BASIC HEALTH MANAGEMENT INTERNATIONAL (BHM)
Evaluates project (SOMARC III) to promote contraceptive social marketing (CSM) programs in developing countries, including social marketing of longer-term family planning (FP) methods.
Handyside, Alan|Brooks, Roy · 1996

Abstract
Interim evaluation covers the period 9/92-5/96. The project is on track, and the demand for SOMARC's activities has been greater than expected. Successful efforts have been made to develop longer-term FP methods and to initiate a new marketing venture. Particular success has been achieved in training, public relations, and collaboration with HIV/AIDS prevention programs. Linkages with the Association for Voluntary Surgical Contraception (AVSC) have been less successful. Contacts with commercial suppliers of contraceptives have met with varying degrees of success in various countries. SOMARC's management is highly qualified and its personnel are dedicated to the project. A fourth regional office has been opened, improving management communications at the country level. Training of local management has taken place, but there is still a need for more cross-fertilization of ideas and experiences not only with SOMARC country advisors but also with the cooperating agencies. A financial management information system (MIS) is now in place. Extensive market research has taken place. Efforts have been made to explore global and regional branding, with some success in the latter; global branding seems less worthwhile. Public relations programs have been well developed, and can be used to counter social and religious constraints to contraception. Implementation of a strategy to promote longer-term contraception has been a little slower and less consistent than desired. Recorded couple-years of protection (CYP), in terms of products sold, increased dramatically in 1994, with IUD sales doing particularly well. More attention needs to be given to launching Depo-Provera, and this is in fact being done, with launches imminent in eight countries. In terms of marketing, there have been some notable successes and considerable experience gained. Great care is needed to ensure quality of care in situations where SOMARC provides short-term marketing TA and also where it has a more direct implementation role. Training is being carried out, but monitoring of activities to ensure continued quality of care needs to become a regular part of SOMARC's tasks. In cases of Mission buy-ins, it is important to establish criteria at the outset to ensure that SOMARC's services are optimally utilized and that the cooperating agency is equally accountable for the funds being expended. Budgeting was difficult during the early stages, due to delays in approval of buy-ins, but the overall budget is on track. The recently revised USAID budget procedure will significantly reduce the amounts received from buy-ins, which in turn will increase demands on the central level and reduce the availability of future funds for management and TA; an amendment is needed to raise the core funding ceiling to accommodate these changes. Also, a mechanism is needed to cope with the likelihood that no-cost extensions -- a regular feature of SOMARC to date -- may be more difficult to obtain in the future. Self-sufficiency has proven highly dependent on the nature of each country and each project. Of the 20 SOMARC III country programs examined, 4 have only just started; 9 are first or second generation models at less than 40% sustainability and would suffer a reduction of services if USAID funding were reduced or withdrawn; and 7 are generation three or four models with self-sufficiency greater than 41% and could probably continue operating with reduced USAID support. It is of utmost importance that USAID and SOMARC continue to evaluate together the nature and aims of the programs, and revise sustainability objectives on a case by case basis, especially since SOMARC is tasked with continuing to target middle and lower income groups. In general, however, it is important that a follow-on SOMARC project be continued after 1997.
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Classification
USAID DEC