Demand Generation I-Kit for Underutilized, Life Saving Commodities

Step 5: Determine Activities and Interventions

Examples of activities and interventions for each of the commodities are provided below as illustrative examples. These should be adapted to the country context.

Activities and interventions allow for communication of key messages through a variety of communication approaches and channels. Well-designed demand generation programs include activities across a range of different intervention areas and communication channels to reinforce messages and reach the audience when they are most receptive to the message. An overview of the types of strategic approaches that can be used is available here.

Activities and channels should be carefully selected based upon type of messaging, ability to reach the intended audience through a variety of media/channels, timeline, cost, and available resources. It is helpful to refer to findings from the situation analysis to guide selection of activities and interventions. Some channels and activities may be better suited to addressing particular behaviors or behavioral determinants than others.

Theories are often used to guide the design of messaging content aimed at increasing demand for health services and commodities. However, it is less common that theories are used to guide the selection of the media through which those messages are conveyed. In fact, given that different media have different capacities and abilities to effectively transmit information, the medium and the message cannot be considered separately—one needs to select media and develop content in concert and in a way that optimizes both. A new “Theory-Based Framework for Media Selection in Demand Generation Programs is a tool to assist program managers carrying out demand generation activities in identifying and selecting the appropriate media channels, including ICT and new media channels. More tools on choosing communication channels are provided in the additional resources.

Recommended communications channels, or intervention areas, for maternal and newborn health demand generation strategies include:

Mass Media

Mass media includes radio, television, print (newspapers and magazines), and outdoor signage (billboards, advertising on buses and taxis, etc.). Mass media is an excellent option to reach a wide audience, although it can be expensive and cost of production and purchase of airtime must be factored into budgeting. Television allows for storytelling, demonstrations of the desired behavior and, when well done, a TV spot can be highly memorable.  In some countries television reaches all socio-economic sectors, while in other countries, TV is a luxury. Radio can also reach a wide audience, allow for storytelling and be memorable, especially when messages are linked with songs or jingles. In some countries, radio stations are targeted to specific audiences, which may be helpful when selecting the best ways to reach audience segments. Radio is typically less expensive than TV.

The effectiveness of print media varies widely by country and literacy rates must be considered. Print can be effective for advocacy efforts, especially when selecting newspapers read by decision-makers. Outdoor advertising reaches audiences based on geography and not based on demographics. The audience reached will likely see the message repeatedly if they pass by the outdoor media regularly.

Given the wide reach of mass media, with the potential to reach thousands of people, a small to moderate effect size will have a greater impact on public health than would an approach that has a large effect size but only reaches a small number of people. Thus mass media can have a major public health impact given its wide reach, when done well. However, not all messages are appropriate for all media, and may for example, be better suited to interpersonal communication or other channels.

Illustrative activities in the mass media domain are provided in the illustrative examples. Materials from mass media campaigns and other tools are also available in the additional resources.

ICT and New Media

Information and Communication Technologies (ICTs) are electronic, digital technologies that enable the creation and exchange of information. ICTs provide the platform for new media, such as web-based applications and social media sites, which, in comparison to traditional media like radio or television, are interactive and empowering. Given the global proliferation of mobile and wireless technologies, ICTs and new media have the potential to transform health communication and service delivery. ICTs and new media offer methods for connecting and mobilizing consumers and providers – even those living in hard-to-reach areas – and reaching them with up-to-date health information.

Examples of demand generation programs utilizing ICT and new media are presented in “Utilizing ICT in Demand Generation for Reproductive, Maternal, Newborn and Child Health: Three Case Studies and Recommendations for Future Programming” which presents key program design elements, evaluation data and lessons learned. Other tools and examples on the use of ICT and new media are also available in the additional resources.

Clinics, Pharmacies and Drug Shops

Demand generation activities focused on clinics, pharmacies and drug shops can be targeted both to providers and to clients. Effective activities targeting providers include medical detailing, provider training, and supportive supervision. For clients, the most common demand generation activity is high quality counseling. Additional activities targeted to clients include clinic-based small group education sessions and availability of print materials such as brochures and posters.

