Prelude to Social Marketing

Social marketing is globally recognized as a key strategy for improving access to a wide range of products and services that directly and positively impact the outreach and coverage of healthcare. It also refers to an application of commercial marketing concepts, tools, resources, skills and technologies to encourage socially beneficial behaviour among those segments of the population not served, or adequately served by the existing public and private systems.Many products and services for reproductive and health care are commercially sold at prices affordable only to the well to do segment of the society. The less well-off currently rely on public health systems which are free of charge. Interestingly though people with some ability to pay are seeking better quality health care facilities, products, and services at affordable prices. The philosophy of Social Marketing evolves at marketing and distributing commonly needed products at affordable prices to the less well-off segments of the population,through commercial networks, and community / NGO based distribution system. These channels are motivated to stock and sell products so as to enhance its availability and visibility in retail outlets of small towns and rural areas. As the consumer’s ability to pay increases, they will graduate from relying upon the public health network to social marketing outlets for the same products, and eventually to commercially marketed products for meeting their needs.

India was one of the first countries globally to adopt social marketing of contraceptives to extend the coverage and outreach of the family planning programme. In the early 1960s India had introduced a brand of condoms, called ‘Nirodh’ for free supplies through government hospital and primary health centres. Exclusive reliance on government machinery was proving inadequate, and clearly, the family planning administered through doctors and clinics could not accomplish this task alone.By 1968, private companies,with excellent distribution systems in FMCG (Fast Moving Consumer Goods) sector,such as Union Carbide, Hindustan Lever, Tata Oil Mills, Indian Tobacco Company and Brooke Bond Tea, were invited by the then Ministry of Health and Family Planning, Government of India to participate in its ‘Nirodh’ social marketing programme. Each organization was given responsibility for operations in assigned geographic territories and collectively they covered the entire country. In those days of ‘License Raj’, all these organizations agreed to participate in the family planning programme of national importance as it earned them ‘brownie points’ to pursue their various licenses and gain favours for their business. However, since social marketing of contraceptives was seen only as an obligation towards the government, the penetration of Nirodh condoms were limited to only some drugstores / retail outlets known for selling high priced speciality goods to the upper income groups in large cities. Only very few FMCGs managed to reach Nirodh to the far flung rural areas and that too by resorting to “tie up” their own products (which were normally in shortages) with Nirodh purchases.

During the 1980s, GOI launched an oral contraceptive pill called ‘Mala-D’with a massive advertising and awareness campaign that spoke of “do ya teen bus”, with a message to not to have more than three children at the most.

The sales/ distribution graph of Nirodhhad reached stagnation in two decades of the social marketing programme. In 1986-87, Parivar Seva Sanstha received the permission from the Ministry of Health and Family Welfare to introduce its own branded condoms ‘Sawan’, under the social marketing umbrella of the Ministry.
 
Soon, other international NGOs joined the programme with their own brands of condoms. Parivar Seva soon added, under its social marketing programme with the government, other brands of condoms such as ‘Bliss’ and ‘Milan’, as well as a brand of oral contraceptive pills – ‘Ecroz’.

With economic liberation in the early 1990s, the private sector companies, which had found the Nirodh distribution to be a non-viable business proposition, began to withdraw from the social marketing programme. The collapse of Union Carbide was the final blow. By this time, the family planning message had been changed to “hum do hamare do”,emphasising a two child norm. The aim was to improve the Couple Protection Rate (CPR) and achieve the Total Fertility Rate (TFR) of less than or equal to 2.1 by the end of 2010.

The period between,1993-1995 saw the emergence of additional organizations joining the programme. During this period the condoms too saw improvisation through lubrication, thinner variety and multiple colours.

Parivar Seva’s Contraceptive Social Marketing Programme

The Contraceptive Social Marketing Programme (CSMP), a unit of Parivar Seva Sanstha since its inception in 1986 has worked in strict accordance with the formal strategies laid down by the Ministry of Health and Family Welfare, Government of India (MOHFW,GOI). Numerous projects have been successfully completed by CSMP, including the ones funded by NACO, MOHFW and bilateral agencies such as KfW and DFiD.

Parivar Seva is able to sell the contraceptives to the rural population, people in urban slums and vulnerable groups at very low affordable prices as they are subsidized by the GOI under a special agreement.For condoms, the GOI has fixed the MRP for SMOs at Rs 3.33 paise per condom and for OCPs it is Rs 10 per cycle containing 21 hormonal tablets + 7 iron tablets. The products reach the targeted customers effectively through a systemic distribution channel, which consists of over 218 approved stockists who purchase the contraceptives directly from Parivar Seva and then supply the products to their network of retailers who are motivated by the sales team of the Sanstha to stock and sell their products. There are an estimated 45,000 Traditional Outlets (TOs) and 35,000 Non-Traditional Outlets (NTOs) covered by Parivar Seva.  Additionally, the stockists also sell to the semi wholesalers from the rural market who, come to major cities to buy stocks and then further sell to smaller shops in the rural areas. The PSS team provides support to the stockists at retail level, provides promotional point of purchase materials and sensitizes the community regarding prevention of HIV/AIDS and unwanted pregnancies. Ultimately the consumers purchase the contraceptives, which is the objective.

