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close this bookSanitation Promotion (SIDA - SDC - WSSCC - WHO, 1998, 292 p.)
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View the documentAdvocacy for sanitation - Sara Wood1 and Mayling Simpson-Hébert2
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View the documentSocial marketing for sanitation programmes - Sunil Mehra1

Social marketing for sanitation programmes - Sunil Mehra1

1 Senior Associate, Malaria Consortium, London School of Hygiene and Tropical Medicine.

Sanitation programmes face numerous challenges in their efforts to change sanitation practices and sustain improvements in sanitation behaviour. To address these, they must enhance the user's contribution in defining needs and how to meet them. The social marketing approach, with knowledge of consumer preferences at its core, is a promising means of addressing issues concerning the demand for sanitation products, provision of sanitation services, and changing sanitation behaviours. It could be used, for instance, to promote use of products such as improved water systems, and latrines, and household behaviours such as proper use and maintenance of latrines, handwashing, and covered storage of water, and proper waste disposal.

This article provides an overview of the social marketing concept so that sanitation planners, and programme managers can decide if they would like to apply it to their own activities.

What is social marketing?

Social marketing is a systematic strategy in which acceptable concepts, behaviours, or products, and how to promote, distribute and price them for the market, are defined (1). More specifically it applies commercial marketing techniques to social programmes in order to improve their effectiveness. It involves building up an understanding of the target group(s) (usually through research) to determine the most effective way to meet the group's needs as expressed by its members. The “Four Ps” which form the basis of commercial marketing - product, price, place and promotion - are used in social marketing campaigns.

Product in social marketing may be a physical product, such as a latrine, or a change in behaviour, such as handwashing after defaecation.

Price in social marketing may be a physical exchange of value, such as a commercial transaction, but it can also refer to the price involved in changing a behaviour. For example, there is a price in terms of time, if time is needed to carry additional water for handwashing rather than for other activities.

Place in social marketing means the distribution channels used to make the product, service, or concept available to the target group. If a physical product or service is being marketed, the place may mean the actual point of purchase or access. It if is a concept, the place would refer to the media through which the target group learns about that concept (2).

Promotion covers the broad range of channels through which the campaign messages are directed to the target group. Channels for promotion include mass media (television, radio, magazines and newspapers), and traditional methods such as plays, folk singers, and interpersonal communication.

To be successful, social marketing requires that the intended target groups, and groups that influence them, participate in formulating and testing products, programme strategies, activities, and specific messages and materials (1).

What does social marketing involve?

The key steps involved in adopting a marketing approach can be summarized as follows:

Problem identification. This needs to be defined in broad terms. Initially, the problem is defined in general terms only. This is because as more becomes known through research, the focus of the activity may shift.

Research. This is needed to identify the target group and its characteristics. Social marketing involves a number of different research stages and different research techniques may be used. For sanitation programmes, basic questions would include:

· How many households/neighbourhoods have adequate sanitation facilities or systems?
· What do people perceive as “good” and “bad” sanitation?
· Are the needs of women and men different?
· How much do people pay and how much would they be willing to pay for latrines?
· What are the perceptions of men and women about latrines, and are they different?
· What type of system do they prefer?
· What important characteristics do they prefer?

Research methods could include focus group discussions, in-depth interviews, observations of lifestyles and large-scale surveys.

Objective setting. This means development of measurable and time-bound objectives.

Target group segmentation. The data gathered during the research step is used to divide the target group into subsets with common characteristics.

Marketing plan development. The data gathered during the research is used to develop a plan detailing the activities that will be undertaken on each of the “Four Ps”, i.e. which products or behaviours will be communicated to the target group, what will be the pricing structure (if relevant), how the product, service, or concept will be made available to the target group, and, finally, how it will be promoted. Decisions will be based on the consumer preferences as identified through research.

Test marketing. Products, pricing, distribution strategies and promotional messages are tested among representatives of the selected target group(s) and modified and retested until they generate the desired result.

Launch. The social marketing campaign moves out of the test phase into the marketplace.

Monitoring and evaluation. This provides the information which can be used to modify any of the aspects of the campaign to make it more effective.

The steps in social marketing are not necessarily discrete stages with each needing to be completed before the next begins. Instead, several steps can be undertaken at the same time; for example, research results may be used simultaneously to develop programme objectives and to identify target groups.

How could sanitation programmes benefit from a social marketing approach?

Lessons (3) from past sanitation programmes and projects have shown that:

· Water and sanitation projects have often not taken adequate account of individual and community behaviour that affects people's use of the facilities provided. Expected health benefits were therefore not realized, despite the safe water provided to thousands of communities worldwide.

· Goals of sanitation projects have tended to focus on the number of latrines constructed or the number of people provided with access to latrines, and failed to consider promotion of the many behaviours - handwashing, safe excreta disposal, good personal and household hygiene, safe food handling, the avoidance of unsafe water sources, and protection of pumps and wells - that largely determine whether new facilities bring health benefits.

Sanitation programmes have been more concerned with the “supply” of sanitation products, and materials rather than with assessing the needs and preferences of intended beneficiaries. Yet responding to these needs and preferences could contribute to the design of appropriate and acceptable solutions to sanitation problems and help make improvements in sanitation sustainable. “Demand-led” sanitation places emphasis on what people want and how they can contribute to these efforts. Demand creation is also part of commercialized marketing, and may also have a role in sanitation programmes, provided the product in question is actually something consumers want and/or need.

