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Marketing contraceptives in rural Thailand.


 It can be difficult to administer and motivate field workers in family planning programs. In the case of social marketing, the last distributors in the chain are small shopkeepers who keep part of the final sale price. Thus contraceptives become part and parcel of their routine business, and the margin becomes both their remuneration and their motivation. In Thailand and most other countries with social marketing programs, part of the selling price also returns to the program, providing some degree of cost recovery. As family planning succeeds and per capita incomes rise, individuals will be able to pay an increasing part of the total cost of family planning. In the interim, international agencies and governments will continue to provide subsidies. In rural countries like Thailand, social marketing programs can be initiated and expanded relatively rapidly because they build on an existing infrastructure; they can also reach the most distant parts of the country. Skills of local advertising agencies are available in practically all Third World countries. Sales are a reliable record of progress and can be used to suggest innovations or practical solutions to problems. Small shopkeepers often feel more comfortable vending contraceptives than many experts would expect and as members of the community, intuitively know what the community's standards are. Individuals handling oral contraceptives often require some training and supervision by full-time staff who can answer questions that arise; local physicians may also be notified of the program for referral of problem cases. If there is a problem with social marketing programs, it is that they are sometimes too successful--leading to large bills for contraceptive commodities. However, if evaluated in terms of cost-effectiveness, they are less expensive than their alternatives. Along with access to voluntary sterilization and community-based distribution programs, social marketing is a keystone in the arch of family planning in the 1990s. Experience in Thailand shows family planning is wanted and relatively rapid changes in fertility and family size can be achieved. Social marketing is a common sense, cost-effective, democratic way of meeting a universal need in a culturally appropriate way.
