uganda and Zambia) between 2009 and 2015 to describe the non-QAACT market and to document trends in availability and distribution of non-QAACT in the public and private sector.
- Catalyzing Markets for Urban Sanitation in West Africa
- Shaping the Family Planning Market by Strengthening the Public Sector
PSI considers total market approaches to be critical for achieving universal health coverage, especially when it comes to contraception. This program brief presents cases, supported by several different donors, which take into consideration the total family planning market.
- Developing Family Planning Markets in Francophone West Africa
In Francophone West Africa, PSI partners with Ministries of Health to achieve the goals set out by the Ouagadougou Partnership to reach at least 2.2 million additional family planning users by 2020. The pillars of our response are access, choice, quality, and equity.
- 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.
- Simplified Asset Indices to Measure Wealth and Equity in Health Programs: a Reliability and Validity Analysis Using Survey Data from 16 Countries
Many program implementers have difficulty collecting and analyzing data on program beneficiaries' wealth because a large number of survey questions are required to construct the standard wealth index. We created country-specific measures of household wealth with as few as 6 questions that are highly reliable and valid in both urban and rural contexts.
- Améliorer L’Accès Et L’Utilisation Des Méthodes Contraceptives Modernes Chez Les Adolescentes Et Jeunes Au Bénin
Presentation on improving access and use of modern contraceptive methods among adolescents and youth and Benin.
- Market Trends for Malaria Blood Testing in Sub-Saharan Africa, 2009-2014
In 2012, the World Health Organization (WHO) launched the Test, Treat, Track initiative recommending confirmatory testing prior to antimalarial treatment. National malaria control programs (NMCP) across subSaharan Africa (SSA) subsequently aligned national guidelines with this recommendation. Strategies to scale up testing using malaria rapid diagnostic tests (mRDT) were introduced by NMCPs. We examine malaria testing availability, price and market share using national market survey data collected by the ACTwatch project.
- SP Availability and (Mis)Use in Sub-Saharan Africa: Antimalarial Market Data From 8 Countries
As evidence of reduced chloroquine efficacy against plasmodium falciparum mounted in the 1990’s, sulfadoxine-pyrimethamine (SP) became first-line malaria treatment in many endemic countries in sub-Saharan Africa (SSA). Between 2002-2005, countries in SSA adopted artemesinin combination therapies (ACT) as first-line treatment. SP is still recommended by the WHO and used across SSA for intermittent preventive treatment of malaria during pregnancy (IPTp). We examine availability and distribution of SP using national antimalarial market survey trend data collected by the ACTwatch project.
- Efficiently Identifying and Addressing Market Failures in Urban Sanitation in West Africa
Coverage of improved sanitation in West Africa is among the lowest in the world. The Sanitation Service Delivery Program (SSD) is a USAID/West Africa urban sanitation project implemented in Benin, Cote d'Ivoire and Ghana by PSI in collaboration with PATH and WSUP. The goal is to improve urban sanitation outcomes through building and testing scalable, market-based models with an initial focus on Cotonou (Benin), Abidjan (Cote d'Ivoire), and Accra and Kumasi (Ghana). Improved sanitation coverage in these countries’ urban areas is currently low.