Save the Children Nepal field office : child survival 3 social marketing project -- final evaluation report

The project has achieved a high level of success. Most objectives were accomplished beyond targets -- a good achievement given the difficult mountainous terrain in the area and the fact that rural communities are usually conservative about purchasing health care products. Most notable is that awareness of family planning and the need for child spacing, and knowledge about diarrhea as the major killer of children, are high among all communities in the project area. SCF's skillful and enthusiastic use of group discussions and mass media promotional activities has desensitized communities to contraceptives and family spacing so that now villagers speak freely about these issues, even in group situations. A great variety of communicational materials (charts, leaflets, videos, audiocassettes, etc.) were produced. Drama was found to be an extremely effective means of mass communication. Sales of both pills and condoms through the project have increased, and contraceptive prevalence has risen significantly, although the latter is partly due to increased use of Depo Provera, which is becoming the method of choice for family planning throughout Nepal. The project has achieved good contraceptive continuation rates, with regular use exceeding targets. The project has also led communities to realize the importance of oral rehydration salts (ORS). Sales of Jeevan Jal ORS rose well (initially 14% higher than targeted), but were adversely affected by a sudden, steep price increase which was beyond the control of the project. The product distribution system works well. The project has ensured a regular supply of products to sales agents and consumers. Further training on storage is needed, however. The school health program is also going well, and should continue. The main failure of the project has been its inability to achieve a phase-over of key activities to Contraceptive Retail Sales Ltd. (CRS), or to any other institution, to ensure future sustainability. Despite this failure, relationships with CRS at the middle management level have been excellent. CRS has provided the project staff with advertising materials, timely distribution of products, and useful marketing advice. Efforts are still needed to reach the poorest of the poor, who remain underserved. The project teaches that start-up costs for a social marketing project are high. Costs have to be incurred for staff training, liaison with other agencies, and in gaining the support and interest of the community. In contrast, recurrent costs are low.