Tool3-condom-market-landscaping-guidance.docx

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE TOOLKIT TO ANALYZE CONDOM MARKET PERFORMANCE: TOOL #3 Mann Global Health (MGH), with the support of the Bill and Melinda Gates Foundation (BMGF), developed a comprehensive tool kit to systematically guide condom market landscaping efforts across 5 countries. The report “Condom Programs for HIV Prevention in East and Southern Africa – A Root Cause Analysis” by MGH outlines the key findings of that project. This guidance in this document includes a description of tool #3 and its use to support condom market landscaping efforts in other countries. Tool #3 Condom Market Landscaping Guidance pulls together general approaches to landscape the core manufacturing to use spectrum, drawing heavily on approaches developed by Population Services International. Indicator guidance is embedded in the doc, with links to supporting guidance/tools. Use as a guide and directs to links of supportive tools. This tool leverages the work of PSI, as well as Springfield, Abt and the USAID market shaping primer. Landscaping the Condom Market A market landscape analysis builds a comprehensive understanding of the condom market structure in a country, focusing on the core demand and supply functions, but also highlighting supportive functions. Market Landscaping supports a strong understanding of the health need, an understanding of condom category dynamics & market performance, and insight into users at the core of the analysis. An introduction to the guidance introducing market landscaping, which was adapted and developed by Population Services International and the Springfield Centre is summarized in figure at right. The steps supporting a market landscape analysis, and proposed indicators/variables to track are outlined below as well. This document curates tools designed and developed by PSI, the Springfield Centre, and Abt Associates; the tools have been slightly modified to address the specific needs of supporting a condom market landscaping project. Use of this Tool: The first part of the tool, the Health Need Analysis, sets the scene for the market – helping us understand general context of epidemiology, condom use, donor trends, etc. Use /Need analysis sets the stage in understanding the total condom needs for a country, against current use.

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE Leverage the below analysis to best understand the production to use spectrum – the variety of actors playing a direct role in the provision of condoms – from manufacturers, importers, distributors, retailers enablers (such as social marketers) and consumers. 1: Health Need Analysis Purpose of analysis: Understand the current situation and key health trends around the condom market. This analysis will help identify epidemiological trends, programmatic priorities - driven by who specifically the market is failing. HEALTH NEEDS ANALYSIS COMPONANTS Step

Objective & Factors to Consider for Analysis

Tool

I. Donor Trends

Identify donor & government funding supporting condom prevention programming. Analysis should consider a) key objectives b) funding timelines & levels c) commodity commitments d) priority pops. Identify the gap between current use and need. This can be understood further by using the following lens to identify the largest gaps in the market: age, gender, wealth quintile, geography, and importantly, risk behavior.

Wksht guiding analysis here (tool 4.8)

Examine use & Need, and how this changes over time. Is Use growing as a % of Need? Or is the Universe of toal Need growing? What is happening to the absolute or relative size of the gap between Use & Need? Is the gap between use and need larger in some pop segments? Which behaviors are driving need? Describe the overall context & trends of the HIV epidemic to paint a picture of the extent of the disease burden in the country, pops at risk, risk behaviors driving epidemic, trends, etc. Important to break down by key and priority populations, geography, and other relevant segmentation – information and epidemiology suggests a number of sub factors driving a country specific epidemic. Highlight behaviors placing pops at risk, such as % of pop reporting sex with non-regular partner, extent of intergenerational sex, etc. Understand condom use trends to identify gaps and challenges. Break down use by risk behavior, population, geography. Important to drive to break down & use with specific partner – e.g., SW use with clients, trusted partner, ‘boyfriend’ can vary significantly, as can young women w/older partner.

PSI guidance outlining approach here

II. Use/Need Analysis

III. EPIDEMIOLOGICAL ANALYSIS

IV. QUALITY OF USE

UNAIDS UNAIDS Condom needs tool

Indicator /variable measured Commodity commitments Funding commitments UofN (outlined below) Condom Use

Present data as meaningful. Trends, charts can support.