Counseling is a critical demand generation activity in clinics because the environment is ideal for communicating key messages.  Counseling sessions are often one-to-one communication opportunities, which allow clients to ask questions and providers to tailor the information and key messages. Second, health care providers are typically trusted and influential sources of information, which lends credibility to the key messages. Counseling tools or job aids can be part of a demand generation plan, and are used to help clients and counselors improve their interactions. Service providers should be trained to use the tools and aids.

Illustrative activities in clinics, pharmacies and drug shops are provided in the illustrative examples. Materials from such activities and other tools are also available in the additional resources.

Community-based services and outreach

At the outset, it is important to note the differences between community-based services and community-based communication efforts, even though both approaches share many similarities.

Community-based outreach is generally face-to-face interaction with a target audience that aims to generate demand for commodities or services, or to change behavior. Community-based outreach can be conducted through interpersonal communication (IPC) in one-to-one or one-to-group counseling. Job aids such as flip charts and brochures are helpful communication tools for IPC workers, when they are culturally appropriate and designed to accommodate literacy levels, and their development or adaptation should be included in demand generation plans that contain IPC activities. Another community-based outreach approach is community mobilization, which is the process of bringing people together to share a vision, promote dialogue, build their capacity and take collective actions to address problems affecting the entire community. It makes people feel that they are a member of a community even if they are not directly affected by the issue.

Community-based services are the provision of health care services in communities, outside of clinics. Most community-based service programs include an IPC strategy to generate demand for the services.

Recent studies are showing that community-based services are effective for improving outcomes in health areas as diverse as post-partum hemorrhage and childhood pneumonia. Incorporating community-based strategies into a demand generation plan can be effective if community-based services are permitted in the context where you work. If community-based services are not permitted, you may consider adding advocacy for this strategy to the demand generation plan.

Illustrative activities in community-based services and outreach are provided in the illustrative examples. Materials from such activities and other tools are also available in the additional resources.

Structural Approaches

Structural approaches for demand generation include development and/or dissemination of policy and guidelines, advocacy with decision-makers, and pre-service training for providers. Scaling Up Lifesaving Commodities for Women, Children, and Newborns: An Advocacy Toolkit  provides advocacy resources for utilizing the Commission platform to raise awareness and engage stakeholders in addressing commodity-related gaps in policy.

Illustrative activities for structural interventions are provided in the illustrative examples. Materials from such activities and other tools are also available in the additional resources.

Linkages with non-communication programs

Communication campaigns will be most successful when they link with programs that have an impact on demand. For maternal and neonatal health communication campaigns, two important program linkages are efforts to train health care providers to utilize misoprostol, magnesium sulfate and chlorhexidine and supply and distribution initiatives to ensure the availability of the commodities. The following are examples of additional programs with which demand generation programs should develop linkages:

  • Other maternal and newborn health/safe delivery programs that do not currently include misoprostol, magnesium sulfate and/or chlorhexidine
  • Quality of care improvement initiatives for service providers/clinics
  • Pre-service education and existing continuing education or in-service refresher training initiatives for clinical and non-clinical providers
  • Supply chain management and market shaping
  • Non-maternal and newborn health programs such as antenatal/postnatal care etc. (e.g. to provide counseling, disseminate materials) – at both the clinic and community levels

Public-Private Partnerships

Public Private Partnerships (PPPs) are sometimes an appropriate and effective way to increase resources, expand revenue streams, increase visibility and expand credibility for demand generation programs. Successful partnerships are engaging and mutually beneficial for both parties and consider the other partner’s relative comparative strengths. Each partner brings expertise to the table, but also each has constraints and competing demands, as well as opportunities to be explored.

"The P for Partnership": Addressing the Role of Public Private Partnerships to Increase the Demand for RMNCH Commodities provides information and practical tools to help program managers determine how to develop PPPs to ultimately increase the demand for and utilization of these commodities. This tool provides a typology of PPP models along with step-by-step guidelines on how to select private sector companies and how to create effective partnerships for demand generation programs. By utilizing this tool, managers will be better equipped to engage the private sector and understand various types of partnerships for demand generation.

Other tools and examples on PPPs are also available in the additional resources. 

Illustrative Activities and Interventions

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Maternal and Newborn Health

Misoprostol Magnesium Sulfate Chlorhexidine

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