A global review of the evidence on the social and behavioral drivers of demand for the child health commodities was conducted and synthesized into summary tables for the child health commodities. This research was analyzed and described in a full report and spotlight brief. Background information and technical documents, such as technical briefs and links to key resources, are available for amoxicillin and ORS/zinc.

The situation analysis focuses on gaining a deeper understanding of the challenges and barriers to address within a specific context that influence the current demand and utilization of a priority RMNCH commodity, including individual knowledge, attitudes and behaviors of providers, end-users and other influencing audiences; social and cultural norms; potential constraints on and facilitators for individual and collective change; and media access and use by the intended audiences. It also examines the status of each commodity, including relevant policies, regulations, manufacturing, prices, supply-chains, and availability. In short, the situation analysis answers the question, “Where are we now?” 

Conducting a situation analysis typically involves collating available data and resources and then convening a group of stakeholders to review and identify key information.

“Conducting a National Assessment on Demand Generation for Underutilized, Life-Saving Commodities: Guidance and Tools” provides guidance to country-based partners to carry out collection of relevant data. Sources of country-specific secondary data may include Demographic and Health Surveys (DHS) or Multiple Indicator Cluster Surveys (MICS), quantitative and qualitative research conducted by NGOs, or private sector market research, where available, such as Nielsen. RMNCH policies and guidelines may also assist in analyzing the situation.

The tool also provides semi-structured interview guides to collect information from key stakeholders, including RMNCH program staff within the Ministry of Health, procurement agencies, donors and other experts such as private sector wholesalers, manufacturers and academic institutions.

Lastly, the tool provides guidance in holding a stakeholder workshop to review the findings and reach consensus on implications and next steps for country activities.

If existing data, particularly on social and behavioral drivers, is not sufficient, is outdated, or does not provide enough insight into priority audiences, it may be necessary to conduct additional primary formative research through quantitative surveys or qualitative research methods such as focus group discussions, key informant interviews, and observation checklists. It may be especially important to conduct formative research around provider attitudes and other drivers to provider behavior, as this information is typically less available. If primary formative research is required, the findings should be analyzed prior to the start of strategy development. Guidance and tools to conduct formative research are provided in the additional resources listed.

The situation analysis has two main sections:

Health and Commodity Context:
An important part of the situation analysis is information on the health situation and the commodity context. This section examines the disease incidence and prevalence of diarrhea and pneumonia, recommended treatment protocols, and issues around amoxicillin and ORS/zinc commodity registration, prices, manufacturing, supply-chains, and point-of-access for end-users.

Audience and Communication Analysis:
The audience and communication analysis examines the social and behavioral drivers that facilitate or act as barriers to uptake of the commodity. Completing this section enables program managers to

1. Determine potential audiences and their characteristics, those who influence them, and the drivers and barriers to behavior change.
2. Identify potential communication resources, including communication channels, ongoing activities, and organizational and professional resources.
3. Assess the environment to determine availability of products and services being promoted, accessibility, affordability and acceptability.
4. Assess the social, economic and political conditions influencing behavior.

Illustrative questions to guide a situation analysis for ORS, zinc and amoxicillin can be found here.

Gender norms, cultural expectations, and roles of males and females within a community may be key barriers to increasing demand for contraceptive implants, emergency contraception, and female condoms. Therefore, it is important to identify gender-related determinants of health behavior during the situation analysis in order to achieve successful program design and implementation.

Addressing the Role of Gender in the Demand for RMNCH Commodities: A Programming Guide provides information and practical tools to help program managers determine how gender norms and roles for both men and women affect the demand for the commodities, and how to address these norms and roles to ultimately increase the demand for and utilization of these commodities. The Guide includes guidance and a checklist on integrating gender into the situation analysis.

After developing a strong situation analysis, program managers should be able to identify the key implications or challenges from the data. What are the reasons that ORS, zinc and amoxicillin are not being utilized? Are the commodities available? Are they affordable? Are they part of the national essential medicines list or standard delivery protocols?  What do potential users – end-user, health care providers, and health educators – believe about the commodity? What is the potential market for commodities? Finally, select only a few key factors that the demand generation strategy will address. While it is tempting to address all factors, successful communication programs focus on the factors that will have the biggest impact given available resources.

Population Services International Global Social Marketing Department offers the following series of questions to guide the the selection of strategic priorities: