Technical Services » Health Markets and Private Sector Engagement

Futures Group’s technical services to improve health markets and private sector engagement include

  • Public-Private Partnerships
  • Innovative Financing
  • Contraceptive Security/ Commodities
  • Health Promotion and Behavior Change Communication
  • Market Analysis, Segmentation, and Growth
  • Product Marketing and Distribution
  • Supply Chain Management

These services are described in more detail below.

Public-Private Partnerships

Since the early 1980s, Futures Group has played a major role in private sector approaches to family planning, reproductive health, maternal and child health, and infectious diseases, such as HIV and AIDS around the world. It has played this role primarily through successful public-private partnerships (PPPs) and integrated social marketing programs under the auspices of USAID, KfW, World Bank, national governments, and the Department for International Development (DFID). Futures Group’s strategy is centered on its “Total Market” approach: mobilizing the resources and competitiveness of the commercial sector, the social focus of the nonprofit sector, and the policies and mandates of the public sector to meet important public health objectives. Partnerships with the public sector are critical: private sector engagement maximizes finite public and donor resources by serving those who can afford to pay, while redirecting subsidies to those who truly need them.

The USAID-funded Innovations in Family Planning Services II Technical Assistance Project (ITAP) has used sustained information-based advocacy efforts to overcome resistance to PPPs. This was done through a series of workshops based on information collected on various PPP models in the health sector. ITAP established PPP linkages and mapped total resources available in both sectors. In consultation with the state governments and private partners, ITAP identified suitable models for three states that are now being implemented—including social marketing, social franchising, contracting out public health facilities to the private sector, demand-side financing through a voucher system, clinic-based NGO projects, and mobile health vans.

Under the POLICY II Project, and continued through the current USAID│Health Policy Initiative, Futures Group seeks to mobilize the private sector through supporting the development of business councils. Established in over seven countries, these business councils have become an effective mechanism for exchanging information across the business community; encouraging members to adopt policies and leverage resources for health programs; and fostering linkages and partnerships among the government, civil society, and private sectors.

Futures Group has worked extensively to develop and improve policies and regulations addressing the private sector in the health arena. Under the Communication for Behavior Change: Expanding Access to Private Sector Health Products and Services in Afghanistan (COMPRI-A) Project, Futures Group created the first formal private-public sector committee and office within the Ministry of Public Health that addresses private sector involvement with public health issues, both legal and regulatory. In addition, the Futures Group team guided the development of a national private sector policy supporting the provision of health care by private practitioners and health facilities.

Innovative Financing

Futures Group has been at the forefront of implementing some of the most successful innovations in healthcare financing—focusing on mobilizing new resources, allocating and using resources effectively and equitably, and designing and implementing innovative financing mechanisms. Futures Group mobilizes resources by advocating for creation of a budget line item for family planning, including FP/HIV into social insurance schemes, and linking FP/HIV to development programs and new financing mechanisms, such as SWAPs, PRSPs, Global Fund, and budgeting processes. We have informed and influenced resource allocation decisions using the ALLOCATE, Goals, Resource Needs Model, and Safe Motherhood models in many countries.

Futures Group has designed and implemented various financing strategies to remove financial barriers to access among rural and urban poor. For example, under the USAID-funded ITAP Project, Futures Group initiated a voucher program that ensured greater access of the poor to accredited healthcare services. Futures Group identified select health facilities and ensured that their quality of services were accredited and met standards set forth by the government of India. Furthermore, Futures Group developed detailed operational plans to ensure that the voucher program addressed financial issues and that those needing the voucher most were the actual direct beneficiaries. Communication tactics were also key to advertising the voucher program to stakeholders and the general population, as well as training those who directly oversaw implementation of the initiative.

Contraceptive Security / Commodities

In promoting contraceptive security (CS), Futures Group advocates for every person having the opportunity to access and use contraceptives freely for HIV/AIDS prevention and family planning. Futures Group strives to ensure long-term access to high-quality contraceptives and other essential health supplies and has a rich history in data-driven contraceptive and commodities needs projections. We were instrumental in developing and applying the Strategic Pathway to Reproductive Health Commodity Security (SPARHCS), a strategic planning tool and framework to help increase access and availability of high-quality contraceptives. Focusing on evidenced-based advocacy, our approach to SPARHCS proved successful in mobilizing government resources for commodities, particularly in the Near East and Latin American/Caribbean, where contraceptive commodity assistance from donors is lessening.