HIV Incidence & prevalence, Risk factors contributing to epidemic

Present data as meaningful PSI guidance here with guidance supporting presentation here (tool 4.5)

Condom Use (disaggregated by KP & priority pops)

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE Analysis from this exercise feeds directly into the Condom Market Development pillar, specifically, indicators 2.1.1 and 2.1.2 – 2.1.6. Pillar: Condom Market Development Element: Supply Forecasting, Demand Creation INDICATOR TITLE: 2.1.1. Universe of Need (UofN) relative to Current Condom Use Tool derived from: UNAIDS cost calculator tool here with guidance from PSI here PURPOSE & DESCRIPTION:  Tool producing condom needs estimates at a national level and by sub-population. An efficient way to estimate existing condom use and total condom needs to meet country targets. Instructions included on tool  Pre-populated country specific database ensures condom needs can be estimated as quickly as writing in the country in appropriate box, and relatively easy to update for country specific data.  A TMA worksheet supports planning of existing and future sector contribution and allocation at a) level of sector, b) distribution channel overall or c) distribution channel by population. Can be leveraged to develop visions of healthy future mkt.  Broad costing data expressed as cost per condom can estimate costs to support certain programs (i.e., cost of SM program).  Examine how current use & total changes over time to fully understand trends in the market, and current trajectory. Is use growing as a % of Need? Is the Universe of Need growing? What is happening to the absolute or relative size of the gap between Use & Need?  Factors contributing to total need include population estimates (disaggregated by pops at risk), coital frequency, target condom use (default is 90%), and wastage factors. DEFINITION: Current estimates of current condom use compared to total condom need (also expressed as the gap between use & need) RATIONALE FOR INCLUSION: It is critical to understand the gap between current use, and condom needs to meet targets, for a country to design sustainable condom programming. UNIT: Condoms (absolute)

DISAGGREGATE BY: KP and other variables, including: age, gender, wealth quintile, geography, risk behavior, as possible.

DATA SOURCE: DHS is default data in tool, but important to use other country specific & population specific data such as IBBSS, population size estimates, National HIV/AIDS surveys, to dial into population size estimates, KP specific condom use, coital frequency) to more accurately reflect current use and need.

FREQUENCY: Annual (and as new data comes available)

Comments:  Current condom use applying demand side estimates is typically higher than that produced by supply side estimates (est. size of free, SM, & commercial mkts). Can be attributed to over reporting of consistent condom use, higher risk behaviors than reported, etc.  Condon need is not meant to guide procurement quantities – demand side realities, programmatic experience, and relative contribution of markets should (obviously) be factored in. Need does not reflect demand. Data produced needs to be reality checked and contextualized.  Guidance: Cost estimates should be taken w/grain of salt as they are global estimated costs. For example, the per unit costs to support SM were derived from PSI HQ, and broad averages mean costs of SM alone could dramatically vary country to country. If country specific data exists that informs costing, use it.  Guidance: SW # partners can significantly swing estimates of use & need – important to seek out data sources to estimate this, or use the default sex acts/year for SW of 400 for the tool. Relevance:

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE

Pillar: Condom Market Development & Condom Market Management Element: 1. Demand Creation & 2. Equity (disaggregated by wealth). INDICATOR TITLE: 2.1.2-2.1.6. Condom use Tool derived from: UNFPA CCP, PSI Landscape Analysis. Supportive worksheets for data input/analysis here (tool 4: 4.5 Condom Use). PURPOSE & DESCRIPTION: DEFINITION: Primary - Condom use at last sex with non-regular partner Parallel analysis should also explore consistent condom with non-regular partners, disaggregated by factors outlined below, to comprehensively explore trends in use. RATIONALE FOR INCLUSION: Direct relationship to health impact. It is critical to understand the gap between current condom use, and condom needs to meet targets, for a country to design sustainable condom programming.

UNIT: self-reported condom use

DISAGGREGATE BY:  M/F, urban/rural, sexual partner (including intergenerational), age (1524, 25+), population (MSM, SW, type of SW if available) and relevant/available demographic.  2. Disaggregation by wealth will support equity measures. Equity also supported by below comments.

DATA SOURCE: DHS, IBBSS, HIV/AIDS surveys, UNICEF MICS surveys, pop specific surveys.

FREQUENCY: As new data comes available

Comments:  Equity can be supported through analysis disaggregating by wealth, and through triangulating & analysis use against urban/rural dynamics, geographic variables (poorer states/counties vs. wealthier) and sub populations at risk (i.e., brothel based SW, which may likely to be poorer, against street based SW)  Note linkage to USE & Need tool above- important to analyze trends, trajectory.  Important to dig into data to understand Relevance: Alternative indicator:

2: Market Structure Purpose of the Analysis: Mapping the market structure, focusing on the relevant players and functions along the production to use spectrum, will support a thorough and broad understanding of the value chain supporting delivery of condom from manufacturer to end user, as well as an understanding of the roles different sectors play in supporting condom use, and identify where and how the market is failing. Important to factor in structure for commercial, SM, & public – interviews with key players in each sector, using the value chain analysis, will support understanding of each. The Value chain analysis (tool 4) is the main tool to guide interviews with actors in the value chain. This analysis was built on PSI tools and approaches.

AREA

MAP MARKET PLAYERS

MARKET STRUCTURE COMPONANTS Objective & Factors to Consider for Analysis

Understand the value chain of market players involved in the production to use spectrum of delivering a product to consumer. Mapping the entire value chain will be necessary to understand market weakness, such as inefficient distribution systems or access

Tool

Mkt structure format_sample (tool 7)

Indicators / variable measured Analysis will support broad understanding of the market

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE issues, as well as support a detailed understanding of the market overall. Note that public sector will include NGO delivery of condoms as well. CORE FUNCTIONS ENABLING ENVIRONMENT

Look in depth at category performance across the four Ps: product, place, price, and promotion to understand demand and supply throughout the value chain. Supporting functions enable the core functions through information, coordination, guidance, quality assurance, financing, and labor capacity. Financing Functions explore the role that subsidy and financing plays in the condom market, particularly important for CSM and public sectors. Rules govern the core functions through policy, regulation, taxes/ tariffs, and social norms.

MKT STRUCTURE Core Functions & Enabling Environment (psi guidance)

but unlikely to produce specific / indicator variables.

Value chain analysis (tool #3)

3: Market Performance Purpose of the Analysis: Supports understanding of underlying existing market performance, in relation to the potential market (based on universe of need), and critical to highlight market underperformance and identification of gaps in the market. Market performance can be boiled down into factor assessing market depth, and market breadth. This analysis was built on PSI tools and approaches. AREA

Market Depth

Market Breadth

Objective & Factors to Consider for Analysis

Aims to understand total volume, disaggregated by each sector, and total value of condoms to examine trends in the size of the market. How is each sector performing over time, in absolute (volume) terms, and relative to other sectors (in share of market). Identify key trends impacting the condom category.

Looks across the marketing mix (4Ps) across sectors to identify:  Brands (Products) available, role they play in market in supporting use, across sectors – explore market share, variants available, value of leading brands;  Pricing: Determine affordability of products on the market, map price-points & tiers serving segments, identify pricing gaps, affordability of different consumer segments, affordability & price elasticity; margins across value chain. Gain insight into incentive structures (monetary, credit or others) for retailers/wholesaler (e.g. retailers may push condoms w/higher margins, ‘hiding’ lower profit SM brands. Likewise, may sell leaked free due to high margins despite low price)  Place: Explore access and availability issues, gaps (across geography,

populations, channels – including those serving KP) ID channel drivers, difference (brands, segments served, etc) btwn pharma & FMCG if any, role of NGO vs. public facility;

Tool

PSI Market Landscape guidance here Supportive worksheets for data input/analysis here (Tool 4) PSI Market Landscape guidance here Supportive worksheets for data input/analysis here (tool 4) condom indicator sheet for more specific

Indicators / variable measured 1. Market Volume 2. Market Value 3. mkt reliance on subsidy

1. # Brands Available 2. Availability 3. Perceived Accessibility

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE  Promotion: Assess capacity of players (across sectors) to generate demand, identify incentives, opportunities & barriers for mkt players to engage. opportunities & bottlenecks to engage (e.g., in Nigeria prohibitions kept condoms adverts off TV before 10pm). Assess which players are driving

guidance here (4.6,7)

demand in the market, activities are they doing, tactics used, amount invested, trends.

Stage of Market

Aggregated indicators assessing the stage of the country’s condom market is a helpful ‘snapshot’ of where a market sits in terms of maturity. It can illuminate the general category of interventions suggested to support development of the overall condom market. For example, nascent markets are likely to require significantly more subsidy to support the supply side of the market such as condoms for free (and even then, through supported through NGOs rather than public systems), in addition to demand creation, allocation of subsidy.

USAID TMA in Condom programs here. Mkt staging on pp 5-6, & 10.

Set of indicators on ‘mkt indicator wksht’ here

The KII and Market Landscape guide will collect all of the data and information required to assess what stage a market is in. After data is collected, refer to the USAID TMA for Condom programs guide to assess what stage a country’s condom market is in based on the market stage indicators located here.

