Making a Business of Good Reproductive Health

Throughout the ten years that Chastain Fitzgerald traveled in Africa, no matter how remote the village, there was one constant. If she asked enough people, she could find the villager who sold some combination of goods-matches, chewing gum, flour- and always, always, Coca-Cola.

The fact that the Coca-Cola Company gets its product to these far-flung customers only excites Fitzgerald, the Director of New Business at Population Services International. “If Coke can get there, condoms can get there,” she says. “When there is already commercial distribution in place, we’re going to work with that.”

If you ask Fitzgerald and her fellow workers at Population Services International, the health care services field can benefit from an entrepreneurial approach. The Hewlett Foundation grantee, one of the world’s largest nonprofit social marketing organizations with programs and local affiliates in more than sixty developing countries, uses the tools of the business and commercial world to help solve health problems among the world’s poor.

Population Services International addresses behavioral and health problems by using the laws of supply and demand. If a country doesn’t have the demand for oral contraception, for example, a local focus group will be conducted and a marketing campaign launched. And if a low-income population wants but can’t afford or find a product, Population Services International will create and distribute its own brand at a subsidized cost.

The goal is to change behavior rather than make money, but Population Services International’s approach looks like that of any successful business. And by not giving it away its products, the organization hopes to stimulate the local commercial market with a profit motive, so that sales and distribution can go on long after the nonprofit has left.

The organization’s work in Zambia offers a case in point. A picture of a smiling Zambian family hangs above boxes of SafePlan, the first low-price contraceptive pill to be made widely available in that country’s pharmacies and drugstores. The faces of a mother, father, and two children beam from a bright yellow background, with an arrow pointed downward and the words “Sold here” below it. Splashed across the advertisement is the reminder that “spacing 3 to 5 years saves lives.”

SafePlan came about after Population Services International’s local affiliate in Zambia-the Society for Family Health-identified a need for a subsidized brand of oral contraceptive pills. The price, brand name, and even the bright yellow marketing tools were all created with information from focus groups of Zambian women. Before the brand’s launch in 1996, affordable oral contraceptive pills were available only through the public health system, which often ran out of supplies. By contrast, SafePlan is marketed in pharmacies and drugstores. With the brand’s greater availability and the marketing campaign, the National Demographic and Health Survey now shows that 22.6 percent of married women use modern contraception, as opposed to 8.2 percent in 1992.

But Zambia is far from the only country being changed by Population Services International’s business-savvy approach. The organization has numerous other projects in place. Across the world, 3 million people use the organization’s water treatment products every day as part of its safe water programs.

“This is fairly new technology in Kenya,” Veronica Musembia, the national sales manager in Kenya, says of the water products. “When we began, we had to do a lot of educating. Now, distributors are increasing their orders.”

Likewise, the organization is using this social marketing approach to promote the use of emergency contraception. With the support of a grant from the Hewlett Foundation, Population Services International has begun a similar campaign about emergency contraception both in Kenya and in Rajasthan, India.
Nor is Population Services International the only Hewlett grantee using the ways of business to improve the health of people in the developing world. DKT International-named for the former Assistant Commissioner of Family Planning in India, D. K. Tyagi-also relies on the profit motive and the distribution model of commercial business to achieve social objectives.

“Using social marketing, these groups convey what people need to hear in a way they want to hear it,” says Nicole Gray, a program officer for the Hewlett Foundation’s Population Program. “We’ve watched as these organizations have used the principles of business and marketing to improve access to family planning resources in the countries most in need.”

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