MID-TERM EVALUATION:
THE PSI/PARAGUAY SOCIAL MARKETING PROGRAM
(Cooperative Agreement No. 526-00-A-97-00004-00)
September, 2000
Prepared by Pamela Faura and Elizabeth Eggleston
USAID/Paraguay
Juan de Salazar 364
Asuncion, Paraguay
tel: (595-21) 220-715/20
fax: (595-21) 213-732
Table of Contents
Executive Summary…………………………………………………… i
I. Introduction……………………………………………………………... 1
II. Program Evaluation………………………………………………….… 2
A. Result 1: Social marketing condom brand achieves .
widespread distribution……………………………………………. 2
1. Background and General Information………………………… 2
2. Findings: Marketing…………………………………….……… 5
3. Recommendations: Marketing and Distribution………………10
B. Result 2: Quality and quantity of family planning IEC
services are improved…………………………………………….. 12
1. Background/General Comments……………………………… 12
2. Findings: IEC…………………………………………………..…15
3. Recommendations: IEC…………………………………………18
C. Result 3: PROMESA institutionalized and progressively
sustainable……………………………………………………….… 19
1. Background……………………………………………………… 19
2. Institutionalization……………………………….……………… 20
a. Findings: Institutionalization…………….……………….… 20
b. Recommendations: Institutionalization…………………… 23
3. Sustainability…………………………………………………….. 24
a. Findings: Sustainability……………………………….….… 24
b. Recommendations: Sustainability………...……………… 28
Appendix 1: List of Persons Interviewed…………………………….……… 30
Appendix 2: Documents Reviewed……………………….……….………… 32
Appendix 3: FOCUS/Tulane University’s Recommendations
for the Arte y Parte Project……………………………………… 33
Appendix 4: Monthly Operating Costs of Mobile Video Unit………….…… 35
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EXECUTIVE SUMMARY
Introduction
In September 1997, USAID/Paraguay awarded Population Services International
(PSI) a four-year cooperative agreement in the amount of US$2,393,614 to
implement the “Paraguay Social Marketing Program” (PSMP). The goal of the
PSMP is to improve the reproductive health of Paraguayans, especially
adolescents and young adults and men and women in rural and periurban areas,
by making condoms accessible and implementing information, education and
communication (IEC) campaigns to increase the demand for family planning
methods. As there existed no local organization capable of partnering with PSI to
implement the PSMP, PSI established PROMESA as an NGO dedicated to
social marketing.
In May-June, 2000 a mid-term evaluation was conducted to assess the
performance of PSI and its local affiliate, PROMESA, in achieving results as
stated in PSI’s cooperative agreement with USAID. The evaluation focused on
PSI/PROMESA’s progress in the three areas of activity: 1. condom marketing
and distribution; 2. family planning IEC; and 3. institutionalization and
sustainability.
Marketing and Distribution. Although Pantera sales have not been remarkable
(304,780 units in 1998, 526,002 in 1999, and 184,897 in the first quarter of
2000), the impact of Pantera can be measured in other ways. For example,
Pantera achieved a 23.5% market share after just 18 months on the market,
second only to Sultan’s 45%. In addition, Pantera is purchased more than other
brands by Paraguayans who are rural, young (15-24 years old) and low income,
the populations that comprise PROMESA’s target group.
Pantera sales in nontraditional outlets have been far lower than anticipated at the
project’s start. At the end of 1999 (year 2), Pantera was being sold in just 7% of
the nontraditional outlets; the project’s target was 10% by the end of year 1.
PROMESA uses a broad distribution strategy to reach its target groups and does
not employ a specific strategy to make condoms more accessible to adolescents,
the project’s primary target. Other condom distributors have followed
PROMESA’s efforts to open the nontraditional market and are now marketing
their products in nontraditional outlets.
Marketing and distribution recommendations include:
· Improve professional relations with distributor partners and explore methods
to motivate PROMESA salesmen to focus more on opening new
nontraditional outlets
· Conduct a strategic planning workshop to define a distribution strategy that
the most effective means of reaching each of PROMESA’s target groups.
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Information, Education and Communication. PSI/PROMESA conducts
information, education and communication (IEC) activities at the local and
national levels to increase demand for all family planning methods. PROMESA’s
IEC activities include the use of a Mobile Video Unit, printed materials and radio
and television spots. In addition, PROMESA’s popular Arte y Parte project is
specifically designed to reach adolescents. An evaluation of Arte y Parte was
conducted in October 1999 as part of the USAID-funded FOCUS on Young
Adults Project.
The MVU is a four-wheel-drive vehicle outfitted with audiovisual equipment and
staffed by a health communicator who presents a combination of entertaining
and educational materials about reproductive health. The MVU is a unique way
to reach rural and low-income communities with limited access to health
information. However, about half the audience at the observed MVU presentation
consisted of young children and adults over age 35. Very limited monitoring and
evaluation of the MVU and PROMESA’s other IEC activities have been
conducted
IEC recommendations include:
· Given the MVU’s high cost, PROMESA may want to reconsider it use, or at
least modify the strategy of its presentations to general audiences.
· PROMESA should guard carefully against technical errors in its products and
materials.
· There is a need for some simple monitoring and evaluation to assess the
appropriateness of the IEC strategies.
Institutionalization and Sustainability.
Institutionalization. Since its creation in 1997, PROMESA has grown to an
organization of 22 employees. It has played a leading role in breaking societal
taboos against talking openly and directly about sexuality, particularly with
adolescents. Considerable attention has been given to building PROMESA’s
internal structure, developing an identity and objectives, and defining policies and
procedures. PROMESA has implemented numerous activities to address
sustainability. PROMESA staff are hard-working, professional and committed to
social change.
PROMESA has an informal structure and management style that gives
employees freedom to manage their own time and projects without excessive
oversight. However, employees at all levels commented that they could benefit
from more guidance in carrying out their responsibilities.
One of PROMESA’s strengths is its relationship with the experienced and well￾established PSI. PSI staff have made numerous trips to Paraguay to offer short￾term training and technical assistance. However, PROMESA staff have limited
communication with PSI/Washington and only rarely seek technical assistance
from Washington.
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In a little over one year, PROMESA is scheduled to have its first Paraguayan
director. It does not appear that the organization has begun seriously planning for
this major transition.
Most staff commented that communication within the organization could be
improved. Division managers have regular contact with the director in weekly
meetings, but other staff have very limited interaction with the director; all-staff
meeting are held only a couple of times per year. Many staff have poor
understanding of PROMESA’s goals and objectives. When asked, most staff,
could not identify PROMESA’s target groups.
