Over the years, we’ve identified different resources that we and our clients have found especially useful for answering their questions about market health and strengthening. We’ll update this list from time to time with stand-out tools that you can use to gain insight into health markets, and monitor and evaluate market performance over time. Market Intelligence is the practice of gathering, analyzing, and using data to inform decision-making and health market strengthening.
Market intelligence helps us understand the state of a health market, who the market is and isn’t serving, and if investments are working. Databoom has created a compendium of resources for measuring the health of condom markets, but many of these resources can be applied to other health markets. Priority areas for measurement are: 1) Need; 2) Demand; 3) Supply; and 4) Sustainability.
Need
How many condoms are needed to protect high risk sex acts?
The Condom Needs Estimation Tool (CNET): CNET generates estimates of total condom quantities and funding required to achieve national targets. It also highlights the gap between current condom use and estimated needs to achieve 90% use in high-risk sex acts. It can help model a sustainable condom market because it accounts for contributions from the public, commercial, and social marketing sectors.
Demand
Which factors are associated with condom use?
Audience Segmentation: Target audience’s needs, motivations, and influencers, and how they affect condom use
Qualitative consumer insight studies:
Project Chitenga: Protector Plus Zimbabwe Project Report: This study on Protector Plus condoms helped PSI Zimbabwe understand its positioning and brand equity at both functional and emotive levels to develop brand management and development strategies.
PSI’s FoQus Studies: FoQus on Segmentation studies provide a structure for collecting, analyzing, and interpreting data to position or reposition products, behaviors, and services.
Quantitative surveys that identify factors associated with condom use:
PSI’s TRaC Surveys: Starting in 2003, PSI used Tracking Results Continuously (TRaC) surveys to repeatedly measure levels and trends for a standard set of indicators, such as exposure to a social marketing intervention and self-reported risk reducing behaviors.
Crowd sourcing:
Girl Effect’s TEGA Program: The technology enabled girl advocate (TEGA) program is Girl Effect’s mobile based research tool, enabling girls to collect real-time insights into the lives of their peers.
What proportion of the population is using condoms?
Condom use at last sex or consistent condom use:Trends in use are depicted over time and condom use can be disaggregated by partner, or age. Targeted surveys are usually needed for key populations
General population-based surveys:
DHS Surveys: Demographic and Health Surveys (DHS) are nationally representative household surveys that provide data for a wide range of monitoring and impact evaluation indicators in the areas of population, health, and nutrition.
PHIA Surveys from Columbia University: Since 2014, the Population-based HIV Impact Assessment (PHIA) Project has conducted nationally representative surveys to capture the state of the HIV epidemic in the most-affected countries.
IPUMS Global Health Project: IPUMS Global Health provides integrated international health survey data at no cost for research and educational purposes from two data sources: the Demographic Health Surveys (DHS) and Performance, Monitoring, and Accountability 2020 (PMA2020).
PSI’s TRaC Surveys: Starting in 2003, PSI used Tracking Results Continuously (TRaC) surveys to repeatedly measure levels and trends for a standard set of indicators, such as exposure to a social marketing intervention and self-reported risk reducing behaviors. TRaC surveys can be conducted among the general population or among key populations.
Key population surveys:
IBBS for key populations, informally known as the Blue Book: CDC’s Division of Global HIV & TB in collaboration with the World Health Organization (WHO), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and FHI 360 provide survey guidelines for working with key populations. The Integrated Bio-behavioral Surveillance Surveys (IBBSS) for Key Populations were formerly known as the Behavioral Surveillance Surveys (BSS).
PSI’s TRaC Surveys: Starting in 2003, PSI used Tracking Results Continuously (TRaC) surveys to repeatedly measure levels and trends for a standard set of indicators, such as exposure to a social marketing intervention and self-reported risk reducing behaviors. TRaC surveys can be conducted among the general population or among key populations.
Modeling:
Commodity Gap Analysis by RHSC and Avenir (for family planning but includes condoms): These reports explore how spending, users, and costs vary across commodities in the public and private sectors as well as within the private sector. The Commodity Gap Analysis (CGA) offers greater visibility into the role of donor-subsidized products in the private sector.
Structural Equation Modeling (SEM): This article by Morales et al. provides a good example of using SEM based on theoretical models and survey data to predict future condom use among adolescents.
Polling booth surveys:
Polling Booth Survey for Key Populations: This survey strategy is intended to decrease over-reporting of desired behaviors like condom use, especially among key populations. During the survey, respondents are separated from each other in a polling booth environment and given three containers as ballot boxes. The facilitator reads out the questions in the local language, and participants answer each question by dropping the card carrying the question number into any of the three containers.
How much are consumers willing to pay for condoms?
WTP studies help decision-makers understand the potential value of the market and are especially important for markets that are transitioning from social marketing interventions to more sustainable social enterprise models or TMA strategies that seek to engage the commercial sector.
Willingness to Pay (WTP) – The maximum price consumers will pay for a product. This report on WTP for condoms in five African Countries from Abt Associates covers the two most common styles of data collection: 1) a series of questions included in surveys to measure value and price sensitivity; and 2) experimental strategies that offer respondents the opportunity to buy condoms through bidding games or discrete choice models.
Which condoms are consumers using?
Condom Use by Source of Supply – The category of condom used by consumers.
Very few surveys ask about “source of supply,” specifically the use of public, social marketed, and commercial brands. This peer-reviewed paper by Htat et al. in Health Policy and Planning describes how to capture condom use by source of supply.
