Condom social marketing in sub-Saharan Africa and the Total Market Approach

Chapman, Steven; Jafa, Krishna; Longfield, Kim; Vielot, Nadja A.; Buszin, Justin; Ngamkitpaiboon, Lek; Kays, Megan

doi:10.1071/sh10165

Cited by 31 publications

(22 citation statements)

References 23 publications

(22 reference statements)

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“…To address both lack of knowledge about the methods and fear of side effects, a series of leaflets has been produced for low-literacy audiences that describes the range of the most widely used methods (Fig 1) as well as brochures for four specific methods. Regarding the cost barrier, several of the programs offering contraceptive methods in sites throughout the city are exploring ways to provide contraceptives free of charge, either routinely or in period “campaign days.” Ideally, it will be possible to segment the market using the total market approach [25–26], such that those able to pay for contraception will do so (paying full or subsidized prices), whereas those unable to pay will have access to a source of free contraception.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Modern Contraceptive Use in Kinshasa, DRC

et al. 2016

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Recent research from Kinshasa, DRC, has shown that only one in five married women uses modern contraception; over one quarter have an unmet need for family planning; and almost 400 health facilities across Kinshasa report that they provide modern contraception. This study addresses the question: with reasonable physical access and relatively high unmet need, why is modern contraceptive prevalence so low? To this end, the research team conducted 6 focus groups of women (non-users of any method, users of traditional methods, and users of modern methods) and 4 of husbands (of users of traditional methods and in non-user unions) in health zones with relatively strong physical access to FP services. Five key barriers emerged from the focus group discussions: fear of side effects (especially sterility), costs of the method, sociocultural norms (especially the dominant position of the male in family decision-making), pressure from family members to avoid modern contraception, and lack of information/misinformation. These findings are very similar to those from 12 other studies of sociocultural barriers to family planning in sub-Saharan Africa. Moreover, they have strong programmatic implications for the training of FP workers to counsel future clients and for the content of behavior change communication interventions.

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Section: Discussionmentioning

confidence: 99%

Barriers to Modern Contraceptive Use in Kinshasa, DRC

et al. 2016

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“…Among studies on family planning use across multiple countries [5][6][7][8][9][10][11][12][13][14][15][16][17][18], few have examined the sector in which women seek services. We identified eight peer-reviewed papers [19][20][21][22][23][24][25][26] and twelve grey literature reports [27][28][29][30][31][32][33][34][35][36][37][38] that examined provision by sector across multiple countries. The characteristics and findings of these studies are described in Table S1.…”

Section: Introductionmentioning

confidence: 99%

Who, What, Where: an analysis of private sector family planning provision in 57 low‐ and middle‐income countries

Campbell

Beňová

Macleod

et al. 2015

Tropical Med Int Health

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Abstractobjective Family planning service delivery has been neglected; rigorous analyses of the patterns of contraceptive provision are needed to inform strategies to address this neglect.methods We used 57 nationally representative Demographic and Health Surveys in low-and middle-income countries (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) in four geographic regions to estimate need for contraceptive services, and examined the sector of provision, by women's socio-economic position. We also assessed method mix and whether women were informed of side effects.results Modern contraceptive use among women in need was lowest in sub-Saharan Africa (39%), with other regions ranging from 64% to 72%. The private sector share of the family planning market was 37-39% of users across the regions and 37% overall (median across countries: 41%). Private sector users accessed medical providers (range across regions: 30-60%, overall mean: 54% and median across countries 23%), specialised drug sellers (range across regions: 31-52%, overall mean: 36% and median across countries: 43%) and retailers (range across regions: 3-14%, overall mean: 6% and median across countries: 6%). Private retailers played a more important role in sub-Saharan Africa (14%) than in other regions (3-5%). NGOs and FBOs served a small percentage. Privileged women (richest wealth quintile, urban residents or secondary-/tertiary-level education) used private sector services more than the less privileged. Contraceptive method types with higher requirements (medical skills) for provision were less likely to be acquired from the private sector, while shortacting methods/injectables were more likely. The percentages of women informed of side effects varied by method and provider subtype, but within subtypes were higher among public than private medical providers for four of five methods assessed.conclusion Given the importance of private sector providers, we need to understand why women choose their services, what quality services the private sector provides, and how it can be improved. However, when prioritising one of the two sectors (public vs. private), it is critical to consider the potential impact on contraceptive prevalence and equity of met need.keywords family planning, method mix, quality of care, public providers, private providers, lowand middle-income countries

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“…For instance, in South Africa as in several African countries, national surveys continue showing progressive increases in rates of condom use at last sex [16]. Social marketing programs have attempted to promote condoms in Africa and many other low and high income countries by trying both subsidization and total pricing marketing approaches with remarkable success in enhancing the rate of condom use [17]. These efforts are commendable, even though evidence of condom use in the beginning of the relationship and later stoppage as the relationship deepens exist [16].…”

Section: Introductionmentioning

confidence: 99%

Acceptability of condom promotion and distribution among 10–19 year-old adolescents in Mpwapwa and Mbeya rural districts, Tanzania

Exavery

Mubyazi

Rugemalila³

et al. 2012

BMC Public Health

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BackgroundThe HIV/AIDS pandemic remains a leading challenge for global health. Although condoms are acknowledged for their key role on preventing HIV transmission, low and inappropriate use of condoms persists in Tanzania and elsewhere in Africa. This study assesses factors affecting acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural districts of Tanzania.MethodsData were collected in 2011 as part of a larger cross-sectional survey on condom use among 10–19 year-olds in Mpwapwa and Mbeya rural districts of Tanzania using a structured questionnaire. Associations between acceptability of condom promotion and distribution and each of the explanatory variables were tested using Chi Square. Multivariate logistic regression model was used to examine independent predictors of the acceptability of condom promotion and distribution using STATA (11) statistical software at 5% significance level.ResultsMean age of the 1,327 adolescent participants (50.5% being males) was 13.5 years (SD = 1.4). Acceptance of condom promotion and distribution was found among 37% (35% in Mpwapwa and 39% in Mbeya rural) of the adolescents. Being sexually active and aged 15–19 was the strongest predictor of the acceptability of condom promotion and distribution (OR = 7.78, 95% CI 4.65-12.99). Others were; not agreeing that a condom is effective in preventing transmissions of STIs including HIV (OR = 0.34, 95% CI 0.20-0.56), being a resident of Mbeya rural district (OR = 1.67, 95% CI 1.28-2.19), feeling comfortable being seen by parents/guardians holding/buying condoms (OR = 2.20, 95% CI 1.40-3.46) and living with a guardian (OR = 1.48, 95% CI 1.08-2.04).ConclusionAcceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural is low. Effect of sexual activity on the acceptability of condom promotion and distribution is age-dependent and was the strongest. Feeling comfortable being seen by parents/guardians buying or holding condoms, perceived ability of condoms to offer protection against HIV/AIDS infections, district of residence and living arrangements also offered significant predictive effect. Knowledge of these factors is vital in designing successful and sustainable condom promotion and distribution programs in Tanzania.

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Condom social marketing in sub-Saharan Africa and the Total Market Approach

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

Cited by 31 publications

References 23 publications

Barriers to Modern Contraceptive Use in Kinshasa, DRC

Barriers to Modern Contraceptive Use in Kinshasa, DRC

Who, What, Where: an analysis of private sector family planning provision in 57 low‐ and middle‐income countries

Acceptability of condom promotion and distribution among 10–19 year-old adolescents in Mpwapwa and Mbeya rural districts, Tanzania

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