Child survival VII : Cameroon social marketing project -- final evaluation

The project"s main activities were social marketing of condoms, oral contraceptives, and oral rehydration salts (ORS). The project covered the 10 most populated urban centers in Cameroon, targeting 515,000 women of reproductive age and 397,000 children under 5 years of age. The project accomplished its target for distributing condoms (16.8 million were distributed in the 3-year period), and thereby the objective of increasing the contraceptive prevalence rate by 3%. Unfortunately, circumstances beyond its control prevented the project from achieving its targets for distributing oral rehydration salts (ORS) and oral contraceptives, and, consequently, from achieving the objective of increasing the use of oral rehydration therapy. Efforts in these areas were impeded by lengthy delays in obtaining a country agreement between PSI and the Ministry of Health (MOH) and regulatory approval for the sale of ORS and the oral contraceptive (Norminest), as well as by a court seal, imposed by the former subcontractor, of the warehouse in which the commodities are stored. The following lessons were learned. (1) Although social marketing involves mainly the private sector, the implementing agency needs to establish a good working relationship with the MOH and to obtain its involvement and formal commitment during the project"s design. Also, the implementing agency needs to establish a presence in the host country"s capital, which is conducive to a close working relationship with the MOH. (2) In order to provide protection from potential litigation, the MOH needs to be formally involved in contractual agreements as a partner. (3) Granting of government regulatory approval for pharmaceutical products or its waiver should be included in the USAID bilateral agreement where such products are funded bilaterally. (4) A regional strategy using sales agents based in each province to assist the local wholesalers in marketing and promotion is successful in increasing sales. (5) Care should be taken in selecting distributors. A monopoly distributor should be avoided. (6) It may be useful to enlist the help of NGOs that have community health projects in order to reach rural areas that are not well served by the commercial distribution network. (7) Small-scale baseline research should be carried out before a promotional campaign or activity, in order to provide a basis for planning, monitoring, and evaluation of the activity. (Author abstract, modified)