Institutionalization recommendations include:
· Hold regular all-staff meetings to facilitate communication and staff
awareness of PROMESA’s mission, target groups and activities.
· The Executive Director should encourage staff to establish relations with
colleagues at PSI/Washington and seek assistance from PSI/Washington
when needed technical assistance is not available at PROMESA.
· PROMESA employees would work more effectively with closer guidance and
direction.
· In the upcoming year, PROMESA should begin developing a plan for the
organization’s transition to Paraguayan leadership.
Sustainability. PROMESA’s current cost recovery is lower than planned (4.3%
in 1998-99) due to factors such as lower than expected condom sales and lack of
cross-subsidy products. PROMESA states that it will have three cross-subsidy
products on the market by the end of Year 4: multivitamins, flavored oral
rehydration salts (ORS) and the female condom.
PSI/PROMESA’s reliance on USAID as its main donor has decreased from 94%
in 1997 to 82% in 2000. To date, USAID funding totals US$3,075,830, and non￾USAID donor funding totals US$466,822.
Financial sustainability recommendations include:
· PROMESA needs to clarify its definition of a cross-subsidy product and price
products accordingly. If a product is intended to generate income to help
support the social marketed products, it should be priced competitively rather
than given a low price to reach low-income populations.
· PROMESA should strengthen its efforts to promote its image through more
and continued press coverage and collaborations with other NGOs and the
MOH to help attract additional donor funding for PROMESA as a local NGO.
· Future sustainability assessment should include a measure of the
effectiveness and cost efficiency of various activities, including mass media
advertising, Arte y Parte, and the MVU.
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INTRODUCTION
Paraguay currently has an estimated population of 5.5 million people and a
fertility rate of 4.3 births per woman. Fertility is significantly higher among rural
women, 5.6, than among urban women, 3.2. Approximately 57% of women use
a method of contraception, 48% modern methods and 5% traditional methods.
About 49% of rural women use a contraceptive method, compared to 65% of
urban women. Adolescents are the age group least likely to use family planning.
Just 42% of adolescent females in union use family planning compared to 57% of
20-24 year-old women. Although the country has made strides in improving the
reproductive health of its population, rural women continue to have contraceptive
usage rates that are substantially lower, and fertility rates higher, than the rates
of urban and periurban women.
The political climate of Paraguay has been and continues to be a key
determinant of the success of reproductive health programs in that country. A
1989 coup ended the 34-year Stroessner dictatorship, during which time
pronatalist policies and opposition from the Catholic Church resulted in the
absence of any family planning activities from the public sector. The 1992
National Constitution established the right of all persons to family planning
services, and improving reproductive health has been a stated priority of the
government since that time. However family planning suffered a setback in 1998
because the Minister of Health at that time was opposed to all modern methods
of contraception. A new Minister of Health was appointed in March 1999, and
modern methods of contraception are once again a priority of the national
agenda.
In September 1997, Population Services International (PSI) was awarded a four￾year cooperative agreement in the amount of US$2,393,614.00 by
USAID/Paraguay, to implement the “Paraguay Social Marketing Program”
(PSMP) in Paraguay. PSI made a counterpart contribution of US$200,000. The
PSMP supports USAID/Paraguay’s 1996-2000 Special Objective, Increased use
of voluntary family planning services. The goal of the PSMP is to improve the
reproductive health of Paraguayans, especially adolescents and young adults
and men and women in rural and periurban areas, by making condoms
accessible to these target groups and by implementing national information,
education and communication (IEC) campaigns that will increase the demand for
family planning methods. As there existed no local organization capable of
partnering with PSI to implement the PSMP, PSI established PROMESA as an
NGO dedicated to social marketing.
A team of two consultants, Ms. Pamela Faura, PSI Country Representative for
Cuba and the Dominican Republic and former Country Representative for
Paraguay, and Dr. Elizabeth Eggleston, Senior Technical Advisor for
Reproductive Health, USAID/Paraguay, conducted the mid-term evaluation of the
program. The evaluation field visits were carried out in the field from May 22 –
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31, 2000. The purpose of the evaluation was to assess the performance of PSI
and its local affiliate, PROMESA, in achieving results as stated in the cooperative
agreement, for the period October 1, 1997 through March 31, 2000, and to make
recommendations for enhancing the project’s efficiency and effectiveness.
The methodology of the evaluation included review of existing written project
documents, reports and media products; interviews with project staff, USAID
representatives, members of the board of directors of PROMESA, distributors, ad
and research agencies and other key stakeholders; and site visits to sales outlets
in Asunción and the Interior (outside Asunción) and to a presentation of
PROMESA’s Mobile Video Unit (MVU) in a periurban area of Asunción. See
Appendix 1 for a list of persons interviewed and Appendix 2 for a list of the
documents reviewed.
The report is organized to respond to the specific results outlined in the
cooperative agreement: Result 1: Social marketing condom brand achieves
widespread distribution; Result 2: Quality and quantity of family planning IEC
services are improved; and, Result 3: PROMESA institutionalized and
progressively sustainable. In each section, the report includes background and
general information, specific findings and recommendations for each result.
PROGRAM EVALUATION
A. Result 1: Social marketing condom brand achieves widespread
 distribution.
Indicators for this result include: 1) condom sales and 2) the percent of
nontraditional outlets carrying the PSMP condom brand.
1. Background and General Information
An April 1997 supplement to the original PSMP proposal provides clarification on
the condom marketing options and financial model proposed by PSI. PSI
participated in meetings with Sultan manufacturer, Ansell, and local Sultan
distributor, PROCON, to explore options of either repositioning the Sultan brand
or developing a second, less expensive Ansell brand that would be tailored to the
specific needs and desires of the PSMP’s target populations. This strategy was
pursued in order to minimize impact on the current commercial condom market.
Ansell/PROCON did not accept PSI’s options, and the decision was made in the
first quarter of 1998 for PSI to introduce its own condom brand that would fill a
void in the current condom market, positioned and priced between the public
sector condom and the least expensive commercial brand. The PSI/Bolivia social
marketing program’s condom, Pantera, along with its logo, packaging and
slogan, was selected for introduction in Paraguay. With condoms provided by
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USAID, PROMESA began distributing Pantera to nontraditional outlets in July
1998.