Under the USAID | HPI Project, Futures Group has supported promotion of contraceptive security in El Salvador by helping form and strengthen a national CS committee, despite many political obstacles, including pressure from the Catholic Church and other groups opposed to family planning. HPI helped the CS committee develop work and action plans, design advocacy strategies, conduct market segmentation analysis, create market segmentation plans, and project contraceptive commodity requirements. Advocacy by the CS committee led the government to establish the National Safe Motherhood Program in September 2008, creating a budget line for procuring all contraceptive commodities. This major victory set up a mechanism to secure national funding for contraceptives and showed government commitment to taking responsibility for and assuring the availability of contraceptive supplies.

Under the KfW-funded Yemen Family Health and Family Planning Program, Futures Group helped the Yemen government meet demand for family planning services by increasing access to and availability of affordable modern contraceptives through the private sector and nongovernmental organizations (NGOs). Futures Group teamed with the local private distributor NATCO, increasing the availability of Protec brand contraceptives in remote regions of the country. Futures Group also brokered the supply of commodities to health facilities of the Charitable Society for Social Welfare and Marie Stopes. The services complemented the public service delivery system and successfully contributed to family planning service sustainability.

Health Promotion and Behavior Change Communication

Futures Group’s vision for health promotion and behavior change communication is to empower high-risk, underserved populations with the information, motivation, and access needed to improve their well-being through informed choices on health products and services from commercial and public outlets.

Communication strategies resulting in sustained behavior change encourage consistent use of reproductive, maternal, and child health products and services and ensure long-term market (public and private) viability. Numerous activities can be adopted to achieve desired behavior change over time; the most successful strategies are underpinned by themes of access, trust, and repetition and shaped by formative research to ensure acceptability and appeal to target audiences. Futures Group’s focus on achieving behavior change, rather than simply generating demand, results in sustained use; the ensuing total market growth stimulates private sector participation in addressing public health goals, which ultimately leads to improved overall population health. We have decades of experience in building effective communications campaigns, tailored for and targeted to specific populations, using a variety of channels and tactics, ranging from electronic media to interpersonal communication.

Futures Group is conducting formative research among Afghan families and healthcare providers to assess the importance of family members and healthcare providers in potential users’ decisionmaking with respect to family planning service uptake, and particularly to better understand the attitudinal and perceptual barriers among influencers that may limit uptake. Research results will enable the project team to better develop a communication strategy for family planning services.

Under the COMPRI-A Project in Afghanistan, Futures Group and its partners are working to enhance existing social marketing initiatives and to generate sustained behavior change around reproductive, maternal and child health. The emphasis of the social and behavior change communication is to empower high risk, underserved Afghan consumers with the information and access to make informed choices about services and products available through commercial and public outlets.

In Niger, under a KfW-funded social marketing project, the intention was to make condoms more affordable and accessible to the Nigerien public by creating and promoting a new brand of condom, called Le Foula. Futures Group’s media campaign, which promoted the use of condoms, was launched at the same time the World Cup soccer tournament was being televised and included six television slots, 12 radio slots, a music video, three posters in different formats, some new road signs, and a whole range of promotional articles. The project worked closely with two local radio stations to create a series of radio programs broaching sensitive subjects such as sex and condom use. Popular theater groups developed sketches that were then played on the radio, which helped grab the attention of key target audiences and spread IEC messages in a subtle, subliminal way on a large scale.

For the Jamaica Social Marketing project, funded by KfW, Futures Group’s work significantly expanded the overall condom market through marketing communications that promoted consistent condom use with both casual and primary partners. The Futures Group team designed and conducted carefully tailored research to support message design, monitor distribution and sales, and assess consumer purchase and usage behavior.

Market Analysis, Segmentation, and Growth

Understanding market segments is critical to stimulating the entry of affordable products by reducing barriers and creating an environment where commercial products can thrive. The most effective programs focus on marketing efforts on consumer groups that most need a particular product and can afford partially or fully sustainable products. Futures Group is experienced and ready to assist in the types of analyses that lay a foundation for increasing market growth.

Market segmentation analysis examines how the market for family planning is structured and helps identify the extent to which different providers serve various population segments. To determine which sources of family planning commodities and services reach a given population segment, the population is divided into quintiles based on a standard of living index, developed by a factor analysis of household assets, rather than income or consumption. This market information helps to match current and potential users better with appropriate sources of contraceptives in terms of user location, needs, preferences, and ability to pay. Assuming that a public sector priority is providing services to those most in need who cannot afford to pay for family planning commodities and services through any other source, public resources should be focused on the lowest two quintiles. People in the middle and two highest quintiles should be able to pay for family planning commodities and services provided by NGOs, social marketing programs, and the commercial sector.

