She’s at the Center of It All: Women and Family Planning Markets

Total Market Approach to Family Planning

Julia N. White

Reproductive Health Supplies Coalition | Market Development Technical Officer
Women in Cameroon receive membership cards for a mutual health organization intended to reduce out-of-pocket healthcare costs.

Women in Cameroon receive membership cards for a mutual health organization intended to reduce out-of-pocket healthcare costs. © 2012 Okwen Patrick Mbah, Courtesy of Photoshare

Markets are made up of human beings. They are not just emotionless spaces where products and services are bought and sold. This is especially true of the market for family planning products, which ideally provides “...women with a range of options, enabling them to choose for themselves how to best fulfill their individual reproductive intentions” (see Market Shaping for Family Planning, p4). And yet, when mired in theoretical discussions of total market approaches, market dynamics and supply chains, it is all too easy to forget these people within the market. But to ensure a healthy market where a woman can choose the contraceptive method that works best for her, we first must understand what she wants and needs (think human-centered design).

This means we should approach the market from the perspective of the consumer, not just the product. Discussions of markets for family planning have historically started by analyzing product supply, including who is providing what, where, and at what price points (see Cases and Evidence for Sustainable Population-Level Behavior Change). This is important, but it is not sufficient. As outlined in USAID’s Healthy Markets for Global Health: A Market Shaping Primer, it is important we observe the market from different angles to see interrelated supply and demand issues described as the “5 As” (Affordability, Availability, Assured Quality, Appropriate Design, and Awareness). While the challenge of taking on this holistic approach is sometimes daunting, especially in the face of limited time and resources, we must ask ourselves: what is the point of making all products and services available [supply], if they will never be used [demand]? This is where the demand-side considerations—so crucial to achieving universal health coverage—come into play.

As such, here are some ideas to consider when designing a market assessment for family planning:

Ethiopian community-based distribution agent

In Ethiopia, a community-based distribution agent, who is also a local traditional birth attendant, visits a village where she is leading a discussion about family planning. © 2005 Virginia Lamprecht, Courtesy of Photoshare

  1. Bring together players from the different sectors to analyze a mix of socio-demographic, method mix, consumer insight, supply and demand data to determine how to sustainably grow the total market in a given country. In the article Applying a Total Market Lens: Increased IUD Service Delivery through Complementary Public- and Private- Sector Interventions in 4 Countries, I talk about the different data PSI affiliates and Ministry of Health counterparts looked at in carrying out family planning market analyses: from contraceptive prevalence rate (CPR), method mix, method use and method source to provider skill and motivation, commodity supply chain, consumer awareness and demand, and availability of equipment. The Total Market Initiatives for Reproductive Health primer gives other examples, including a one-day workshop conducted in Cote d’Ivoire with key stakeholders and available data.
  2. Systematically integrate an understanding of consumer behavior into market assessments. Building on its promotion of client-centered market segmentation under the PSP-One and SHOPS projects, SHOPS Plus has taken on a more systematic and strategic approach to integrating market segmentation into private sector assessments. In addition to looking at the demographic and socio-economic situation of potential family planning users in their assessments, SHOPS Plus incorporates behavioral dimensions. Monitor Assessment to Action for updates. Contact SHOPS Plus for more information.
  3. When assessing the market, don’t forget about the importance of key gatekeepers, such as providers. In family planning, they can heavily influence consumer choices.
  4. Bring consumers and gatekeepers to life by creating archetypes based on relevant market data and descriptive information (see Qualitative Research for Social Marketing: One Organization’s Journey to Improved Consumer Insight).
  5. Write up and share your approaches and experience with the family planning community. We need more case studies and we at the Reproductive Health Supplies Coalition would be happy to disseminate them through the Market Development Approaches Working Group. Contact me, Julia White.