Social marketing bases the selling price of a product on market research and on
a price that is within the buying power of potential low-income consumers. A two￾pack of Pantera is sold to the Paraguayan consumer for 1,000 guaraníes (Gs.),
or approximately US$.30 (US$.15 per condom unit).
Table 1 shows PSI/PROMESA’s target indicators. The target of 5,000,000
condom sales in Year 1 (the 1997 Paraguayan condom market was estimated at
4.3 million at that time) and 10,000,000 in Year 4 assumed that the PSMP brand
would be a repositioned Sultan, thereby building on an existing brand equity. As
stated previously, discussions with Ansell/PROCON did not produce the intended
result and PROMESA introduced its own condom brand, Pantera. In 1999,
PROMESA revised its targets, indicated in the second row of Table 1. The
revised figures also took into account USAID/Paraguay’s request that PROMESA
not distribute the social marketing condom brand to pharmacies. This decision
was later reversed in mid-1999, largely because many pharmacies also served
as distributors to other outlets. PROMESA’s year 2000 workplan included the
revised sales targets for Pantera.
Table 1: PSI/PROMESA Target Performance Indicators
Lower Level
Result
Indicator 1998 1999 2000 2001
(9 mos.)
1. Condom sales
(targets from original
PSMP)
5,000,000 6,500,000 8,000,000 10,000,000
2. Condom sales
(targets revised in
1999)
400,000 750,000 750,000* 750,000
Result 1: PSMP
condom brand
achieves
widespread
distribution
3. Percent of
nontraditional
outlets carrying
PSMP condom brand
10% 20% 30% 40%
*The target for 2000 is identical to 1999 because it was based on actual sales in 1999 of 526,002
and, therefore, represents a 42.5% increase.
In August 1999, PROMESA subcontracted a market research firm (ICA) to
conduct six store audits, one every two months, in order to determine condom
market share and the size of the overall condom market. The current commercial
condom market is estimated at 4.9 million units, representing an increase of 14%
in three years. Paraguay’s conservative social climate and the economic
recession that began about one year ago may have influenced this slow rate of
increase in condom sale. ICA suggested that competition from Playboy, a low-
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priced (3/1,000 Gs.) condom introduced in early 1999, might also contribute to
the lower-than-anticipated sales of Pantera.
The store audits indicate a slow, steady growth trend for Pantera, especially in
the Interior. Sales are higher in the central and southern regions of the country
and lower in the east (border with Brazil). ICA suggested this may be due to
competition with inexpensive condoms that come over the border from Brazil.
Although Pantera sales have not been remarkable (304,780 units in 1998,
526,002 in 1999, and 184,897 in the first quarter of 2000), the impact of Pantera
can be measured in other ways:
· According to the January/February 2000 store audit, Pantera achieved a
23.5% market share after just 18 months on the market, second only to
Sultan’s 45%.
· Pantera is being sold in 2,000 nontraditional outlets that previously did not sell
condoms.
· Store audits indicate that condom brands Sultan and Preventor are now being
sold in many of the nontraditional outlets where Pantera is sold, perhaps
thanks to the efforts of PROMESA to open this market.
· A KAP (Knowledge, Attitudes and Practices) study conducted by PROMESA
at the end of 1998, indicated that Pantera was the condom brand most
recognized (82%), followed by Sultan (73.4%).
· Pantera was being purchased more than other brands by people identified as
rural, young (15-24 years old) and low income, the populations that comprise
PROMESA’s target group.
The target indicator, percentage of nontraditional outlets carrying the PSMP
condom brand increased from 10% in year 1 to 40% in year 4, was based on a
1996 estimate of 16,000 nontraditional outlets. Sales in nontraditional outlets
have been far lower than anticipated at the project’s start. At the end of
December 1999, Pantera was being sold in 1,156 nontraditional outlets, or 7% of
the nontraditional outlets counted in 1996, and in 2,652 traditional outlets. By the
end of May 2000, Pantera was being sold in 4,875 outlets (both traditional and
nontraditional) and, although PROMESA expects to exceed its target of 5,000
outlets by the end of the year, Pantera’s presence in nontraditional outlets is
expected to remain well below original projections. Factors that have contributed
to a slower progress than planned in the nontraditional sector include:
· PROMESA was not permitted to sell Pantera to pharmacies until May 1999.
PROMESA claims this may have had an impact on the credibility of Pantera
as a quality condom to the nontraditional retail owner. (In other PSI projects,
the condom brand is sold simultaneously in traditional and nontraditional
outlets).
· Storekeepers over age 50 were found unlikely to agree to sell condoms.
5
· The PSMP distribution strategy was revised in mid-1999 to include traditional
outlets such as pharmacies and chain supermarkets. This may have resulted
in salesmen being less eager to seeking out new nontraditional outlets, as
larger volume sales were easier to complete at pharmacies and
supermarkets.
2. Findings: Marketing
Product
PROMESA salesmen reported that there have been occasional comments from
retailers that some clients have complained about the small size of the condoms
or that they tore.
The salesmen interviewed also stated that, according to their retail customers,
the biggest barrier to Pantera’s acceptance is that consumers do not completely
trust the product because they equate low price with low quality. The evaluator
confirmed this opinion during the interviews conducted with two distributors and
with retailers during the site visits to outlets.
One of the PROMESA salesmen in Asunción stated that he has received
comments from some of his larger retail customers complaining about the
expiration date on Pantera (February 2001). PROMESA uses a three-year
expiration date, which is recommended, for countries with hot, tropical climates
such as Paraguay. Other major condom brands were found to use the five-year
expiration date.
Price
All but one of the 60 outlets visited, were found selling Pantera for 1,000 Gs. The
1998 KAP conducted by PROMESA indicated that 89% of those interviewed
knew that the price of Pantera was 1,000 Gs. This was likely due to the fact that
the price is printed on the packaging and on the point-of-sale posters.
Distribution and Sales
Distribution Strategy
The original distribution strategy of the PSMP called for making condoms
available in nontraditional outlets frequented by its target groups such as, motels,
small grocers, convenience stores, kiosks, pancheros (portable food carts), bars,
beauty shops, barbers, bus terminals, etc. As previously mentioned, this strategy
was revised in May 1999 to include pharmacies, which also serve as distributors
to other outlets. Pantera sales increased by 75% between May 1999, when
PROMESA launched a new advertising campaign and began selling Pantera to
pharmacies, and September 1999. PROMESA’s Sales and Marketing Manager
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felt that the boost in sales had more to do with the new advertising campaign
than the expansion to pharmacies, where Sultan has had a long and strong
presence.
