[Music: "I'd Like to Buy the World a Coke"]I'd like to teach the world to sing/in perfect harmony (perfect harmony) I'd like to buy the world a Coke/and keep it company/ That's the song I sing [Narrator:] Thanks to international advertising, certain commercial product names are household words around the globe. In recent years, leaders of the developing world have recognized that these same commercial marketing techniques can be used to sell products associated with maternal and child health, and general family betterment. [Announcer 1:] Eveready wants you to know. [Engine revving] [Commercial jingle:]Volkswagen does it again [Commercial jingle:]Everyone likes the way it says hello/ Wrigley's Spearmint Gum/ We all like the way it says hello [Narrator:] Out of this conviction has grown a new approach to the problem of introducing such health measures as contraceptive methods by making them widely known and conveniently available at low cost. It is known as social marketing. [Music][Social Marketing] [Music] The island nation of Jamaica moves to its own vigorous beat with jaunty self-confidence in life and a love of human contact. Perhaps this is only the surface character of people wholly serious about their goals and problems, but it is nonetheless real and a factorin what the people of Jamaica respond to. The panther is not indigenous, but it is somehow a known and alluring image of strength and cleverness. [Commercial jingle:] Everyday, I [?]/We all like protection [Narrator:] The pearl has associations with mystery and purity, and high intrinsic value. So the choice of these symbols for the contraceptive retail sales campaigns has a certain specifically Jamaican logic. In Jamaica, as in most other countries where a successful retail sales program has been launched, already existing local expertise in research, advertising, and selling techniques was fundamental. The project began with an exhaustive study of the potential market in which interviews with a broad sample of consumers played an important part. Then, a local advertising agency was empowered to design and execute a program based on the research findings. [Commercial jingle:]...happen to/ And you must found the man can do/Because he's strong, strong/ and good for protection/ Too much I'm watching you/Man... [Man 1:] The, uh, commercial distribution of contraceptives in Jamaica presented the agency with a very unique marketing problem. We were faced with two decisions: One, how do we get across to the public the message that practicing contraception isgood for their own lifestyles? And secondly, how do we motivate the public to use specific brands of a condom or an oral contraceptive? Well, in the first instance, we decided that we would separate the issues. And realizing that as far a oral contraceptive is concerned, the major problem was one of ignorance. Ignorance to the extent that there were lots of comments being made in the media and generally with regards to the side effects in the utilization of an oral contraceptive. We therefore had to come up with a program which overcame people's inhibitions towards using an oral contraceptive based on the knowledge they have had, rightly or wrongly, of oral contraceptives. As far as the condom was concerned, we were specifically faced with a problem of the image of using a condom. By that I mean, condom uses in Jamaica was very much related to one of illicit love, a situation where a man in a marital situation would not conceive of using a condom inside the home. Whereas, if you were having some kind of relationship outside of the home, the first thing he would think of doing is using a condom. We therefore had to overcome the problem of the image of the condom. Now, how do we do this? In Jamaica we've got a situation where because of the literacy rate, or one should say the illiteracy rate, the population relates very strongly to the sound, sound being radio. So we decided that radio had got to be the primary medium for carrying the message on commercial brand distribution. [Man 2:] Hey there, sweetness. [?] you no want a baby. [Woman 1:] You ready to take care of your big mouth? [Man 2:] I think you ready. [Woman 1:] Listen, man. Is two people make a baby, I know. Is two people have to take care of it. Why we have got baby if [?] already? You just keep on use Panther. That way, we're both protected 'til it where we're ready. [Announcer 2:] Panther Condoms, the safe sensible way to prevent unwanted pregnancies. Panther Condoms, if you care about life. [Man 1:] Our advertising was based primarily on the thought that we were not telling people how many children they should have. We were saying to people if you've got any sense of responsibility, if you care at all about the style of life, if you care at all about the life you live, then you should use a contraceptive. As a woman, Perle. As a man, Panther. The line we have used, therefore, is "If you care about life." [Narrator:] This key slogan appeared on bus stop shelters and billboards, and in newspaper and radio messages. The advertising agency, the National Family Planning Board, and Westinghouse HealthSystems, the consultants, cooperated in making Panther, Perle, and their slogans familiar and acceptable to all levels of Jamaican society. An interesting element here has been the referral system which was devised for Perle Pills, which are available island-wide in the small shops where women make everyday purchases. The very fact that a tradesman in a small neighborhood has direct, personal acquaintance with most of his customers and knows their family situation is a virtual guarantee against contraceptives falling into the wrong hands. [Man 3:] [?] [Woman 2:] And another problem is burning. In the mornings, I have a terrible headache and vomiting. [Man 3:] That being the case... [Narrator:] Women find a visit to a shop not only more convenient but less daunting than a visit to a clinic. The tradesmen in a small town or an urban neighborhood store is a known and responsible figure. His signature on the referral card on the pill packet is an introduction to the clinic. [Non-English speaking] [Man 3:] Take this to the clinic, where you'll see the doctor or the nurse, and hand him this one. [Commercial jingle:] The population/is getting bigger/ Look how much mouth to feed [Narrator:] It was believed that a system