Parivar Seva Brands
Parivar Seva Sanstha has been marketing its own brands of condoms and oral contraceptive pills focussing on making them easily available. Apart from medical and general stores, they can be procured from dispensing doctors, Anganwadi workers and even Roadside kiosks.
Sawan was the first branded condom in India from an SMO launched in 1987. The objective was to address spacing methods and to achieve high couple protection rate. The target segment was rural married couples. The artwork on the pack was aesthetically designed with rainbow,and clouds, depicting the rainy season Monsoon or Sawan, which is revered in Indian literature and classics as the season of romance. This decent concept in a market full of sexual pictures on condom packs were comfortably accepted by the target segment as they could now carry the pack conveniently in their pockets without any embarrassment. The pink coloured Sawan condoms was first made available in a pack of 4.

After a few years, the picture of a couple with a child was added to the pack design. Condom packs of 3 and 7 were introduced. Later, this was converted to packs of 5 and 10. The current pack design has an umbrella instead of the couple and child picture and is in a pack of 3.

Bliss was introduced with a subtle difference: invoking extra pleasure because of its USP – ultra-thin and peach / natural coloured condoms. HIV/ AIDS prevention was added on to the family planning positioning. It was aimed at men, who wished to purchase a more modern condom. It was initially made available in packs of 4 and 12.

Milan colourless condoms were introduced to meet the needs of the very poor and vulnerable populations. It was priced at only Rs3/- for 4 condoms.

Ecroz the low dose Oral Contraceptive Pills was evolved with the 21 hormonal tablets (dl Norgestrel 0.3 mg & Ethinyl oestradiol 0.03mgms) which was the standard at that time. However, Parivar Seva innovated and added 7 iron tablets (LEVENORGESTREL 0.15mg& ETHINYLOESTRADIOL 0.03mg with FERROUS FUMARATE I.P. 60mg) so that women got into the habit of taking a pill every day, without any gaps. This concept helped to improve compliance of the patient and also helped to combat anaemia, which is very common in the country.This was soon adopted by the Government of India as well for its own product, MalaD and Mala N. Other SMOs also brought out OCPs with 21+7 concept.

Parivar Seva also used the unique positioning of Ecroz as a multi-benefit product. This was important as there were several myths associated with OCPs, both amongst the consumers as well as the doctors.

Recently, the Ecroz pack has been further modified. Gold has been added to Ecroz to give it an up market look and barcode has been introduced in the pack for easy marketing.

Rider was introduced to cater to the young generation with benefits like extra raised dotted coloured condoms with the benefit of extra time to enhance pleasure. More value for money.

Satin: One of our focus areas has been menstrual hygiene especially in adolescent girls. In a study it has been stated that only 37.52% girls were aware of menstruation prior to attainment of menarche. The difference in the awareness regarding menstruation in urban and rural area was highly significant. Only 36% girls in the urban and 54.88% girls in the rural area used homemade sanitary pads and reused the same in the subsequent period.

Therefore, hygienic practices during menstruation were unsatisfactory in the rural and peri rural areas as compared to the urban areas. We at Parivar Seva Sanstha undertake education of such target groups through competent and well trained Education & Training team. They counsel such target audience on the pros and cons of such traditional beliefs, misconceptions, and restrictions regarding menstruation and its hygiene. Insufficient, incorrect information leads to restrictions in daily normal activities of the menstruating girls, creating various psychological issues. Besides, the lack of knowledge and awareness also lead to some poor personal hygienic practices during menstruation leading to many reproductive tract infections.

Poor menstrual hygiene causes great impact in increased vulnerability to reproductive tract infections (RTI). Currently millions of women suffer from RTI and this infection is transmitted to the offspring. Women having knowledge regarding menstrual hygiene are less vulnerable to RTI and its consequences.

This underlying concern prompted PSS to introduce Satin sanitary napkins to address the youth and the adolescent women during menstruation. We at Parivar Seva continue to address various such target groups in schools, slums, construction sites, Aasha workers and NGOs who have taken up such focus areas. The importance of education and issues needs to be addressed, especially the myths and how girls are treated during menstruation.Satin, our sanitary napkin, comes in a hygienic pack of eight with an MRP of Rs 30. The figure on the artwork of Satin immaculately depicts the mother and daughter, where the mother protects and educates her daughter on the aspects of hygiene and developments from childhood to puberty, with the apt statement Mera Sahara, Meri Suraksha.

Three channels of promotion have been adopted in marketing these products: Media in the form of press advertisements; outdoor promotional activities, which include hoardings, wall paintings, posters and danglers at chemist shops and awareness campaigns using traditional methods like folk music, street plays and through doctors and chemists wherein sales officers of the organisation apprise them of the benefits and quality of our contraceptives.
 

Special care and effort has been taken to create a brand image for each product. Posters, hoardings, danglers, stickers and shop window promotions are all part of the outdoor campaign where strategies are chalked out for each product according to its image and target audience.

The organisation has established strong distribution and retail links for marketing. Every state is divided into different parts, each coming under the jurisdiction of a sales officer who reports to the area sales manager. The sales officer and his team coordinate with the stockist and the retailer. The team also uses vans to reach out to inaccessible areas and supply ready stock on a regular basis.

The Contraceptive Social Marketing Programme covers Rajasthan, Himachal Pradesh, West Bengal, Odisha, Uttar Pradesh, Madhya Pradesh, Delhi, Haryana, Uttarakhand and Jammu and Kashmir.