PROMESA decided that its original target groups were too broad to reach
effectively and revised them in their 2000 Workplan. The current target groups
are:
· Primary target group: 1) youth (15-24) in periurban and rural areas;
· Secondary target groups: 1) low income, adults (25-34) in urban, periurban
and rural areas and 2) high-risk populations such as commercial sex workers
and their clients, truck drivers, soldiers and migrant workers.
It was surprising to discover that the project still follows a broad distribution
strategy to reach these target groups. For example, there was no specific
distribution strategy to make condoms more accessible in outlets frequented by
youth, the project’s primary target.
The evaluators found that most staff were unaware that the target groups had
changed and could not name either the new or the former target groups. While
some, but not all, division managers could name PROMESA’s main target
groups, they were not aware of the last target subgroup.
Trade Margins
Social marketing offers competitive margins to distributors, wholesalers and
retailers to stock, promote and sell the social marketed product. And, in theory,
high sales volume should make up for the commission on a low-priced product
such as a condom. When sales of Pantera did not result in the expected increase
anticipated from entry into pharmacies, PROMESA revisited their margin
structure and found that it was less than competitive. A change in price structure
was instituted in October 1999 (see Table 2), after which time distributors bought
more stock and sales increased.
Table 2: Pantera Margin Structure (from 2000 Workplan)
Distribution Level Price* Margin
Distributor Gs. 500 ($.14) 40%
Wholesaler (usually sells directly to the consumer) Gs. 600 ($.17) 66%
Retailer Gs. 700 ($.20) 43%
Consumer Gs. 1,000 ($.28)
*Exchange rate: US$1 = Gs. 3500
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Distribution Channels
PROMESA employs two main distribution channels: subcontracts with national
distributors and its own team of five sales agents who report to the PROMESA
Sales and Marketing Manager.
PROMESA staff commented on their continued disappointment with the results
of their main distributor, Aconcagua. PSI Marketing Manager, Françoise Armand,
reviewed this issue during her March 1999 visit to provide technical assistance to
PROMESA. At that time she took part in a meeting between PROMESA and
Aconcagua’s sales supervisor and territory manager and proposed a strategy
that would lead to a healthier relationship between the two organizations. This
included PROMESA salesmen turning over new traditional outlets to Aconcagua.
Unfortunately, Aconcagua soon had a major turnover at the management levels
and PROMESA’s Sales and Marketing Manager did not meet with the new
managers to follow up on Ms. Armand’s proposed strategy. PROMESA’s
salesmen stopped turning over their new outlets to Aconcagua after about six
months (September 1999), stating to the evaluator that they were not anxious to
turn over their outlets and future sales to one of the distributors without a strategy
to compensate for this loss in sales commission.
The same issues remain unresolved: a.) the competition between the distributor
and PROMESA salesmen for the same sales outlets and b.) the advantage that
PROMESA’ salesmen have of a lower price and more incentive items to offer the
retailer served as a disincentive to Aconcagua. Aconcagua now has a new
General Manager, Oswaldo Fernández, who appears interested in increasing
Pantera sales and improving Aconcagua’s relationship with PROMESA. Mr.
Fernández came to a meeting at PROMESA with the acting Sales and Marketing
Manager during this evaluation period, to discuss the current relationship and
offer some suggestions. In addition, PROMESA’s new oral contraceptive product
manager is working to develop a better relationship and strategy with another
distributor, Superfarm, which sell about 100 gross Pantera per month.
PROMESA reports that they are launching a new incentive strategy with
Superfarm in June, to encourage their salesmen to sell more Pantera. Superfarm
also distributes Sultan and Preventor.
PROMESA’s five salesmen (two in Asunción, one in Central, one in the east, and
one in the south) received training in social marketing and sales from the Sales
Director of the social marketing program in Brazil in mid-1998, prior to the launch
of Pantera. The three salesmen interviewed appeared knowledgeable about their
sales regions and dedicated to their jobs. They have monthly sales targets, are
paid a commission on all sales, and receive a bonus for each new outlet that they
open. Although the salesmen are aware of the goal of expanding the
nontraditional sector, they feel that it is financially more beneficial to focus on
sales to pharmacies and larger customers than to the smaller, nontraditional
outlets. Selling to nontraditional outlets requires that the salesmen spend time
8
educating the retail owner about the PSMP and motivating him/her to agree to
sell condoms.
PROMESA also employs a mobile video unit (MVU) that travels around the
country, making scheduled presentations to communities in the Interior to
promote safer and responsible sexual behavior. The communicator of the MVU
was recently fired due to her resistance to promoting and distributing Pantera
during the MVU presentations and coordinating with the PROMESA salesman in
the region. A new communicator was hired in May 2000, and the evaluation team
attended her first presentation, where she promoted and distributed samples of
Pantera. PROMESA hopes that this strategy will help promote the brand and
increase sales.
Visit to Outlets
Visits were made to a total of 60 Pantera sales outlets: 30 in the Asunción area
including the neighborhoods Obrero, Alto Tacumbú, San Pablo and Hipódromo,
and 30 in towns of the Interior including Areguá, Altos, Eusebio Ayala, Santa
Helena, San José de Arroyo, Guairá, Coronel Oviedo and the road to Caaguazú.
Many of the outlets visited were selected at random by the evaluator and
included pharmacies, marketplaces, despensas (small grocers), gasoline
convenience shops, self-service grocery stores, a bus terminal, and motels.
Approximately half of the outlets that were visited did not carry Pantera. Of those,
approximately half said that they would sell it if offered to them while the other
half said that they would not because people don’t ask for Pantera. Several
sources commented that the Paraguayan retailer culture is to buy only products
to sell that his/her customers asks for. Discussion with the distributors confirmed
that their own salesmen see Pantera as one product among many others and
that little effort was made to push a product that the retailer did not ask for.
Many of the smaller outlets and some smaller pharmacies in the Interior were
found to have poor product rotation. A common sale to a despensa is one
dispenser of Pantera (24, 2-packs) every two to three months. This situation is
unlikely to change unless consumer demand is increased for the product.
Sultan and some Preventor condoms were found in many nontraditional outlets
that sold Pantera. PROMESA salesmen commented that other brands are now
taking advantage of PROMESA’s efforts to open the nontraditional market. Many
of the retailers that carried both Pantera and Sultan claimed that Sultan was the
condom of choice and that, although people were aware of Pantera from the
publicity, they didn’t trust it because of its low price. No educational pamphlets by
any brands were noted at any outlets.
