Condom Social Marketing in Sub-Saharan Africa and the Total Market Approach

Noting the importance of social marketing interventions in developing nations, "Both increasing use and shifting users from receiving subsidized condoms need to be pursued using a Total Market Approach (TMA)," said the study authors. They reviewed the performance of social marketing through a cross-country comparison of condom use, equity, and market share, plus a case study illustrating how TMA can be applied.

Demographic and health survey data from 1998 to 2007 provided condom use trends, concentration indices, and sources of supply by gender for 11 countries in Africa. Service delivery information and market research provided market share data for the review period. For the case study, two-yearly surveys (2001-09) were the source for condom trends, and retail audit data (2007-09) provided sustainability data.

Among women, condom use with a non-marital, non-cohabitating partner increased significantly in seven of 11 countries. For men, an increase in condom use was seen in five of 11 countries. Equity improved for men in five countries and was achieved in two; for women, equity improved in three. Most participants obtained condoms from shops and pharmacies; social marketing was the primary supply source. Data from Kenya were informative for TMA, demonstrating improvements in condom use over time, but sustainability results were mixed and equity was not measured. Overall market value and number of brands increased; however, subsidies increased over time.

"Condom social marketing interventions have advanced and achieved the goals of improving use and making condoms available in the private sector," the authors concluded. "It is time to manage interventions and influence markets to improve equity and sustainability."

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