Progression

1. Information Dissemination Malaria Job-aids in Kenya Behavior Change Social Marketing Smoking Cessation Commodity Social Marketing Use of Condoms in Philippines, Bangladesh, etc. Interactive Social Marketing/ Lite-Franchising Malarine Treatment in Cambodia Social Franchising Smiling Sun Myanmar Progression Montagu, Dominic

2. Building Public/Private Partnership for Health System Strengthening Social Marketing Maya Baltazar Herrera, FASP, PhD Asian Institute of Management Bali Hyatt Hotel, Sanur, Bali 21-25 June 2010

3. “Why can’t you sell brotherhood and rational thinking the way you sell soap?” – Wiebe, 1952 Social Marketing

4. Outline • Definition of Social Marketing • Role of Social Marketing in PPP and the Health Sector • Sample Social Marketing Programs • Changing the Social Contract: Developing Social Marketing Programs

5. Social Marketing • Use of the tools and principles of social marketing in order to achieve a social good: • Accept new behavior • Use helmets when riding motorcycles • Abandon current behavior • Stop smoking • Reject potential behavior • Avoid alcohol when pregnant • Modify current behavior • Cook using heat that does not produce smoke

6. Marketing • Fundamental unit of marketing is the exchange • At least 2 parties • Each party has something the other wants • Goal is value maximization • Focus of social marketing is behavior change • Also at least 2 parties: policymakers and target adopters of desired behavior • Policymakers reap the public good • Adopters goal is still value maximization • Value = benefit - cost

7. Social Marketing • Focus on target audience: target adopter of new behavior • Presumes that change in behavior is a voluntary act (WIIFM) • Enhances the factors that would increase likelihood of voluntary change in behavior • Matter of creating net perceived value = perceived benefits minus perceived costs • Enhance perceived benefit • Reduce perceived cost

8. Continuing Desire Price Cost Supply Creating Sustainability Demand Differentiating Values Affordability Alternatives Core Competencies Customer Surplus Supplier Earning Support Competencies Threshold Values Source: Herrera, M.B. Asian Institute of Management

9. The Customer Value Equation TOTAL CUSTOMER VALUE TOTAL CUSTOMER COST E Q U A L S Net Delivered Value Product Value PRICE L E S S Services Value Time Cost Personnel Value Energy Cost Image Value Psychic Cost Source: Lopez, T. Asian Institute of Management

10. Tangible Product/Commodity Control of Diarrheal Diseases (e.g. Egypt 80’s) Contraceptive social marketing (Bangladesh 70’s to 80’s, Dominican Republic 80’s) Condom Promotion (Kenya 70’s) Sustained Health Practice Weaning projects (Cameroon 80’s, Indonesia 80’s) Campaigns against smoking Services Utilization Vaccines and Immunization (Colombia, 80’s Philippines 80’s) Commodity-based vs. Behavior Change

11. Commodity-based Social Marketing • Sometimes the desired change in behavior is to promote the general use of a particular commodity (e.g. Condoms for safe sex) • The final desired behavior, then, is the use of the commodity • Supporting behavior changes may be necessary (e.g. of influencers) • Additional interventions may be required (e.g. enhance the supply side)

12. Social Marketing Frontier • More efficient markets in desirable products • Commodity-based marketing • Creating markets where they don’t exist • Non-existent supply • Uncertain unit of exchange, ethical issues • Example: donor organ market

13. Use nets instead TO EARN MORE Not Just Communication A critical mass is necessary Sustainable, commercial supply No communication traction until the message is proven Target Adopters Tropical Fishermen Using cyanide Earn more depends on Price:Effectivity equation Adoption depends on Availability Lopes, T. & Herrera, MB Source: Lopez, T. & Herrera, M.B. Asian Institute of Management

14. Role of Social Marketing in Private-Public Cooperation & Health

15. Social Marketing for PPP • Objective is a social good • Many PPP interventions dependent on reaching new (desired) market equilibrium for sustainability • Change in behavior necessary for achievement of goals • Main public is individuals, who make decisions based on net perceived value • Other players contribute based on goal of value maximization. Different player, different definition of value. • Private sector: profit or mission • LGE: political capital

16. PPP for Social Marketing • Social Marketing complex and multi-phased • Private sector players can provide expertise, reach, efficiency • Private sector participation in social marketing project can be based on: • Commercial transaction • Philanthropy • CSR