9
Marketing
Advertising
According to the advertising and market research firms used by PROMESA, no
other condom has had the amount of publicity and promotion in Paraguay that
Pantera has had. In fact, according to the KAP study conducted at the end of
1998, the 1998 TV and radio campaign succeeded in achieving extremely high
brand awareness (82%) with its Pantera TV spot, radio jingles (“Ponete Pantera”)
and point-of-purchase posters. The first campaign, in 1998, had four objectives:
1) to increase condom use as a contraceptive method; 2) to increase condom
use in high-risk situations; and 3) to create the habit of buying condoms; and, 4)
to create demand for Pantera.
In October 1999, a new advertising campaign was launched that included three
new radio spots (two in Spanish and one in Guaraní) and one new TV spot (“Los
Piezecitos”). This campaign was conducted in conjunction with an IEC campaign
that included five television testimonials from well-known Paraguayan
personalities about pregnancy prevention, abstinence and STI/HIV prevention
and 12 radio testimonials (eight in Spanish and four in Guaraní).
Broadcasting on television is very expensive in Paraguay. PROMESA has
succeeded in achieving discounts for its advertising and obtaining free air time
for educational spots in conjunction with the purchase of Pantera spots.
PROMESA has not succeeded in creating significant demand for Pantera; that is,
in translating brand awareness into product trial and continued use. Limited
public demand for Pantera has probably contributed to apathy on the part of the
wholesalers and retailers to promote Pantera. Nasta Publicidad, the advertising
agency used by PROMESA, Aconcagua and Superfarm all commented that they
were surprised that Pantera has resulted in such low demand given all the
publicity that PROMESA has invested in it.
PROMESA’s KAP study, conducted in late 1998, allowed for the measurement of
the impact of the first advertising campaign. The KAP indicated that Pantera was
the brand most recognized (82%), followed by Sultan (73.4%). PROMESA staff
conducted two focus groups in December 1999 (one in Asunción and one in
Coronel Oviedo) to assess the results of the second campaign. The focus groups
showed that the “umbrella ” poster was not effective and the voices in the “Los
Piezecitos” television spot spoke too fast. PROMESA is currently planning a
consumer intercept study to get a profile of Pantera users, measure the impact of
the most recent advertising and IEC campaigns and validate the price of Pantera
to the consumer.
Nasta Publicidad suggested that some additional market research would be
helpful to explore message recall, assess public opinion regarding Pantera, and
identify barriers to buying Pantera in order to better help them design an
advertising strategy. Nasta staff also felt that it would be helpful if PROMESA
10
were to share their sales strategy and Pantera sales with them and give them
feedback on the results of their second campaign. Their main contact at
PROMESA was the Sales and Marketing Manager, whose background was
primarily in sales.
Product Promotions
Discounts in price are given to wholesalers and retailers who purchase quantities
over five and over 10 dispensers. Incentive items (T-shirts, baseball caps and
duffel bags) are also reserved for the larger buying customers. There is currently
no incentive for the small retailer to buy Pantera.
PROMESA is about to begin a consumer product promotion that consists of a
scratch card to identify a prize. Some of the PROMESA salesmen commented
that they had suggested some ideas for regional promotions. However, they feel
that their ideas have not been heard and that the marketing strategies are
targeted more to Asunción.
Point-of-Sale Material
The current Pantera dispenser is black and contains 24 two-packs. Many
dispensers were observed sitting in a corner on a shelf, or hidden under a
counter. In comparison, Sultan has recently come out with a large red display
stand. PROMESA salesmen said that they had requested a nice display stand of
the Sales and Marketing Manager over a year ago. PROMESA reports that work
is now underway to produce one in the next month.
The current dispenser size appears too large and too expensive to interest the
smaller kiosk retailers and pancheros, who have limited space and considerable
purchasing limitations.
Visits to outlets revealed that most of the retail shops that sold Pantera had at
least a sticker and, in some cases, also a poster on display. However, these
were usually difficult to locate due to their dark color (black) and the fact that
most of the nontraditional outlets were not well lit. Two new blue posters were
developed in 1999. One, depicting a couple standing beneath an umbrella, is not
being distributed in rural areas because the focus groups conducted in
December 1999 indicated that using an umbrella to symbolize protection with a
condom was not understood in rural areas. The second poster uses a “stop light”
motif on a blue background. This poster was seen in only three outlets in the
areas visited in the Interior.
3. Recommendations: Marketing and Distribution
1. PROMESA should revise its condom sales and percent of nontraditional
outlets indicators as well as its sales per capita projection and submit these
officially to USAID.
11
2. Continue to improve professional relations with distributor partners and
explore a new compensation scheme for PROMESA salesmen that will
motivate them to turn over their outlets to the distributors and focus more on
opening new nontraditional outlets. Consider using Marcos Frutos, the most
experienced and well spoken of PROMESA’s salesmen, as a resource in the
field for the others.
3. Conduct a strategic planning workshop with PROMESA managers, IEC staff
and Pantera salesman to define a distribution strategy that will better meet
the needs of each of the project’s key populations (youth, high risk groups).
This meeting could also serve to clarify PROMESA’s goals, target groups and
definition of social marketing with the managers and staff of PROMESA. All
staff should all be able to talk about these with ease.
4. Request or purchase a distribution map from the market research firm ICA to
help identify those outlets in each community that have higher product
rotation. These should be the outlets that PROMESA salesmen focus on
reaching until a general demand is created for Pantera. Incentives need to be
developed for each distribution channel. Until a demand is created, even the
small retailers will need to be motivated.
5. Change the expiration date on the packaging to coincide with the local
standard of five years. However, PROMESA salesmen should be aware of
the importance of suitable condom storage conditions.
6. Although there was no evidence that the selling price of Pantera should be
increased, especially given the current economic crisis, PROMESA might
want to consider selling Pantera in a three-pack for 1,500 Gs., as many of the
retailers that were interviewed in the Interior claimed that consumers did not
notice that Pantera contained two condoms, as opposed to three, as in the
other brands. This strategy might help to save on packaging costs.
7. Design and produce a display that draws attention to Pantera condoms and
reprint stickers and mobiles with florescent eyes so that they stand out.
8. Develop a dispenser that holds 10 packages for the smaller pancheros and
kiosks.
