The Social Marketing of Micronutrient Powder in Sudan

Applying Formative Research to Design Social Marketing Strategies

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In this backstory we explore the article, ‘The Social Marketing of Micronutrient Powder in Sudan – Generating consumer insights to address micronutrient deficiencies’ written by Yana Manyuk in the Sight and Life magazine, Focus on Food Culture edition. Yana Manyuk is the Program & Policy Officer, Behavior Change Communications, for the World Food Programme (WFP) Regional Bureau for the Middle East, North Africa, Central Asia & Eastern Europe.

In 2013, the introduction of MNP was originally piloted in three localities of Sudan’s Red Sea state in 2013 by the Sudanese Ministry of Health, in collaboration with the World Food Programme. The research allowed an understanding of the consumer experience which was essential for reshaping program services and communication activities to fit beneficiary requirements.

After graciously accepting an interview with Sight and Life, Yana shared her experience and insight on the formative research she conducted in Sudan to gain consumer insights in order to design social marketing strategies that would generate demand for micronutrient powders (MNP). 

Ms Manyuk told Sight and Life she believes nutrition cannot be taken as a stand-alone subject, but one that takes into consideration underlying behavioral and socio-cultural perspectives.

Sight and Life magazine (SAL): What inspired you to choose this topic, and how did collect your data?

Yana Manyuk (YM): The WFP that distributing fortified flour at that point was facing quite low uptake. The Sudanese government, together with WFP, had already agreed on a decision to change the program design, as it required more effort from beneficiaries to collect and grind flour, and also to use the product. A decision had already had been made to change fortified flour to single-dose sachets. So, instead of coming to the centre and picking up a heavy bag full of flour, recipients could pick up a small sachet. They would still receive food; however, they could now use the food they received how they wanted, and could use the sachet how they wanted – for example when their children were eating separate food.

I was then brought on board to carry out formative research to see what we would need to do. The initial idea was to see what we needed to do to ensure the new program design and sachets would be accepted. Of course, we could have taken lots of angles to this research, such as looking into what packaging, color or design people preferred, and we could have simply researched the branding. But what was really important for me was knowing that the introduction of a new product into a community – especially a product that was a novelty for people – requires more than colorful branding to be accepted. It was essential to take a systems approach, and look at what needed to be improved from the beginning of providing the service – servicing the product, marketing, communicating, and using the product. So our research focused on the entire social marketing process, and the gaps and strengths of service provision, as well as the  marketing.  I was inspired by the desire to understand how to make the entire programme better, not just how we could make the product look and feel nicer.

SAL: How typical is social marketing in the development sector?

YM: The difference between our research and research you very commonly find around topics of introducing MNP, or introducing any new service or behaviour in the developing sector, is quite focused on the product or the service itself, as well as the barriers associated with that specific product or service. This is instead of taking the consumer of that service or product in the round, and really trying to get under the consumer’s skin, and discover the hooks in the lives of the people that we can use to market our service and product. Sometimes these hooks have nothing to do the qualities that we as nutritionists attribute to a product or service.

Scientifically, MNP is supposed to prevent anemia, which has certain symptoms and causes. If we had conducted research to understand whether or not people know what anemia is, what causes it has, and what symptoms, we would have found out that actually knowledge around anemia is pretty low. Our conclusion would have been: ‘Okay, we need to educate people about anemia, what it is, and why its important to prevent it.’ But that would not have told us one important thing: People care about anemia. So, is informing them going to help us gain acceptance of product, or do we have to understand what people really care about in their community? How do they frame issues about health? What symptoms do they associate with diseases? And then we need to explain in a language which people speak, and using symptoms they know.

I’m not saying it’s not important for people to watch out for symptoms of certain diseases. Some of the most successful education nutrition programmes take people’s own perspectives and understandings into account. For example, a Kenyan non-governmental organisation (NGO) designed a campaign around breast cancer prevention and self-examination … They were dealing with a quite illiterate population, so they took nuts and beans from what was available locally, and created a string of different-sized beans and nuts so that women could feel what a possible tumour could feel like – instead of explaining in medical language what it means to have cancer.

It’s very practical to use local materials. People are all about teaching, feeling, hearing, and  smelling, so what makes our research approach different is that we took the audience as the centre of our research. We took a step back from the thing we wanted to promote, and tried to understand what was important to people and their lives. It helped us immensely to brand MNP around those little nudges that would trigger people to accept the product.