to provide backup care for women buying the pill would offer reassurance, both to the consumer and the health community. In actual practice, side effects, which the referral system was designed to monitor, created a problem in only a handful of cases. [Commercial jingle:] We'll make it happen, too/ And [?] a man can do [Narrator:] Today, the social marketing program which brought Panther and Perle to Jamaica is administered wholly by the National Family Planning Board, and sales are increasing at the rate of 20 percent per year. The commercial retail sales program here has made Panther and Perle synonymous with condoms and contraceptive pills throughout Jamaica. Further, the media campaign has helped not only other suppliers of contraceptives but the whole field of family planning. [Commercial jingle:] ...your Panther/Oh, yeah [Music] [Narrator:] El Salvador is the smallest of the Central American republics, where arable land and natural resources are minimal, and population is disturbingly large. Fortunately, there have been in the last two decades a growing number of Salvadorians who recognized overpopulation as a pressing economic rather than an ethical problem and took a pragmatic view of the situation. The Salvadorian Demographic Association took the first steps in 1964, and within a decade, private policy had become public policy, with an integrated national population program. A limited system of commercial marketing already existed. Condom vending machines were established in high-density gathering places such as billiard rooms and clubhouses. [Music] Military bases were other logical sites, as were the social rooms or meeting halls of factories. Thus, commercial retail sales of contraceptives were no new concept. The idea simply had to be formalized and expanded. [Music] [Spanish speaking] [Narrator:] The Demographic Association, with the help of Development Associates, Incorporated, took the lead and began a long series of meetings in which the groundwork was laid very carefully indeed. A full-time staff member of the Association was assigned to work with a consulting organization. The experiences of other countries with successful commercial retail sales programs were studied for their relevance to the El Salvador situation. [Spanish speaking] [Narrator:] Literally all elements of the public and private sectors in any way involved with family health care were called upon at the outset, not only for their individual suggestions and caveats, but for their long-term support to what could be a sociologically important program. [Spanish speaking] [Narrator:] There was strong emphasis on an educational program. Not simply the multimedia campaigns, which a local advertising firm would devise, but a broad plan which would involve all of the agencies in a responsible approach to nationwide understanding. [Spanish speaking] [Narrator:] Donor agencies, consultants, and ultimately the formal committee which supervises all population activities for the government were given an opportunity to participate at every step in the development. [Spanish speaking] [Narrator:] Out of the initial research and subsequent study, the optimal price affordable generally for a contraceptive product was determined, and subsidy was arranged to permit the product to be sold at this low price. [Spanish speaking] [Music] [Narrator:] Radio was, of course, the first major communications outlet. A variety of simple musical messages were audience tested. [Spanish speaking] [Music] [Spanish speaking] [Narrator:] At least one radio spot, although generally admired, was reluctantly rejected as being capable of too broad an interpretation. [Spanish speaking] [Narrator:] Images and symbols were presented to sample audiences in both urban and rural areas. The condor, symbolic of strength and an untrammeled spirit, became the Salvadorian image for the condom. The pearl was named as the most appropriate symbol for a pill program which would follow the launching of the condom campaign. Then the Demographic Association began an intensive effort to enlist the active support, not only of the small urban and rural stores, but of the highly-influential chemists and pharmacists whose advice in healthcare matters is frequently sought by people who might hesitate to seek help from a clinic. [Machine whirring] [Narrator:] Finally, the Condor package went to press, perhaps the most carefully studied container which has ever appeared on the local market. It would soon be available in the furthest reaches of the country at minimal cost and maximum convenience. The condor is already beginning to be as familiar, and acceptable, and ordinary an image as the panther is in Jamaica. In a warehouse in Bangladesh, on the other side of the world, women repackage oral contraceptives under the label Maya. The process represents a dual advance for the women of Bangladesh. For they are still new to the working world, and the product is the pill, which has brought so many of them independence from the ancient burden of almost yearly childbearing. In another room, men are packaging Raja condoms. Raja means "ruler" throughout the subcontinent, but the familiar face of the playing card king acknowledges that the Bangladeshi are passionate card players. These symbols, kingliness for men and beauty for women, dramatized the massive multimedia campaignwith which the Bangladesh government launched its social marketing program in cooperation with Population Services International. Newspaper advertisements and feature stories, radio messages, billboards, and posters, supported by intensive sales and information promotions, made Raja and Maya not only household words, but active promises of a better life for the people of a complexly troubled nation. Here, perhaps first among all the developing nations in which such programs have been tried, the primary consideration was economic, the need to saturate the market through already existing commercial channels at the lowest cost to the consumer and to the administering organization. Today, outlets number more than 32,000 and are constantly increasing, selling an average of two million condomsand 100,000 cycles of pills every month. To date, the Bangladesh total social marketing program has cost about $3.25 per couple per year, including the cost of contraceptives to prevent unwanted pregnancies.