9. Develop regional promotional strategies that the salesmen suggest such as:
handing out free samples at gas stations (should be popular with the scratch
cards inside), sponsoring local sporting events (much cheaper than
sponsoring a national soccer game), offering prizes for a local radio contest or
helping sponsor a fiesta patronal. A suggestion made by Aconcagua’s
General Manager included talking to retailers about promoting Pantera (and
why they should) and announcing that they could win a prize for doing so. A
12
“mystery client” could then visit outlets and instantly give the retailer who
promotes Pantera, a little prize (i.e., key chain, T-shirt, baseball cap). If the
retailer doesn’t promote Pantera, the “mystery client” announces, “too bad,
you could have just won a prize!”
10.Coordinate the visits of the MVU so that, when possible, they correspond with
Pantera promotional activities in the regions. The MVU schedule should be
developed with input from PROMESA’s regional salesmen.
11.Track sales by department, not just by sales zone, and track trends as they
relate to advertising campaigns, trade promotions and MVU presentations.
12.Given limited resources, PROMESA should also confirm the most effective
means of reaching its target groups. Popular youth radio programs and radio
programs that broadcast sports games (males in Paraguay still make the
majority of decisions regarding use of condoms) might be good bets.
PROMESA could look into the costs of advertising on regional TV stations in
the bigger cities, as opposed to national stations.
B. Result 2: Quality and quantity of family planning IEC services are
improved
Indicators for this result include: 1) Target populations view regular condom use
as responsible behavior; 2) Target populations report condom use with
nonregular partner and; 3) Target groups recall contraceptive products benefits.
1. Background/General Comments
Prior to the establishment of PROMESA in 1997, activities and campaigns
promoting the use of family planning in Paraguay were few in number and limited
in scope. Paraguayan culture is socially conservative, and there has been little
open discussion of sexuality, particularly adolescent sexuality. Since 1997,
PSI/PROMESA has played a leading role in breaking taboos concerning
discussion of sexuality by conducting information, education and communication
(IEC) activities at the local and national levels to increase demand for family
planning methods in general.
The PSI Social Marketing and Information, Education and Communication
Program for Paraguay (PSMP) proposal states that the goal of PSI/PROMESA’s
IEC campaigns is to “increase the knowledge and quantity of information and
knowledge of family planning methods among consumers and providers, and to
translate that knowledge into contraceptive use” target groups. PSI/PROMESA
changed its target groups in late 1999, narrowing its focus from all Paraguayans
of reproductive age in rural and periurban areas to: (1) youth aged 15-24 in rural
13
and periurban areas and (2) low-income adults aged 25-34 in all areas (urban,
periurban and rural). PSI/PROMESA’s 2000 Workplan also identifies high risk
persons such as commercial sex workers and their clients, truck drivers, and
soldiers, as a third target group.
PSI/PROMESA’s IEC activities make use of both interpersonal communication
and mass media and include:
· Printed materials distributed through the MVU and Arte y Parte
presentations;
· Radio spots promoting family planning use;
· Educational television spots, including spots featuring Paraguayan celebrities
promoting condom use;
· Mobile Video Unit (MVU) presentations;
· Family planning and reproductive health workshops in community
organizations (limited number, in 1999 only)
· Reproductive health counseling workshops for providers (limited number, in
two departments in 1999 only)
The 2000 workplan notes that PROMESA also will support the following new IEC
activities:
· Launch website providing reproductive health information;
· Produce television “debate” show to be aired in prime time;
· Hold “Concierto de la Vida”;
· Train journalists and opinion leaders about reproductive health topics;
· Conduct meetings with groups of professionals such as pharmacists,
laboratories and pharmaceutical distributors;
· Place IEC messages in bulletins and journals of the above professionals;
· Establish telephone hotline to answer reproductive health questions;
· Conduct STD-related IEC activities addressed specifically to commercial sex
workers.
Most of the above activities were scheduled to begin in the first six months of
2000. The last two activities, the hotline and IEC for commercial sex workers, are
scheduled to be launched in July-September. However, PROMESA reports that
it currently has inadequate funds to launch the telephone hotline. The IEC
activities for commercial sex workers have been rescheduled for December
2000-January 2001.
· Arte y Parte
In addition to the above IEC activities, PROMESA has a program specifically
designed to reach adolescents, Arte y Parte The project is very popular locally,
14
with presentations booked months in advance. Arte y Parte includes a wide
variety of IEC activities:
· Street theater presentations;
· School-based reproductive health workshops;
· Radio program by Arte y Parte teens for adolescents, “Con S de Sexo,”
broadcast on two radio stations;
· “Infosex” news flashes on “Con S de Sexo”
· Question-and-answer column in a popular teen magazine;
· “Hablemos Claro Sobre Sexualidad” booklet for adolescents on sexuality and
reproductive health;
· Television spots;
· Development of three videos about: (1) contraception, (2) sexually
transmitted diseases, and (3) negotiation in relationships;
· Promotional items such as T-shirts, stickers and wristbands.
The Arte y Parte project was designed to: (1) increase knowledge about sexual
and reproductive health issues among adolescents aged 15-19 in order to
promote responsible sexual behavior, and (2) to increase the communication
and negotiation skills related to sexual and reproductive health issues. This
evaluation report does not assess in detail the implementation or impact of Arte y
Parte, as a thorough evaluation of its reach and impact was conducted in
October 1999 by Tulane University as part of the USAID-funded FOCUS on
Young Adults Project.
The FOCUS evaluation deemed Arte y Parte “moderately successful” overall. A
high proportion of youth in the target areas, almost 44%, were reached by at
least one Arte y Parte activity/product. The evaluation stressed that a major
contribution of the project was its role in the weakening of social taboos against
open discussion of adolescent sexuality and reproductive health issues In
Paraguay. The project was not as successful in reaching low socioeconomic
status and out-of-school adolescents as it was in reaching middle-income in￾school youth. The project increased adolescents’ levels of knowledge of selected
sexual/reproductive issues, as well as a few attitudes and beliefs concerning
responsible sexual behavior. However, the range of attitudes and beliefs on
which significant changes were observed was narrower than hoped for. There
was no clear evidence of sexual and contraceptive behavior change as a result
of Arte y Parte. Such behavior is very difficult to change, and the lack of impact
on behavior is not surprising given the project’s broadly defined target group. The
recommendations from the FOCUS/Tulane University Arte y Parte evaluation
final report are included in Appendix 3.