SAL: I hear that you have a master’s in social marketing, Yana. How often do you find people with your skill-set in the sector where you work? 

YM: I think that my social marketing degree has significantly contributed to the ways in which I think today.  Many of these may be unconventional, in that I step back and look at the entire system of issues, from the side of supplying certain services, products, or behaviors to the demand side. But I also think the few programs that look at health and social marketing today – and I have been asked to be a lecturer on a distance social marketing programs – may be lacking a little bit of technical nutritional understanding. What’s important is that public health and nutrition degrees today integrate courses on behavioral economics, on marketing. I feel nutrition has been increasingly medicalized in the developing world. As a result, we have somewhat lost that human touch, and the socio cultural drivers of what is causing many of these problems. So a degree or course on these disciplines can be very, very helpful. But we don’t find many people with this degree. We are a rare breed!

SAL: If people wanted to learn more about social marketing, where could they go? Is there a website or distance learning course they might take?

YM: A number of universities offer social marketing courses. But the social marketing sphere is  still quite small in terms of places where to go. The annual World Social Marketing conference 2017 was in Arlington and, as far as I know, this was the first time UNICEF was represented there by the global director of their communications for developme[U2] nt department. This was a big deal, as the social marketing sphere is still quite dominated by actors from the developed world, addressing problems such as overweight, obesity, smoking, HIV, drug prevention, and so on.

The UK is very strong in the social marketing field. The National Social Marketing Centre in London started off as an NGO, and is now a consulting firm. It provides free online resources on the social marketing planning providers, plus some foods. The University of Brighton, UK, offers a social marketing programme, as does King’s College, London.

Different discussions about behavioral change communication (BCC) are taking place globally. BCC puts communication at the centre, and is all about designing communication strategies. Meanwhile, social marketing looks at understanding problems, and finding solutions which can be of a different nature. They can, but don’t have to, include communication and education, ways of redesigning an environment. It also looks at putting up control mechanisms. Thus, at policy levels, if we look at banning smoking, these are all technically tools that are the outcome of thoroughly-done social marketing research that understands the barriers, behaviors, and chief benefits.

From my heart, I wish to see more actors in this field who put one and one together, and include an understanding of people’s behaviors in their nutrition analyses, instead of adding these topics as an afterthought. We need to realize today that, in societies that are being increasingly diverse, globalized, and complex in terms of the industrialization of food systems marketing, we cannot take nutrition as a stand-alone subject. We have to look at the underlying behavioral and socio-cultural perspectives. I hope nutrition degrees not only educate people about nutrition, but help us understand why people do what they do.

Improving Nutrition Equals Improving Lives

A partnership fighting the debilitating effects of hunger and malnutrition in the developing world

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Sight and Life is an active member of the DSM-World Food Programme (WFP) partnership, entitled “Improving Nutrition – Improving Lives”. The partnership aims to fight the debilitating effects of hunger and malnutrition in the developing world. This shows how public-private partnerships can work and deliver, through harnessing individual strengths.

“I am the co-chair of the partnership from DSM’s end. As part of the joint management team, I provide strategic guidance and my expertise in nutrition science to the partnership.
– Klaus Kraemer, Director Sight and Life

Sight and Life provides the partnership with scientific expertise. Areas include food vehicle development using a consumer-first approach; rice fortification technical advice for efficacy trials and programs; an advocacy and communication platform; and capacity building through training on nutrition basics, situation analysis, response options, behavior change communication and advocacy, and program resource materials such as the Cost of the Diet Tool.

“I’m assessing World Food Programme (WFP) behavior change communication strategies, and developing a framework that can be used across all the nutrition programs in both emergency and non-emergency settings, as well as developing the guidance documents to help country program officers.”
– Eva Monterrosa, Sight and Life Scientific Manager 

The partnership also helps to implement large-scale micronutrient powder (MNP) programs as part of WFP nutrition strategy. As a co-founder and member of the Home Fortification Technical Advisory Group (HF-TAG), Sight and Life has played an important role in the development of a 15-micronutrient formulation for MNPs that has been endorsed by both the WFP and The United Nations Children’s Fund (UNICEF). MNPs have now been recognised as an effective way to deliver indispensable nutrition, through various delivery platforms, either free or through a market based approach.