Are subsidies targeting the right consumers?
Equity: The distribution of condom users across wealth, geography, and gender categories to understand how well subsidy is targeted at those most in need.
Equity Tool: The Equity tool uses a reduced number of asset questions to estimate relative poverty (by SES quintile). Metrics for Management collaborated with several agencies, and equity experts to shorten and simplify the Demographic and Health Surveys (DHS) asset index questions.
Asset to Income Estimator (A2IE): The A2IE connects the relative measure of assets and quintiles to an absolute measure of dollars per capita. The tool allows you to compare how much an individual or household makes per day, month, or year in more than 55 low- and middle- income countries through an interactive, web-based tool.
The Progress out of Poverty Index (PPI): The PPI uses the answers to 10 questions about a household’s characteristics and asset ownership to calculate the likelihood that the household is living below the poverty line. There is a fee for the PPI if it has not already been calculated for a country or if the score needs to be updated.
Supply
What is the total size of the market?
Market share: The total volume of product on the market, including condoms distributed through the public, social marketing, and commercial sectors.
Public Sector Distribution Data: This paper from PSI and the HC3 Project highlights the need for investments in the quality and consistency of public sector distribution data down to the district level to track subsidy and the targeting of free condoms.
Social Marketing Data: DKT International publishes distribution data for social marketing programs that report their sales data to DKT on an annual basis.
Commercial Sector Data: Nielsen provides commercial retail audits—the best source of commercial sector data. But in many low- and middle-income countries, typical retail audits are not available.
Procurement and Supply Chain Data: The Global Family Planning Visibility and Analytics Network (Global VAN) captures data from multiple sources to improve supply chain visibility. The Global VAN offers the family planning community a platform to assess supply needs, prioritize them, and act when supply imbalances loom.
Customs data can also be used as a resource. Commercial agencies can provide customs information for a fee, like Export Genius. Alternatively, data may be available from the government free of charge.
What is the total value of the market?
Value: The value of the market is the average consumer price multiplied by market volume.
Value is a simple calculation of the total volume of social marketed and commercial condoms multiplied by price to consumer. Public sector condoms, which are usually distributed for free, are not included in the calculation.
What is product availability at different delivery points in the market? What is the range of products (includes types, brands) and price points available at different delivery points?
Availability: The degree to which condoms are present on the market. Availability can be measured by 1) market penetration – the proportion of outlets with condoms; or 2) coverage – the proportion of geographic areas where condoms are available according to pre‐defined minimum standards.
Public Sector Distribution Data: Public data should also be tracked regularly through logistic management information systems (LMIS). It is important to track distribution by sub-distribution channel or specific populations to better understand and categorize who condoms are targeting.
Outlet Surveys: Outlet surveys can provide information on condoms in stock, prices, number of brands, and stock-outs. While primarily used in the past for commercial retail outlets, they can be effective for measuring free distribution at priority outlets, such as guesthouses or bars for key populations. Outlet surveys can use a census of outlets, a sample of outlets, panels, or Lot Quality Assurance Sampling (LQAS) to measure geographic coverage, quality of coverage, and access. Here are two examples:
1. FPWatch: The BMGF-funded project FPWatch used nationally-representative, cross-sectional outlet surveys (a census of outlets), which included condom availability. These studies were conducted in just five countries, but provide rich data on brands, pricing, and visibility in both the public and private sectors.
2. PSI/Mozambique Retail Audit: PSI piloted a retail audit panel in Mozambique to generate condom market performance information routinely. PSI/Mozambique used a panel of retailers to collect data on volumes, stock rotation, product and brand variants, pricing, source of supply, and stock keeping units (SKUs).
Commercial Data: Commercial sector data are often unavailable, either because commercial actors will not share their sales figures or because the commercial sector has such a small presence that it does not merit counting. Commercial retail audits, like those by Nielsen, are usually the best source of data.
Crowd Sourcing: Ushahidi Tool: Ushahidi provides software and services to help improve the bottom-up flow of information. PEPFAR’s Dreams Project has used Ushahidi crowdsourcing as part of its measurement program.
What is perceived availability by users?
Perceived availability, or self-reported availability by users, should be tracked on a regular basis.
Population-based Surveys: Condom availability ‘when and where I need them’ is a question that can be included in population-based surveys, including surveys among key populations. DHS Surveys, PHIA Surveys from Columbia University, PSI’s TRaC Surveys, and IBBS for key populations typically include questions about perceived availability.
Sustainability
How much do national governments spend on condoms?
Domestic funding: Funds spent on prevention; funds spent on condoms.
National Budget for Condoms: Government figures for annual expenditures on condoms are usually the best source of information.
IHME Health Expenditures Report: This report is a repository of available national health expenditure data for 195 countries by healthcare function and providers of such services. Data are from 2000-2017. A complete set of detailed health expenditures is estimated through statistical methods.
How much of the market is reliant upon donor subsidies? What are trends over time?
Donor funding: Funds spent on prevention; funds spent on condoms.
IHME Annual Financing Global Health Report: These annual reports provide estimates of development assistance for health, domestic spending on health, health spending on two key infectious diseases – malaria and HIV/AIDS – and future scenarios of health spending.
Country-specific data may also be available from donors in country
How sustainable are markets?
Market reliance on subsidy: A country’s reliance on external subsidy in support of commodities.
Mann Global Health (MGH) Landscaping tools:MGH offers a comprehensive tool kit to systematically guide condom market landscaping efforts across five countries. The tool kit includes this subsidy calculator in Excel.