17. Health Sector: Outcomes and Behavior • Medical and family history • Lifestyle choices • Living situation • Health-seeking behavior • Timing, locus, treatment • Challenges: • Lack of information • Information assymetry • Affordability and availability of financing • Limited capacity and choice • Multiple decision-makers (patient, doctor, payor)

18. Employing Social Marketing • Increasing the adoption of a product, service or behavior change • Possible Objectives: • Enhance access • Increase alternatives; and enhance quality • Improve affordability • Volume-price dynamics • Increase Quality control • Improve effectiveness and/or efficiency • Especially appropriate when multiple decision-makers are involved (mass markets) and the objective is a degree of self-sustaining market equilibrium

19. Changing behavior through: • Changing mindset • Providing better information • Deliver information from an audience-focused point of view • Enhancing perceived benefits • Message is important: What defines value? • Improve product (e.g. lower dose pills) • Decrease perceived cost • Interventions to decrease price • Interventions to increase availability and choice

20. Increase use of a commodity • Enhancing pereived net value • Interventions to increase demand to commercial volumes • Interventions to establish or strengthen supply chain • Temporary support to manufacturer • Temporary support to distributor • Increase players • Supporting programs • Price control

21. Some Case Studies

22. Motorcycle Helmet CampaignVietnam

23. A Behavior Change Campaign • Vietnam: Over 11,136 people motorbike accident deaths annually between 2002 and 2006. • Ogilvy created a pro bono advertising campaign for the Asia Injury Prevention Foundation. • Multi-media: Television, print, postcard, radio and internet ads.

24. Shock Tactics • The Ogilvy Campaign • %age of helmet-wearing in Hanoi and Ho Chi Minh doubled (10.8% to 19.2%) in four months. • Campaign influenced legislation. Mandatory helmet wearing advanced to 2007 from 2008.

25. Evolution Children are exempt from mandatory helmet-wearing Cost is a barrier for many motorcycle riders A coalition of public sector agencies, corporations and non-profits pursue a multi-pronged approach: Awareness campaigns. Making helmets more affordable. Giving away helmets. Vietnam Helmet Wearing Coalition 2-hour parade through Hanoi Open air concert News stories Stories of victims

26. Commodity-based Campaigns • Many cases in Reproductive Heath – Condoms and Pills • Raja and Maya in Bangladesh • Trust in the Philippines • A mix of communication, initial subsidies and other (e.g. funding and financing) interventions • Two general approaches • NGO-based • Manufacturer-based • Financial Sustainability is key • Unrealistic expectations often a cause of failure

27. Behavior Change with a Product • Eliminating Leprosy in Sri Lanka • “Hidden” cases, high involvement decisions, irrational fears • Promo: Communication campaign addressed to “possibly infected” and influencers • Place: Increase treatment points-75 to 225 • Price: Novartis Foundation provides MDT free of charge • Monitoring: Opinions, epidemiology • Williams, et al. Social Marketing Quarterly, Summer 1998 • Similar campaigns used for HIV/AIDS and TB

28. Branding • A recognizable identity • Credibility • Can be leveraged to other projects • Can be leveraged to increase participation • When highly successful, the brand itself becomes a message

29. The Magic EyesCampaign Began in the 1980’s to address environmental concerns Directed at children Historically highly successful Now on-line interactive Expanded into forest conservation and waterways restoration

30. A New Social Contract

31. Marketing CampaignCore Elements • Cause-Social Objective • Change Agent-Individual/organization • Target Adopters-Individuals/groups/societies • Channels-Communication/distribution paths • Change Strategy-Direction and program

32. Analyze the social marketing environment Researching and selecting the target adopter population Designing social marketing strategies Planning social marketing mix programs Organizing, implementing, controlling, and evaluating the social marketing effort Social Marketing Process

33. Product KNOWLEDGE ATTITUDE PRACTICE Promotion Behavior Price Target Adopter Supplier Social Marketing Mix Place Other Stakeholders, Influencers Policy, Politics Partnerships Purse Strings The Social Marketing Mix Source: Herrera, MB Asian Institute of Management

34. Understanding Behavior Exposure Attention Mind share Mindset Retention Input Thinking Feeling Action Behavior Belief Organization Cues Mindset Attitude Habit Source: Herrera, MB Asian Institute of Management

35. Working with the Private Sector • Market Research • Communications Campaign • Professional Provider • NGO, FBO, MBO • Communities, Social Networks • Follow up communication and monitoring • Manufacturers • Distributors • Project Managers • Evaluation Why PPP? Capabilities & Success

36. Life Cycle of A Social Marketing Campaign Popular Cause Managerial Crusade Bureaucratic WJ Schroer & Co.

37. Reality Check • What is the objective? • Who is the primary audience? • What change in behavior are we looking for? • What other conditions are necessary to achieve desired change in behavior? • Who are other stakeholders, publics? • Are there required changes in behaviors of other publics?