15
2. Findings: IEC
· Printed Materials
PROMESA produces a series of about five flyers or pamphlets of one to four
pages each. The flyers and pamphlets contain drawings and text, and each
addresses a theme such as sexually transmitted infections, the condom or the
general use of family planning. These printed materials are distributed to
individuals during Mobile Video Unit (MVU) presentations. A pamphlet promoting
Pantera also contains some generic IEC information. Printed materials have not
been revised in scope or focus since PROMESA changed its target groups in
1999.
The written materials honestly address questions about sexuality without using
euphemisms or avoiding sensitive topics. They use simple language and are
accurate and informative. Unfortunately, the pamphlets are not widely distributed
outside the MVU presentations, and many persons receiving the materials at
MVU presentations are not in PROMESA’s target groups.
For its Arte y Parte project, PROMESA produces printed materials intended for
both individuals and mass media, such as informative pamphlets for adolescents,
the magazine question and answer newspaper column and the sexuality booklet
Hablemos Claro Sobre Sexualidad. The evaluation notes that the Arte y Parte
pamphlet depicts an circumcised penis. This may be inappropriate for the
Paraguayan context, where male circumcision is rare. PROMESA reports that it
uses PSI IEC materials that were developed for use elsewhere in Latin America.
However, male circumcision is not routinely performed in any Latin American
country.
Mass Media
Radio
PROMESA has developed radio spots with reproductive health messages that
are broadcast in Spanish in urban and periurban areas, and in Guaraní and
Jopará for periurban and rural audiences. The radio spots are broadcast
nationwide on 20 radio stations. Each spot lasts an average of 45 seconds. In
each, a man or woman speaks in the first person, giving a clear message
promoting contraceptive use and reproductive health.
Television
PROMESA has developed two types of television spots. Five “testimonials” are
narrated by Paraguayan celebrities, identified in focus groups as persons from
whom family planning messages would be respected, and touch on three general
themes: abstinence, condom use, and fidelity within relationships. The
testimonials are professionally produced, and their messages were clear and
direct. In addition, two animated spots advertising Pantera condoms also contain
16
generic family planning messages. In 1999, the testimonials were broadcast for
three months, 3-4 times per day, on national television channels with high
numbers of viewers.
Due to its high cost, PROMESA decided not to make use of television for its
IEC activities in 2000. However, the testimonials created for television broadcast
are being shown during Mobile Video Unit presentations.
• Mobile Video Unit (MVU)
The MVU is a four-wheel-drive vehicle outfitted with audiovisual equipment and
staffed by a health communicator. The communicator presents a combination of
entertaining and educational materials about family planning and other aspects of
reproductive health. Since late 1999, the MVU has also promoted and distributed
Pantera condoms. The MVU presentations are made largely in rural and low￾income periurban areas where mass media are less likely to reach.
The PSMP proposal and the 1999 workplan state that the MVU will visit 20 sites
per month. The number of persons the MVU aims to reach is unclear. The PSMP
proposal states that the MVU will reach 5,000-8,000 persons per month, while
the 1999 workplan states it will reach 3,000-4,000 persons per month. The 2000
workplan states that the MVU will reach 25,000 rural persons (or just 2,083
persons/month) in 175 presentations in 2000.
In 1999, the MVU made 171 presentations, or an average of 14 per month,
reaching approximately 19,060 persons, or 1,588 per month. In comparison to
PROMESA’s other IEC activities, MVU costs are estimated to be high relative to
the number of persons reached. The vehicle and its shipping to Paraguay cost
$30,000. The cost of the audiovisual equipment and electrical generator,
purchased in and shipped from the U.S., was approximately $20,000. The
monthly cost of operating the MVU is approximately $2,113.00. Thus, PROMESA
is spending over $25,356 per year to operate the MVU, excluding vehicle and
equipment purchase costs. See Appendix 4 for MVU cost details.
MVU Site Visit
The evaluation team visited a MVU presentation in a low-income periurban
neighborhood of Asuncion. About half the audience of about 100 persons at the
presentation consisted of young children and adults over age 35. The MVU driver
confirmed that the high number of young children in attendance is typical. A
PROMESA staff suggested that adolescents, PROMESA’s primary target group,
may still be in school or on their way home in the early evening.
After starting off the presentation with a series of musical videos, a Spanish￾language foreign educational video about sexually transmitted diseases (STDs)
was shown. The video included interviews with people in the street about their
beliefs about STDs. Then, a medical doctor provided factual information about
17
STDS. The video also depicted diagrams of male and female reproductive
organs. In this section, the penises depicted were circumcised. (Male
circumcision is very rare in Paraguay and all Latin American countries.)
After the video, the newly hired coordinator of the MVU talked to the audience
about STDs. She was dynamic, comfortable in front of a crowd, and effective at
eliciting audience participation. However, she did not clarify or correct incorrect
beliefs expressed by persons interviewed earlier in the video, even when an
audience member repeated one of the misconceptions.
The MVU audience responded particularly enthusiastically to a Paraguayan
video produced by PROMESA about how to put on a condom correctly that was
in Jópara ( a mixture of Spanish and Guaraní). Other materials used were not
produced in Paraguay.
• Technical Errors in IEC Activities
The evaluation team noted that the MVU coordinator made a few incorrect
statements during the observed presentation. For example, she stated that
people should go to a health clinic regularly to get blood tests to prevent STDs. In
addition, she failed to correct or clarify a couple of incorrect statements from the
audience given in response to her queries.
Another technical error was noted during a Saturday morning Arte y Parte radio
program the evaluation team listened to. The Arte y Parte youth announcer
incorrectly told the radio audience that a Paraguayan man must obtain his wife’s
permission to obtain a vasectomy. The Ministry of Health’s manual of family
planning norms, a copy of which is located in PROMESA’s library, contains no
mention of such a restriction.
• Monitoring and Evaluation of IEC Activities
The PSMP proposal stresses that all PROMESA activities will be continually
monitored and evaluated. However, limited monitoring and evaluation of IEC
activities have been conducted. While one manager developed her own
monitoring system to track her project’s activities, there has been no overall
organizational system of monitoring or evaluating IEC activities. Very recently, in
the second quarter of 2000, PROMESA developed a monitoring plan with an
activities matrix in response to AID’s suggestions but no evaluations have
assessed the impact of IEC activities other than Arte y Parte’s. Periodic
evaluation is important to verify the immediate impact of activities. If
PSI/PROMESA evaluates only the long-term impact of its IEC activities at the
end of the 4-year PSMP, an opportunity to measure a possible short-term effects
will have been lost. It is important to know if audiences understand PROMESA’s
IEC messages upon hearing them, even if retention of the message is not long￾lasting.
