Benin is a small West African country with a population of more than 9 million people, 37 percent of whom live on less than $1.50 per day. Despite some economic progress, Benin continues to struggle under pressures of underdevelopment, poverty and disease. The health sector in particular faces several challenges in delivering the population with basic health services.
PSI/Benin was created in 1992 to support the government of Benin in improving the health of the Beninese population. Established in 1994 and revitalized in 2009, ABMS (Association Béninoise pour le Marketing Social et la communication pour la santé) works closely with PSI in Benin to continue PSI’s commitment to local, socially dedicated organizations capable of decentralized initiatives and decision-making that lead to effective operations. ABMS’s intervention areas in malaria, HIV and AIDS, child survival and reproductive health continue to have a significant health impact in Benin.
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 15 percent. 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 to equalize access and ensure fair market price through the Super Moustiquaire, the first pre-treated insecticide-treated net (ITN) sold in urban areas via the commercial sector.
In 2006, ABMS switched to a long-lasting insecticidal net (LLIN), SuperMoustiquaire Longue Duree, and distributed LLINs through routine distribution in antenatal clinics to pregnant women and children under 5 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 has distributed more than 300,000 LLINs to the population of Benin.
Since 2008, PSI has supported the National Malaria Program’s efforts to help pregnant women obtain artemisinine-based combination treatment (ACT). ABMS also participates in ACTWatch, a research project focused on exploring methods to increase ACT availability and decrease the consumer price of ACT.
The HIV and AIDS prevalence rate in Benin has been stable at 1.2 percent since 2006. Through peer education activities, mass media campaigns and HIV and AIDS-specific activities funded by Kfw, ABMS interventions seek to promote healthy behavior and proper condom use among Benin’s high-risk groups: trucker drivers, commercial sex workers, and schooled and un-schooled 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 the public and private health sectors promote and strengthen HIV and AIDS integrated services in HIV testing, counseling and referral, STI testing and treatment, and prevention of mother to child transmission. Mobile units 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) with funding from the Dutch government. Amour & Vie is a program that works to increase the use of condoms among youth, encourages them to postpone sexual relations and ensures that when they do engage in sexual relations, they protect themselves against HIV and STIs. “Amour & Vie” also reaches youth through radio and TV shows, a bi-monthly magazine, and clubs for schooled and un-schooled youth as well as community activities in partnership with the Peace Corps. The upcoming launch of youth centers will increase youth’s access to sexual and reproductive health services.
ABMS and its local partners also worked with the government of Benin in developing and implementing the government’s HIV and AIDS strategic plan through support for policy development, including the coordination of a national response to HIV and the strengthening of a single monitoring and evaluation system, the capacity building of NGOs, and improved epidemiological surveillance.
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 sought to reduce diarrhea morbidity and mortality in children by increasing the accessibility to and demand for the household water treatment, Aquatabs, as well as the diarrhea treatment, OraselZinc with funding from USAID. Through mass media campaigns and peer education activities, ABMS’s interventions with local partners also work to improve the use of household water treatment and diarrhea treatment practices in Benin. Specifically, activities focus on increasing knowledge on safe water storage and hand-washing as well as self-efficacy on diarrhea prevention and treatment.
Child survival interventions also promote routine vaccinations in children under 5 in areas with low vaccination rates through mobile video activities, mass media activities and field supervision visits. In addition, ABMS and the Beninese government support activities to promote routine vaccinations in public health centers in collaboration with local authorities, health agents and opinion leaders.
ABMS offers a range of family products that include 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®. According to a pre-test, 80% of women identified the Laafia® brand with 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, including family planning counseling and services, post-partum counseling for couples, fistula diagnosis and referral, and safe childbirth through antenatal care, prevention of mother-to-child transmission of HIV, prevention of post-partum hemorrhage and active management of third stage of labor. To facilitate these services, ABMS offers clinics Laafia® brand contraceptives at lower than market prices and facilitates their access to central medical stores for other necessary medical supplies.
- 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
- 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.
- Improving Provider Behavior Change Communication and IPC: Best Practices from the Women’s Health Project
This brief describes the challenges faced, strategies developed, and lessons learned by the Women's Health Project. It also proposes a set of best practices for improving productivity of interpersonal communications (IPC) agents and increasing providers' skills and motivation.
- Approaches to Measuring Equity: Methods & Pilots from 12 Franchise Programs
PSI's presentation at the iHEA conference highlighted equity results from social franchising programs and introduced standard methods for the collection and analysis of equity data.