Pillar: Condom Market Development Element: Supply & Sustainability INDICATOR TITLE: 2.2.4. Size of Market - Total number of condoms sold, distributed, or provided, all sectors (based on data available, may be adjusted condoms supplied) 3.3.1 Condom Market Value: Tool derived from: Market Depth Indicators: PSI Market Landscape tools here & supportive worksheets for data input/analysis here (Tool 4, 4.1 condom distribution) PURPOSE & DESCRIPTION: Supports understanding of underlying market performance, and how the actual condom market is performing in relation to the potential market DEFINITION: 1. Condom Market volume: total # of units sold, distributed, provided in each period in the market 2. Condom Market Value - Dollar value of the total number of products or services sold, distributed, or provided (price to consumer bands sold in market (SM & commercial) * # condoms sold RATIONALE FOR INCLUSION: Market volumes are a measure of condom health, and proxy for condom use – especially important given that use data is available at 3-5 year intervals. Also indicates relative contribution of each sector, over time. UNIT: 1. Condoms (absolute) 2. USD (for SM & Commercial)

DISAGGREGATE / Analyze by: Public, SM, and commercial sectors. Sector trends over time, and sector (or mkt) performance across regions if possible.

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE

DATA SOURCE: programmatic data (SM); public/NGO sector facility distribution MIS for free (or adjusted procurement estimates); commercial sector triangulated from interviews enhanced by retail panel data if exists

FREQUENCY: Annual

Comments:  Public sector / donor-funded condoms data are available from donor specific sources (PR for GF), governments, or the RH Interchange (here). Note depending on procurement, not all donors report to RH interchange, and most SM do not – take care not to double count. Given poor to non-existent LMIS, procurement likely to be proxy for distribution. o Contextualization through interviews is necessary - esp given some donors will make one procurement in support of multiple year use – quantities procured in year x may have to spread against years a,b,c.  SMOs will report sales to outlets/distributors. Take care not to double count sales, as many SMOs will also distribute to NGOs.  Commercial data is a challenge to get. Opps include leveraging SM market intel; interviews with the largest players (importers, generally); registered imports for countries with functioning systems; retail outlet surveys or more likely, triangulating from various data sources.  Include all sector on an annual basis, presenting trend lines. Relevance: Alternative indicator: condom use per man (condoms imported into country / # sexually active men in country.

Pillar: Condom Program Stewardship Element: Financing INDICATOR TITLE: 1.3.4 Market Reliance on Subsidy Tool derived from: Sample presentation of data here , Supportive worksheets for data input/analysis here (Tool 4, wksht 4.4) PURPOSE & DESCRIPTION: Two measures: 1. Relative reliance of the entire condom market on subsidy (commodity & packaging).2. Absolute value of subsidy supporting entire condom market (commodity, packaging). Both measure the extent to which subsidy is supporting condom mkt. DEFINITION: 1. Relative reliance of the entire condom market on subsidy: Expressed in %. e.g. - if commercial mkt is 33% of market and 0% reliant on subsidy, SM is 33% of market & reliant on 50% subsidy (that is, product is 50% cost recovery) and free is 33% & completely reliant on subsidy, then market is 50% reliant on subsidy. Do not factor in distribution/promotion/admin costs.) 2. Absolute value of subsidy supporting the market: Analyze sum net cost of supporting commodity + packaging of each sector of market. Commercial s/be zero, public likely total value of condoms in market, SM requires cost recovery data. Do not factor in distribution/promotion/admin costs.) RATIONALE FOR INCLUSION: Indicates how reliant market is on subsidy and thus indication of sustainability (to sustain current use, and scale to meet future need) UNIT: % and absolute USD value DATA SOURCE: SM data & programmatic data from variety of sources (need absolute condom volume of SM, public, commercial, % cost recovery of SM)

DISAGGREGATE BY: N/A

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE

Pillar: Condom Market Development Element: Supply (and informs equity) INDICATOR TITLE: Basket of indicators measuring Market Breadth 2.2.8 Brands Available 2.1.2. Availability 2.2.1. Perceived Accessibility Tool derived from: PSI Market Landscape tools here & Condom Metrics here, supportive worksheets for data input/analysis here (tool 4.6 Condom Availability, 4.7 Brands Available) PURPOSE & DESCRIPTION: Supports understanding of underlying market performance, and current performance in relation to the potential market (need) through a bucket of indicators. Looks across the marketing mix to identify which products are available, how they are priced, availability across channels and how demand is being generated. DEFINITION & Guidance: (reference condom indicator sheet for more specific guidance here 1. Brands Available - # distinct products/brands on the market – measuring commercial sector interest. Analyze across price points / extent of availability (punctuated vs. consistent presence), predominate channels) 2. Available - % / # outlets selling condoms in given geographical area. Disaggregate by geography, outlet type, public/private, 3. Condom Perceived Accessibility - % of consumers who report knowing where to obtain a condom, or that distance to a retail outlet / public outlet is not a barrier to use. Important to disaggregate by KP, such as SW; geography (urban/rural, state); age; wealth quintile etc. RATIONALE FOR INCLUSION: A basket of indicators measuring market performance serve as a foundation of understanding weaknesses contributing to need. UNIT: various (refer to spreadsheet)