38. Thank you!

39. Resource Slides

40. A Historical Perspective

41. Stage 1 (1960’s to 1970’s) • Early forms PSA’s and slogans • Use of full range of marketing techniques for social causes in 1960’s • Nutrition and health education • “Social Marketing” first coined by Kotler & Zaltman, 1971 • Social change management strategy • Coincided with 1970’s push towards greater individual responsibility Sources: Walsh et al, Social Marketing, for public health Ling et al, Social Marketing, its place in public health

42. Stage 1 (1960’s to 1970’s • What is it? What can it do? Is it even marketing? What is involved? • “Demarketing” • Advertising to Communication to Social Marketing • Practice and Guidelines developed • 1980’s (Kotler; Manoff) Sources: Walsh et al, Social Marketing, for public health Ling et al, Social Marketing, its place in public health

43. Evolution – Stage 2 (1980’s) • Does it work? What affects how well it works? • Evaluation of methods, esp. of evaluation (after only; no control groups) • Earliest documented success: contraceptive social marketing (Population Reports, 1980) • Preceded and enhanced by general societal shifts in attitudes on sex & gender • Identification of challenges involved in public health • Health related commercial marketing begins Sources: Walsh et al, Social Marketing, for public health Ling et al, Social Marketing, its place in public health

44. Stage 3 (1990’s and onwards) • Social marketing much more pervasive in public health • Generally regarded as a useful tool • Still little understood by many health professionals • Capabilities and expertise largely in the private sector • Integrate with allied practices ; Take a broad view; Broader coalitions Sources: Walsh et al, Social Marketing, for public health Ling et al, Social Marketing, its place in public health

45. Lessons Learned • Segmentation and target market understanding critical • Strategies must address motivations of each sector • In implementation: leadership support and community participation are important; integrating learning from monitoring in implementation is critical Source: Walsh et al, Social Marketing, for public health

46. Limitations and Caveats • Theory versus Practice • Research to know vs. Research to show • Market vs. Social values Source: Walsh et al, Social Marketing, for public health

47. Some References • Total Exposure, Gustav Carlson • Walsh et al, Social Marketing for Public Health (w/ Primer) • Ling et al, Social Marketing, its place in Public Health • Social Marketing Quarterly • www.social-marketing.org • www.wpp.com (CSR) • http://www.psp-one.com (USAID resource) • Private Sector Partnerships for better health • Managing Brand Equity, David Aaker • WJ Schroer Co. – website • Corporate Image, Wally Olins • www.social-marketing.com • What is Social Marketing?, Nedra Kline Weinreich • Serrat, O. The Future of Social Marketing. ADB paper. January 2010. (Note: Short and sweet primer)

48. Micro (Individual) Group (Organization) Macro (Society) Short-term Change Behavior Change Change in Norms Macro (Society) Long-term Change Lifestyle Change Organization Change Macro (Society) Dimensions of Social Marketing Source: Levy & zaltman. Marketing, Society and Conflict, Prentice Hall, 1975

49. Cell A Initiative to persuade men to be examined for colon cancer - cost is low -action clearly benefits the individual Cell B Recycling programs - cost is low - action benefits society TheType of Initiative... Cost is low Intangible, societal benefits • Cell D • Initiative to reduce • chlorofluorocarbon (CFC) • - cost to affected chemical • companies is high • - action benefits society • Cell C • Smoking cessation program • - cost is (difficulty) is high • -action clearly benefits • individual first Tangible, personal benefits Source: Do Better at Doing Good; Rangan, Karim and Sandberg Cost is high

50. Cell A - clear, direct benefits - change is easy - communication and information are key Cell B - intangible, indirect benefits - change is easy - ultimate benefits should be stressed - convenience is key …and the Challenge It Presents Cost is low Intangible, societal benefits Tangible, personal benefits Cell D - intangible, indirect benefits - change is difficult Try to reposition into Cell C; if repositioning is impossible: 1) Try leveraging the enthusiasm of early adopters 2) Try supply-side persuasion Cell C - clear, direct benefits - change is difficult - balancing communication efforts with strong support system is key Source: Do Better at Doing Good; Rangan, Karim and Sandberg Cost is high