WEBVTT

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[Music: "I'd Like to Buy the World a Coke"]
I'd like to teach the world to sing/
in perfect harmony (perfect harmony)

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I'd like to buy the world a Coke/
and keep it company/

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That's the song I sing

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[Narrator:] Thanks to international advertising,

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certain commercial product names are household words around the globe.

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In recent years, leaders of the developing world have recognized that these same commercial marketing techniques

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can be used to sell products associated with maternal and child health, and general family betterment.

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[Announcer 1:] Eveready wants you to know.

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[Engine revving]

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[Commercial jingle:]
Volkswagen does it again

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[Commercial jingle:]
Everyone likes the way it says hello/

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Wrigley's Spearmint Gum/

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We all like the way it says hello

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[Narrator:] Out of this conviction

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has grown a new approach to the problem of introducing such health measures as contraceptive methods

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by making them widely known and conveniently available at low cost.

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It is known as social marketing.

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[Music]
[Social Marketing]

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[Music]

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The island nation of Jamaica moves to its own vigorous beat

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with jaunty self-confidence in life and a love of human contact.

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Perhaps this is only the surface character of people wholly serious about their goals and problems,

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but it is nonetheless real and a factor
in what the people of Jamaica respond to.

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The panther is not indigenous, but it is somehow a known and alluring image of strength and cleverness.

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[Commercial jingle:] Everyday, I [?]/We all like protection

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[Narrator:] The pearl has associations with mystery and purity, and high intrinsic value.

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So the choice of these symbols for the contraceptive retail sales campaigns

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has a certain specifically Jamaican logic.

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In Jamaica, as in most other countries where a successful retail sales program has been launched,

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already existing local expertise in research, advertising, and selling techniques was fundamental.

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The project began with an exhaustive study of the potential market

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in which interviews with a broad sample of consumers played an important part.

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Then, a local advertising agency was empowered to design and execute a program based on the research findings.

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[Commercial jingle:]
...happen to/

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And you must found the man can do/
Because he's strong, strong/

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and good for protection/

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Too much I'm watching you/
Man...

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[Man 1:] The, uh, commercial distribution of contraceptives in Jamaica

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presented the agency with a very unique marketing problem.

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We were faced with two decisions:

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One, how do we get across to the public

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the message that practicing contraception is
good for their own lifestyles?

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And secondly, how do we motivate the public to use specific brands of a condom

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or an oral contraceptive?

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Well, in the first instance, we decided that we would separate the issues.

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And realizing that as far a oral contraceptive is concerned,

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the major problem was one of ignorance.

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Ignorance to the extent that there were lots of comments being made in the media and generally

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with regards to the side effects in the utilization of an oral contraceptive.

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We therefore had to come up with a program

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which overcame people's inhibitions towards using an oral contraceptive

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based on the knowledge they have had, rightly or wrongly, of oral contraceptives.

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As far as the condom was concerned,

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we were specifically faced with a problem of the image of using a condom.

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By that I mean, condom uses in Jamaica was very much related to one of illicit love,

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a situation where a man in a marital situation would not conceive of using a condom inside the home.

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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.

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We therefore had to overcome the problem

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of the image of the condom.

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Now, how do we do this?

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In Jamaica we've got a situation where because of the literacy rate, or

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one should say the illiteracy rate,

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the population relates very strongly to the sound, sound being radio.

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So we decided that radio had got to be

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the primary medium for carrying the message on commercial brand distribution.

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[Man 2:] Hey there, sweetness.

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[?] you no want a baby.

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[Woman 1:] You ready to take care of your big mouth?

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[Man 2:] I think you ready.

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[Woman 1:] Listen, man. Is two people make a baby, I know.

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Is two people have to take care of it.

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Why we have got baby if [?] already?

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You just keep on use Panther.

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That way, we're both protected 'til it where we're ready.

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[Announcer 2:] Panther Condoms,

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the safe sensible way to prevent unwanted pregnancies.

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Panther Condoms, if you care about life.

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[Man 1:] Our advertising was based primarily on the thought

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that we were not telling people how many children they should have.

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We were saying to people if you've got any sense of responsibility,

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if you care at all about the style of life, if you care at all about the life you live,

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then you should use a contraceptive.

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As a woman, Perle.

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As a man, Panther.

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The line we have used, therefore, is "If you care about life."

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[Narrator:] This key slogan appeared on bus stop shelters and billboards,

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and in newspaper and radio messages.

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The advertising agency, the National Family Planning Board, and Westinghouse Health
Systems, the consultants,

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cooperated in making Panther, Perle, and their slogans

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familiar and acceptable to all levels of Jamaican society.