DISAGGREGATE BY: as appropriate to tell rich story – geography, outlet type, distribution channel, KP, etc.

DATA SOURCE: Market visits, interviews, programmatic data (SM MAP data/retail outlets key)

FREQUENCY: Annual

Comments: Important to triangulate data to tell rich story – for example, condom availability can be measured by MAP studies, program data (public, commercial, SM); self reported by income group, disaggregated by KP, geography, etc. Alternative indicator

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE

Market Stage: A potentially helpful summary that proposes generic strategies markets of a specific stage are likely to be in. USAID TMA in Condom programs here. Mkt staging on pp 5-6, & 10.

Market stage Nascent

Key issues

Possible Strategies

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Stigma around buying and selling condoms Restricted distribution and access The need to recruit new users and to initiate trial

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Developing    

Mature

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The need to recruit new users, build the market size, and begin to serve the developing tastes of experienced users The need for more focused messages to influence behavior of high-risk groups An emerging need for the government to coordinate promotion and distribution activities An emerging need to target subsidies to where they are most needed

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A greater need for data collection to understand market evolution and to identify gaps in condom use and coverage A need to transition from highly subsidized promotion, procurement, and distribution approaches to commercially sustainable ones A need to tailor promotion and behavior change messages to the needs of key target groups

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Market to general population Host campaign-style events Subsidize distribution to expand channel penetration and to overcome seller stigma Invest in social marketing brands Push condoms mainstream as a consumer good Use a subsidized social marketing price to increase affordability and put downward pressure on commercial prices Use more targeted messaging and communications Reduce donor support for brands Introduce condom brand extensions Use subsidized distribution only in areas of highest need Introduce mid-priced brands and cross subsidy schemes Explore opportunities for commercial engagement Government and donors actively engage commercial partners to grow market All branded promotion is commercial or fully sustained from product revenues Focus use of subsidies on distribution or promotion Introduce new condom brands for which consumers are willing to pay more Invest in retail outlet surveys and target group studies to inform TMA analysis

4. Target Audience Insight Purpose of the Analysis: Based on the priority target groups from the Health Need analysis, conduct a deep dive assessment into the target audience to build an understanding of the target audience’s needs, motivations and influences and how this impacts behavior. This should be done for KP, priority pops, and general pops engaging in high risk behavior. Expect data gaps, and that time is unlikely to permit a deep analysis of the target audience. This step does, however, ensure the user remains a focus of the analysis.

TOOL # 3: CONDOM MARKET LAND SCAPING GUIDANCE Consumer segmentation from a use perspective is also a very important component of the analysis. Breaking down the role of free currently, and potentially, in serving the needs of various populations is one of the greater challenges to implementing a TMA. This analysis was built on PSI tools and approaches. Target Audience Insight Components AREA

MAPPING OF INFLUENCERS

MOTIVATORS & BARRIERS TO BEHAVIOR

AUDIENCE SEGMENTATION

Objective & Factors to Consider for Analysis

To extent possible, and given time available, use a socio-economic model to illustrate all the social and economic dynamics that may affect user’s behavior. (may be a challenge given resources avail) For each of the main target audiences, dig deeper to understand what motivates or impedes their behavior. These factors can be at the individual level (opportunity, ability, motivation), the community level or in the enabling environment. This exercise divides and organizes audiences into smaller groups with similar needs, preferences and characteristics. This may help to prioritize limited resources by reaching a defined audience with more impact.

Tool

PSI guidance Map of Influencers

PSI guidance Key Motivators Barriers to Behavior

PSI guidance Audience Segmentation Prioritization Other (imperfect) tools to support segmentation from supply side, include WTP studies, and pop surveys which break out purchase decisions by sub population.

Indicators / variable measured Ultimately measured by condom use by pop, outlined above