To be successful, social programmes must meet the needs of the target group in a way that they prefer; this is often called consumer-orientation, an important facet of social marketing. Consumer orientation has been shown to be successful in a number of social programmes dealing with family planning, nutrition, immunization, oral rehydration, smoking, cancer detection, use of seat belts and prevention of heart disease and AIDS. It is a particularly valuable approach for solving problems that are related to behaviour, rather than technology (3).

Some recent accomplishments in social marketing include (4):

· The 30 per cent decline in infant mortality in Egypt due to promotion and marketing of oral rehydration salts.

· Improved use of contraception in Bangladesh. Around 44 per cent of men in Bangladesh talked to their wives about family planning within 12 months of a campaign launch and contraceptive prevalence increased by 10 per cent.

· Improved child nutrition in Indonesia. In this country, 85 per cent of women now feed their child a mixed food with green leaves, which has led to improved nutritional status of 40 per cent of Indonesia's children under two years of age.

· A decrease of almost 50 per cent in deaths due to diarrhoea in Honduras following a programme to educate mothers about the use of oral rehydration salts.

Applying social marketing in sanitation programmes

It is usually necessary for sanitation programmes to include those with proven experience in applying social marketing to development activities. And since social marketing activities involve a variety of different skills, it is likely that expertise from a number of different specialist areas will be needed. The following table provides some suggestions on where you may find expert help and the kind of expertise that might be offered.

Table 1. Sources of expert assistance on social marketing

Source of expert assistance

Type of expertise available

Private marketing companies experienced in social marketing agencies

· Practical experience in applying social marketing
· Project management
· Knowledge of specialized agencies such as research companies and advertising

Advertising agencies

· Developing communication messages including television, radio and press advertising
· Selecting the most effective way to reach the target group through mass media, traditional methods, interpersonal channels or a combination of these
· Buying media time and space, e.g. television advertising, newspaper space, etc.

Local media personnel from radio, television, newspapers or magazines

· Broadly, the same expertise as for advertising agencies but specialized to the particular medium they represent

Research institutions, organizations and private research companies

· Research (different organizations often specialize in one specific type of research, therefore, a number of research organizations may be involved if a variety of research techniques are used)


· Academic advice on marketing and social marketing
· Research skills and experience

Government departments or agencies

· Practical experience in applying social marketing in different situations
· Project management
· Various specialists, e.g. anthropologists, researchers, social scientists, marketers
· Advice on how to select appropriately experienced external specialists

Social development organizations

· Similar expertise to that available from government departments

Initial problems in applying a social marketing approach are likely to be poor understanding of the concept among the institutions and organizations responsible, and difficulties in bringing together experts and personnel from engineering, promotion, marketing, and health education. Social marketing experiences in other programmes show that one of the ways of overcoming these problems is to involve and inform all concerned from the start of the process (5).

Social marketing worksheet

The following worksheet is provided to help you understand the steps involved in adopting a social marketing approach in your programme. It may help you to identify whether use of social marketing would be appropriate, whether you would need to seek expert help, and what information you lack.

Try and fill in the last column of the worksheet below for your programme or project. Information on the target group(s)' preferences is required to define each of the “Four Ps” for social marketing to be successful.

Table 2. Worksheet 1: Applying the “Four Ps” to your sanitation programme

“Four Ps” of social marketing

Examples for sanitation

For your programme or project

Decide on what the product is, its form, format, presentation, in terms of packaging and characteristics

Products (tangible outputs): latrines
Practice or behaviour:
Using and cleaning latrines, washing hands after using the latrine
Clean environment, good sanitation for health/hygienic excreta management

Decide on what the consumer would be willing to pay, both regarding direct and indirect costs and perceptions of benefits: make the product worth getting

Cost of products (with or without subsidies)
Opportunity cost:
Time lost from other activities, missed opportunities, transport, loss in production or income
Psychological or physical:
Stress in changing behaviour, effort involved in maintaining latrine or obtaining additional water

Where will the product be available for the consumers, including where it will be displayed or demonstrated

Delivery of product:
Health centres, clinics, pharmacies, households, clubs, local businesses, schools

How the consumers will know the product exists, its benefits, costs, and where and how to get it

Delivery of message:
Television, radio, newspapers, posters, billboards, banners, folk singers or dramatists, public rallies, interpersonal/counselling

Source: Adapted from (2).

To find out more

This article provides an introduction to social marketing. Readers are encouraged to refer to the references overleaf for more information.


(1) Attawell K, ed. “Partnerships for change” and communication - guidelines for malaria control. Division of Control of Tropical Diseases, World Health Organization (1211 Geneva 27, Switzerland) and Malaria Consortium (London School of Hygiene & Tropical Medicine, Keppel Street, London WCIE 7HT, UK).

(2) McKee N. Social mobilization and social marketing in developing communities, lessons for communicators. South Bound, Penang, 1992.

(3) WASH. Lessons learned in water, sanitation and health: thirteen years of experiences in developing countries. WASH, Arlington, VA, 1993.

(4) Griffiths M. Social marketing: a key to successful public health programs. Paper presented at the Social Marketing for Public Health Conference, 5-7 March 1991.

(5) WASH. Social marketing and water supply and sanitation: an integrated approach, Arlington, VA, May 1988 (WASH Field Report No. 221).