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Volume 8, Supplement 1 – Winter 2014

Growth of the total market approach in developing countries.

Richard Pollard1
Cases in Public Health Communication & Marketing. 2014;8(suppl 1):S4-S18.

Author Affiliations

1 Independent Consultant, Fredericksburg, VA 22406.


Background: This paper sets out to review the history of social marketing (SM) practice and the implementation of the Total Market Approach (TMA) with respect to the distribution of health and family planning commodities in low income countries.

Methods: The United Kingdom Department for International Development (DFID) undertook a significant review of SM practice in 2002-2003, with the collaboration of the US Agency for International Development (USAID) and the German Aid Development Bank (KfW). The DFID review concluded that too few country programs clearly articulated the socioeconomic profiles of the consumers of their products or those obtained from non-governmental organizations (NGOs) and commercial sectors. Important questions included: “Was the total market equitable and efficient in delivering subsidies across all sectors?” and “Where should a donor put its money?” Findings from the DFID study suggested that social marketing served a useful purpose in expanding access to commodities and services, but that these programs should be integrated into market segmentation strategies across the public, NGO, social marketing, and commercial sectors under the developing concept of a Total Market Approach (TMA). This led to the search for benchmark case studies to help elucidate best practice strategies and management policies.

Results: Two projects were identified that seemed to best meet these requirements; Indonesia’s Family Planning Program and the work of the USAID-supported Commercial Market Strategies (CMS) project in North India. Of the two, the Indonesian family planning program appeared to meet all five of the key “benchmark” issues articulated for TMA development: (1) clear data that allowed analysis of equity in provision of commodities and services across all socioeconomic groups and all providers; (2) specific strategies to shift consumers from free public sector provision to private/commercial sector provision, with scarce public-sector resources better targeted to the most vulnerable; (3) the opening up of new private-sector networks of supply in rural areas; (4) close collaboration with the private/commercial sector and the provision of incentives for them to come in with mass-market products at mass-market prices (often linked to public sector procurement policies and procedures); and (5) an integrated management system of the whole market that went beyond just collaboration between sectors. Important characteristics of the Indonesian program are described.

Conclusions: Very significant progress has been made since 2003 in implementing TMA strategies across the across the total market of players — the social marketing, commercial, public, traditional, NGO/CBO, UN Agencies, and related players with some encouraging results. This paper clarifies some of the management and strategic issues that limit the success of programs in the short term, in many countries, and recommends that donors articulate longer-term funding approaches to further develop this important aspect of social marketing and TMA management practice. (Full-text PDF)


  • Social marketing
  • Public health
  • Family planning
  • Contraceptive methods
  • Government subsidies
  • Public-private sector partnerships

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Copyright © 2014 by the Cases in Public Health Communication & Marketing journal.

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