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An interesting element here has been the referral system which was devised for Perle Pills,

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which are available island-wide in the small shops where women make everyday purchases.

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The very fact that a tradesman in a small neighborhood  has direct, personal acquaintance with most of his customers

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and knows their family situation is a virtual guarantee against contraceptives falling into the wrong hands.

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[Man 3:] [?]

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[Woman 2:] And another problem is burning.

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In the mornings, I have a terrible headache and vomiting.

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[Man 3:] That being the case...

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[Narrator:] Women find a visit to a shop not only more convenient but less daunting than a visit to a clinic.

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The tradesmen in a small town or an urban neighborhood store

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is a known and responsible figure.

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His signature on the referral card on the pill packet

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is an introduction to the clinic.

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[Non-English speaking]

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[Man 3:] Take this to the clinic,

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where you'll see the doctor or the nurse, and hand him this one.

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[Commercial jingle:] The population/
is getting bigger/

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Look how much mouth to feed

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[Narrator:] It was believed that a system to provide backup care for women buying the pill

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would offer reassurance, both to the consumer and the health community.

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In actual practice, side effects, which the referral system was designed to monitor,

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created a problem in only a handful of cases.

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[Commercial jingle:] We'll make it happen, too/

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And [?] a man can do

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[Narrator:] Today, the social marketing program which brought Panther and Perle to Jamaica

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is administered wholly by the National Family Planning Board,

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and sales are increasing at the rate of 20 percent per year.

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The commercial retail sales program here has made Panther and Perle synonymous

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with condoms and contraceptive pills throughout Jamaica.

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Further, the media campaign has helped not only other suppliers of contraceptives

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but the whole field of family planning.

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[Commercial jingle:] ...your Panther/
Oh, yeah

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[Music]

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[Narrator:] El Salvador is the smallest of the Central American republics,

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where arable land and natural resources are minimal, and population is disturbingly large.

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Fortunately, there have been in the last two decades

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a growing number of Salvadorians who recognized overpopulation as a pressing economic rather than an ethical problem

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and took a pragmatic view of the situation.

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The Salvadorian Demographic Association took the first steps in 1964,

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and within a decade, private policy had become public policy,

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with an integrated national population program.

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A limited system of commercial marketing already existed.

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Condom vending machines were established in high-density gathering places such as billiard rooms and clubhouses.

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[Music]

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Military bases were other logical sites,

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as were the social rooms or meeting halls of factories.

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Thus, commercial retail sales of contraceptives were no new concept.

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The idea simply had to be formalized and expanded.

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[Music]

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[Spanish speaking]

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[Narrator:] The Demographic Association, with the help of Development Associates, Incorporated,

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took the lead and began a long series of meetings in which the groundwork was laid very carefully indeed.

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A full-time staff member of the Association was assigned to work with a consulting organization.

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The experiences of other countries with successful commercial retail sales programs

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were studied for their relevance to the El Salvador situation.

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[Spanish speaking]

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[Narrator:] Literally all elements of the public and private sectors

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in any way involved with family health care were called upon at the outset,

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not only for their individual suggestions and caveats,

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but for their long-term support to what could be a sociologically important program.

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[Spanish speaking]

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[Narrator:] There was strong emphasis on an educational program.

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Not simply the multimedia campaigns, which a local advertising firm would devise,

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but a broad plan which would involve all of the agencies in a responsible approach to nationwide understanding.

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[Spanish speaking]

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[Narrator:] Donor agencies, consultants,

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and ultimately the formal committee which supervises all population activities for the government

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were given an opportunity to participate at every step in the development.

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[Spanish speaking]

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[Narrator:] Out of the initial research and subsequent study,

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the optimal price affordable generally for a contraceptive product was determined,

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and subsidy was arranged to permit the product to be sold at this low price.

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[Spanish speaking]

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[Music]

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[Narrator:] Radio was, of course, the first major communications outlet.

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A variety of simple musical messages were audience tested.

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[Spanish speaking]

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[Music]

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[Spanish speaking]

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[Narrator:] At least one radio spot, although generally admired,

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was reluctantly rejected as being capable of too broad an interpretation.

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[Spanish speaking]

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[Narrator:] Images and symbols were presented to sample audiences in both urban and rural areas.

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The condor, symbolic of strength and an untrammeled spirit,

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became the Salvadorian image for the condom.

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The pearl was named as the most appropriate symbol for a pill program

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which would follow the launching of the condom campaign.

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Then the Demographic Association began an intensive effort to enlist the active support,

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not only of the small urban and rural stores,

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but of the highly-influential chemists and pharmacists

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whose advice in healthcare matters is frequently sought by people who might hesitate to seek help from a clinic.

