Issue: For 15 years, Population Services International/Myanmar (PSI/M) has socially marketed condoms to female sex workers (FSW), their male clients (MC), and men who have sex with men (MSM). Concerns about appropriate pricing strategies, “crowding out” the private sector, and inefficient use of public funds, prompted PSI/M to adopt a total market approach (TMA) to help manage the condom supply in Myanmar. TMA requires that the three sectors – private, socially marketed, and public – work together to “grow the condom market” and meet the needs of different socioeconomic segments of the population.
We use TMA metrics to describe the size and composition of the Myanmar condom market and understand the effect of free and subsidized condoms on the market. Metrics are: i) universe of need – number of condoms needed to protect risky sex acts; ii) demand – proportion of need that is converted into use; iii) market share for each sector; iv) total volume and value of the condom market; and v) and number of brands on the market. We then show how collaboration between the three sectors can improve the health of the market, reach those in need, and improve sustainability by more appropriately targeting subsidies.
Description of program: PSI/M sells Aphaw brand condoms at 132 Kyats (0.16 $US) per 3-pack, primarily in brothels, guest houses, pharmacies, and among street vendors. The retail price for the most popular commercial condom brand is 1,035 Kyats (1.22 $US) per 3-pack. UNFPA provides condoms to government and partners for free distribution. Several data sources from 2008 to 2011 were used to calculate TMA metrics: PSI sales reports, UNAIDS reports, PSI consumer surveys, and retail audits.
Lessons learned: The universe of need for condoms was 91.0 million in 2010. Condom use for FSW, MC and MSM ranges from 62% to 76.4%. The market share for free condoms increased from 33.37% to 51.71% between 2009 and 2011. There was a reduction in the market share for socially marketed condoms during the same period (53.55% to 40.53%). Market share for the commercial sector remained below 6%, and the number of condom brands on the market reduced from 34 to 29.
The total value of the condom market decreased significantly between 2009 and 2011; the decline was steepest in socially marketed condoms. A substantial number of free condoms are sold on the market rather than being distributed at no cost. Our analysis concludes that an untargeted, large supply of fully subsidized condoms hinders development of the private sector and results in an inefficient use of subsidies.
Next steps: PSI/M is building strategic partnerships with the private sector to promote and sell commercial brands to wealthier male clients. It is also considering offering a brand priced to fill the large gap between the socially marketed and private sectors. PSI/M is working with UNFPA and other public sector partners to more accurately forecast the need for free condoms and prevent large influxes of poorly targeted condoms from entering the market.
1. Han Win Htat is the Marketing Director at PSI/Myanmar and has worked for the organization for more than 8 years. He is responsible for managing PSI/M’s Targeted Outreach Program (TOP) which is the largest community based HIV program in Myanmar with more than 200 FSW and MSM peer educators and a Marketing and Communications team with 25 professionals providing services for PSI/M and beyond. In addition, he has a strong understanding of PSI’s social marketing, social franchising, commercial distribution, and HIV prevention activities in Myanmar. Han Win Htat has a Bachelor of Medicine and Bachelor of Surgery and received international certificates for Social Marketing and Public Health.
2. Kim Longfield is the Director for Research and Metrics at PSI and has worked for the organization since 2001. She is responsible for a team of more than forty international researchers and the quality of research implemented in approximately sixty countries. Kim’s expertise is in social marketing, qualitative research and studies among populations at high risk for HIV/AIDS. Kim earned a PhD in Sociology and International Health and a MPH in International Health/Health Communication and Education, both from the Tulane University. She is the author of more than two dozen published journal articles, reports, book chapters and working papers.
3. Gary Mundy is the Senior Regional Researcher for PSI in Asia and Eastern Europe. He supports the research, monitoring and evaluation work of teams across 13 PSI country platforms, covering a wide range of public health programs and methodological approaches. He holds a Masters Degree in Social Science, and has 10 years experience of delivering and supporting research on behavior change communications, social marketing and social franchising in over 20 countries in Africa and Asia.
4. Zaw Win is the Research Manager for Research Unit at PSI Myanmar and has worked for the organization since 2008. He is responsible for a team of more than 15 researchers in the unit. Zaw Win’s expertise is in social marketing, quantitative research and studies among populations at high risk for HIV/AIDS, Malaria, Diarrhea, TB, Reproductive Health and Sexually Transmitted Infection (STI). Zaw Win earned a Master of Economics in Statistics from Yangon Institute of Economics. He is the author of two abstracts.
5. Dominic Montagu is an Associate Professor of Epidemiology and Biostatistics, and lead of the Private Sector Healthcare Initiative at the Global Health Group, of the University of California, San Francisco. His work is focused on private delivery of health services in developing countries and on market functions for health services and health commodities. He holds Masters degrees in business administration and public health and a doctorate in public health from the University of California Berkeley. Professor Montagu has worked extensively in Africa and Asia, and teaches on the private sector in developing countries, and on regulation of private hospitals and public-private-partnerships at UCSF, UC Berkeley and on behalf of the World Bank Institute. He currently has ongoing research projects on aspects of private healthcare delivery in Ghana, Kenya, Myanmar, and Nigeria.
Key terms: social marketing, condom use, total market approach, sustainability, subsidy, Myanmar
Disclosure: no conflict of interest
- Populations Served
- Clients of Sex Workers, Female Sex Workers, Men Who Have Sex with Men
- Health Areas
- HIV and Sexually Transmitted Infections
- Developing Markets, Marketing Products and Services
- Resource Types
- Condoms and Lubricant, HIV Prevention, Male Condom