Condom Social Marketing in India

Innovations to drive condom usage

International AIDS ConferenceWashington

July 2012

Background• Condom Promotion historically

associated with Family Planning.– Focus on high fertility states – govt. distribution : free supplies :

public health system

• Communication limited to family planning

• Gap in availability and affordability; – Commercial condoms restricted to

Urban India; – Limited or negligible interest of

private sector in rural areas– High distribution cost barrier

Background….

• Very few (4-5) social marketing organizations covering the entire country. – Only donor supported programs

received adequate coverage– Independent activity in limited

areas by different donors leading to disparate efforts

• Lack of technical and professional management of condom promotion.NACO recognized the need to a have “single national program” with a “focussed approach” to ensure availability of subsidized

condoms to consumers in high priority districts.

Condom Market Segmentation

Commercial Condoms • Urban• Affluent Population

Socially Marketed Condoms• Clients of FSWs, Migrants, Truckers, Males in rural India / lower

income segments in urban India• Subsidized by GoI ; • distributed through retail network via social marketing

organisations (SMOs)

Free Condoms• Marginalised communities• Procurement cost borne by GoI• distributed to Public Health System, NACO TIs.

Government

Targeted Condom Promotion

• Availability and Accessibility: Expanding social marketing programs in the high priority (HP/HF) districts to ensure availability of subsidized condoms to consumers who cannot afford market priced (commercial) condoms

• Focused on increasing demand for condoms among high risk, bridge and general population

• Increasing consumer usage of paid condoms to ensure sustainability

• Ensure condom availability (paid /free) in 100% high risk areas in– Targeted Intervention sites – Trucker halt points– Migrant districts (source,

transit and destination)– Large construction sites

• Minimizing wastage in free supply of condoms while maximizing its access the most vulnerable groups

Targeted Condom Promotion

Implementation Approach

• Comprehensive Targets to ensure program priorities – targets on sales, outlets, demand generation activities with

specific focus on non traditional outlets, rural and mid media contacts, and government brand

• Performance based contracting : – Unique contracting with SMOs with payouts pro-rated to target

achievements– Weightage given to key program priorities

Implementation Approach

• Real-time monitoring of program implementation– field-level information ensures timely interventions and

corrective actions if any required.

• Experienced, professional implementers with strong marketing and sales experience

The Innovations

• Distribution through non traditional outlets– taking the condom to

where the consumer is….

• Demand Generation - –Mid-media – Using local

theatre and folk culture for active social messaging and mass media

Mass media…message deepening

…to enhancing Risk Perception

…to Consistent use

Condom normalization

Phase I2008-09

Phase II2009-10

Phase III2010-11

Phase IV 2011-12

Phase V2012-13

targets

Sales 111m 322m 525m 439m 772m

Outlets 0.3m 0.57m 0.8m 0.63m 1.2m

Districts

194 284 370 398 434

Massive scale up of NACO’s Condom Social Marketing Programme

ImpactCondom market growing at 15% YoY

2007-08 2008-09 2009-10 2010-11 2011-12

0tan6a566260tan8a566280tan7a566170tan17a5662170tan8a56628

0tan21a5661210tan7a566270tan8a566380tan3a566330tan21a566321

0tan18a566118

0tan12a5662120tan8a56628

0tan12a566312

0tan21a566321

Free condom supply Socially marketed condoms Commercially marketed condoms

1,852m

2,694m

2,216m

2,479m

3,008m

Ensuring sustainable condom usage thru increased use of paid condoms

2007-08 2008-09 2009-10 2010-11 2011-12

42%34%

24% 24% 24%

58%66%

76% 76% 76%

Free Paid

Impact

*BSS- Behavioral Surveillance Survey 2006

** Condom Promotion Impact Survey 2010

Condom is easily

accessible

Mean time to access

condom

Consistent Condom Use can prevent

HIV AIDS

Condom use with

non-regular/ casual

partner

Condom Use with

FSWs

98% 77% 89% 77%30min

88% 19min 81%65% 58%

Other Innovations

• Female Condom Program– encourage condom use by

empowering FSW in low negotiating situations.

– FC programme implemented by NACO in 13 states

• Condom Vending Machines (CVM) Program• 10,000 CVM installed across major

towns in the country to provide 24x7 access to condoms

• CVMs integrated into CSMP as non-traditional outlets

Thank You