Market segmentation underpins our social marketing efforts, applied over several decades beginning with the global SOMARC project. Further, we have used market segmentation information in countries such as Bangladesh, Egypt, El Salvador, Ethiopia, Ghana, India, Indonesia, Jordan, Kenya, Mali, Malawi, Morocco, Peru, Philippines, Romania, Rwanda, Tanzania, Turkey, and Uganda for awareness raising, advocacy, and policy dialogue and to inform development of relevant policies and plans. Using this information helps explain the relative roles, responsibilities, and weights of different players in the various health markets.

Product Marketing and Distribution

Futures Group’s overarching strategy in product marketing, sales, and distribution is to develop sustained behavior change through customer satisfaction in a robust, responsive national market that ensures widely available and accepted products demanded by consumers. Strategies supporting this goal include

  • Generating substantial consumer demand by positioning information, products, and services as a “health value”
  • Ensuring widespread availability and access with aggressive, but cost-effective, distribution, especially to remote areas, building on existing local distribution channels
  • Creating innovative IEC/BCC campaigns that are culturally appropriate and have broad appeal to target groups and family and or other community influencers

Futures Group has successfully marketed a range of healthcare products and used supplier networks for optimal consumer reach. Our product marketing experience in over 45 countries across 25 years of work in this area includes
Family planning: Condoms, oral contraceptive pills, injectable contraceptives, intrauterine devices, and Moon Beads (traditional family planning)
Micronutrients: Zinc, iron folate, and iodized salt
Other products: Safe home birth kits, oral rehydration salts, insecticide-treated bed nets, point-of-use water treatment, medical equipment sanitization powder, and emergency contraceptives

Under the COMPRI-A Project, Futures Group is marketing a variety of health products and working to establish a local, Afghan-owned and managed not-for-profit social marketing organization that will continue to support a private sector network of product promoters and distributors. We have also worked with an Indian company to help a local Afghan pharmaceutical company attain ISO 9001:2008 management and quality certification for its operations. Direct investment in the company and targeted management technical assistance led to Afghan manufacture of two of the project’s products—oral rehydration salts (Sheefa) and chlorinated water treatment solution (Abhakon)—directly benefiting Afghans with affordable, quality products and indirectly contributing to the country’s overall economic growth.

Under the AFFORD project, Futures Group is responsible for marketing and distribution in Uganda of anti-malarial, zinc, water solution, family planning, and reproductive health products. AFFORD promotes positive health behavior changes among key target groups through innovative communications and widespread access through the private sector to affordable, high-quality products and services. Futures Group trained over 2,000 private practitioners on artemisinin-based combination therapies (ACTs) under the new malaria treatment policy and supported the launch and promotion of two private sector ACT brands manufactured by two Ugandan companies. AFFORD is also establishing a sustainable health marketing organization, the Uganda Health Marketing Group.

Supply Chain Management

Futures Group has supported supply chain management in over 35 countries through such projects as the 15-year global USAID-funded SOMARC Project and bilateral programs with the Centers for Disease Control and Prevention, DFID, KfW, USAID, and World Bank. This has included direct procurement, shipping, distribution, management information systems, monitoring and evaluation, and training of service providers for local government health, private, and nongovernmental organizations. Futures Group assures robust decisionmaking via market segmentation, willingness-to-pay, production and distribution capacity, and legal, regulatory and policy analyses, as well as consumer group profiles and partner mapping.

Under the COMPRI-A Project in Afghanistan, Futures Group established schedules for donor-funded and commercial procurement that includes packaging and point of sale materials. Commercial procurement is both domestic and international to ensure a continuous supply of product and communications material in the market. We also developed and implemented a national supply chain strategy using several private traditional and nontraditional distributors, and NGOs, to ensure wide availability of products in all provinces, especially hard-to-reach ones and subsequently vulnerable groups.

Under the SOMARC project, Futures Group was active in providing supply chain management services in Kazakhstan, Kyrgyzstan, Moldova, Russia, Turkey, Turkmenistan, Ukraine, and Uzbekistan. For a DFID-funded insecticide-treated nets project in Nigeria, we managed supply chain components such as building and supporting procurement; shipping; local manufacture and distribution of nets and insecticide; and related monitoring, tracking, and information systems. In Madagascar, Futures Group provided training and technical assistance to government and private distribution operatives in long-range reproductive health supply forecasting and budgeting for commodity procurement, transport, and warehouse and logistics systems planning and management. In The Gambia, Futures Group provided full supply chain support for a World Bank-funded national family planning program, including the selection process for establishing a nationwide supplier and creation of a management information system to track commodity movement, commodity inventory, and revenues earned. We also developed a subdistribution strategy with local NGOs to ensure a consistent supply of products.