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[Machine whirring]

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[Narrator:] Finally, the Condor package went to press,

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perhaps the most carefully studied container which has ever appeared on the local market.

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It would soon be available in the furthest reaches of the country

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at minimal cost and maximum convenience.

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The condor is already beginning to be as familiar, and acceptable,

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and ordinary an image as the panther is in Jamaica.

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In a warehouse in Bangladesh, on the other side of the world,

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women repackage oral contraceptives under the label Maya.

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The process represents a dual advance for the women of Bangladesh.

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For they are still new to the working world,

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and the product is the pill, which has brought so many of them independence

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from the ancient burden of almost yearly childbearing.

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In another room, men are packaging Raja condoms.

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Raja means "ruler" throughout the subcontinent,

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but the familiar face of the playing card king

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acknowledges that the Bangladeshi are passionate card players.

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These symbols, kingliness for men and beauty for women,

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dramatized the massive multimedia campaign
with which the Bangladesh government launched its social marketing program

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in cooperation with Population Services International.

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Newspaper advertisements and feature stories,

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radio messages, billboards, and posters,

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supported by intensive sales and information promotions,

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made Raja and Maya not only household words,

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but active promises of a better life for the people of a complexly troubled nation.

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Here, perhaps first among all the developing nations in which such programs have been tried,

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the primary consideration was economic,

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the need to saturate the market through already existing commercial channels at the lowest cost

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to the consumer and to the administering organization.

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Today, outlets number more than 32,000 and are constantly increasing,

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selling an average of two million condoms
and 100,000 cycles of pills every month.

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To date, the Bangladesh total social marketing program has cost about $3.25 per couple per year,

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including the cost of contraceptives to prevent unwanted pregnancies.

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An important factor in the cost effectiveness of the program

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is the speed and thoroughness with which the marketing structure can be used to saturate the market with inexpensive contraceptive products.

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Momentum is maintained by continuing use of colorful displays and the performance of memorable radio jingles.

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[Music]
[Non-English singing]

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[Non-English speaking]

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[Narrator:] Mobile units carry the message out into remote villages.

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Life can be both dull and hard in an overburdened society such as this one.

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Anything new, a fresh voice, a new product,

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can make for a bit of precious entertainment.

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The medicine man in the frontier town is an appreciated figure around the world and throughout history.

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[Non-English speaking]

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[Narrator:] Family planning would be mistaken to overlook such a consummate communicator.

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[Non-English speaking]

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[Narrator:] Now, national leadership has begun to perceive the broader implications of social marketing.

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[Man 4:] Family planning social marketing project in Bangladesh is a three-year-old program.

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It has been distributing mainly contraceptives,

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like condoms and pills, mostly in the rural areas

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and the small towns.

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We have now over 32,000 outlets,

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and this program is covering now one fourth of the total supplies

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of condoms and pills in the country.

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This is a tremendous success for the project.

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We thought that we should be able to use this organization,

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the marketing technique,

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for distribution of other socially desirable

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and priority items in health and family planning program.

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We have got now five items

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for marketing through the social marketing project.

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Number one, in this country, a large number of children

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die because of dehydration, as a result of cholera, diarrhea,

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and other intestinal diseases.

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We have a mix called Oralyte for treatment of dehydration.

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Secondly, the nutritional level is relatively low.

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Less than five percent of children are really in a good condition.

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78 percent of women suffer from various degrees of malnutrition.

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Therefore, we want to introduce vitamin A

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and nutritional supplement, particularly for children,

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pregant women, lactating mother.

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Thirdly, between eighty to ninety percent of our women suffer from various kinds of vaginal infection,

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and there is no good sanitary napkin is available at a reasonable rate, particularly for the rural women.

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Along with that, we are also introducing a foaming tablet as a family planning method

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which has as a side effect, a good side effect,

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of treatment of some of these vaginal infection.

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Then finally in this country, as you know, in the rural areas,

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the clinical services are not easily available.

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We want to use the private practitioner and their clinics.

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We want to support them, and we want to provide social marketing subsidized products,

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particularly in the rural areas.

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[Narrator:] Social marketing can do more than circumvent a cumbersome health care system.

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It can employ those existing outlets which are already familiar and trusted elements in the life of the urban and rural poor.

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It can give them some of the basic aids to family life betterment without costly inconvenience.

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Even more important, without robbing them of the individual independence and dignity

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which all men and women at whatever economic level deserve.

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[Music]

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[Producer: Douglas Larson
Writer: Miriam Bucher
Director of Photography: Paul Noonan]

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[Editor: Michael Barrett
Cameraman: Robert Fennell
Sound: James Reid]

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[The George Washington University School of Medicine and Health Sciences]

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[Department of Medical and Public Affairs
Airlie, Virginia]