18
3. Recommendations: IEC
1. Given the MVU’s high cost, PROMESA may want to reconsider it use, or
at least modify the strategy of its presentations to general audiences.
Perhaps MVU presentations could be made in locations where more
members of PSI/ PROMESA’s target groups would be present, Selecting
the intended audience more carefully, as Arte y Parte does by focusing on
a captive audience of adolescents in high schools, would help ensure that
the MVU reaches its target audience of adolescents in rural and periurban
areas, adults aged 25-35, and high risk groups.
2. PROMESA should reexamine its IEC materials to determine if they are
effectively targeting its primary target group of adolescents. Print and radio
IEC could be modified to appeal specifically to this age group.
3. Considerable care should be taken using materials developed in other
countries for all IEC activities. For example, both printed and video
materials depicting males with circumcised penises may be inappropriate
in Paraguay. (The IEC manager has indicated concern for this issue; she
recently decided to stop using a video depicting an indigenous Bolivian
couple discussion reproductive health due to negative reception from
Paraguayan audiences.)
4. PROMESA should guard more carefully against technical errors in its
products and materials. So that staff have the skills to review materials
and verify their completeness and accuracy, PSI/PROMESA should
ensure that that MVU coordinator, as well as other staff who work in the
area of IEC, receive some basic training in reproductive health and have
ample access to materials and information. PROMESA is handicapped by
its dearth of staff members with academic training in reproductive health.
However, access to and review of informational materials could help
PROMESA avoid technical errors in its IEC materials. Informational
materials are available in Paraguay but could also be accessed from
PSI/Washington or via the internet.
5. There is a need for some simple monitoring and evaluation to help assess
the appropriateness of the IEC strategies. This information could help
PROMESA develop a long term IEC strategy, expanding those activities
with the greatest impact, modifying others, and eliminating or narrowing
the scope of the least successful activities.
19
C. Result 3: PROMESA institutionalized and progressively sustainable
Indicators for this result include: 1) institutional base established and; 2) financial
strategies instituted.
1. Background
PSI established PROMESA in 1997 as an NGO dedicated to social marketing.
The PSMP proposal stated that PSI would develop within PROMESA the
“systems, structures and linkages that together constitute the institutional base of
a strong…organization.” A Board of Directors, with the Program Director as
president, was established to provide guidance to the NGO as it grew and
developed. After four years, the Executive Director’s responsibilities should be
transitioned to a Paraguayan, with PSI continuing to provide technical support to
PROMESA after this transition.
The PSMP proposal notes that institutionalization encompasses various
components: management systems, administrative and financial systems, human
resources, external relations, and governance. PSI’s management philosophy is
characterized by: commitment to collaborative interaction with public and private
sector organizations; dedication to the transfer of social marketing technology
and management skills to local partners; and experienced field management,
and technical and administrative support systems.
The PSMP proposal states that the foundations of financial sustainability derive
from entrepreneurial revenues, donor funding and cost management, the former
two deriving fundamentally from entrepreneurial and institutional strength,
respectively, while cost management determines the required level of resource
generation. It is important to note that sustainability in the PSMP does not refer
only to financial sustainability but rather to a combination of programmatic,
financial and institutional factors that lead to achieving public health impact over
time. Strengthening local capacity to implement quality programs is just as
important to increasing PROMESA’s sustainability as are financial resources.
The original PSMP proposed a design that would not only make the PSMP
condom, Pantera, sustainable, but also move PROMESA toward increased
sustainability over ten years. Revenues from sales of the social marketed
Pantera were to provide the financial base, but the strategy also called for the
introduction of products compatible with PROMESA’s distribution channels, cost￾saving measures, fees for service, creative merchandising and identification of
additional donors to help ensure the future financial viability of PROMESA.
The PSMP financial model proposes a cost recovery of 19%, fund balance of the
capital development fund equal to US$345,000. and a solvency ratio (the ratio of
cash on hand to current liabilities) ³ 2 by the end of the agreement period.
PROMESA revised its financial model in 1999 based on 100% brand ownership
20
but with lower sales indicators. This revision was never officially submitted to
USAID.
In December 1999, PROMESA revised its sustainability plan, using an evaluation
method called PRISMM, and produced a new plan for 2000-2004. While PSI’s
cooperative agreement with USAID ends in 2001, when a Paraguayan national
should take over leadership of PROMESA, the sustainability plan did not note
this transfer.
In 1998, Paraguay was added to PSI’s portfolio of countries under the
“Sustainability Matching Grant,” a three-year grant awarded to PSI by USAID to
define sustainability in a social marketing context. Matching grant support has
provided PROMESA with institutional analysis, planning and development
assistance. The grant period ends September 30, 2000.
2. Institionalization
a. Findings: Institionalization
· External Image
PROMESA has been a groundbreaking organization in Paraguay and is unique
in Paraguay in doing the work it does. Its contribution of breaking societal taboos
against talking openly and directly about sexuality, particularly with adolescents,
cannot be overemphasized. In particular, the adolescent project Arte y Parte has
been unique in Paraguay in its focus on honest communication about sex and
sexuality with adolescents. Persons interviewed commented that Arte y Parte,
generic IEC and Pantera ads all have influenced other organizations’ and
companies’ methods of communicating and marketing.
However, PROMESA is still a young organization, and public awareness of
PROMESA as an institution is not yet widespread. PROMESA staff, Board of
Directors members, consultants who have worked with PROMESA, and donors
commented that people have heard of Pantera condoms and of Arte y Parte, but
they do not link them to PROMESA. Interviewees suggested that PROMESA
needs to market itself to the public more effectively, so that its products and
activities are perceived as PROMESA outputs. For example, PROMESA is not
acknowledged as the author and publisher of the adolescent sexuality booklet
“Hablemos Claro Sobre Sexualidad.” A PROMESA logo appears on the back of
the booklet amidst the logos of organizations who supported the booklet, but
nowhere is PROMESA identified as responsible for the booklet’s content.
In 1999 there was considerable effort placed on promoting PROMESA in the
press. The launching of Arte y Parte also helped PROMESA develop a good
relationship with the Paraguayan press. However, in the past six months, with the
21
departure of the former IEC coordinator in December 1999, interviewees
commented that there has been less contact with the press, and the
organization’s prominent position in the public eye has diminished somewhat as
a result.
· Internal Sustainability
Since its creation in 1997, PROMESA has grown into an organization of 22
employees. Since the organization’s inception, considerable attention has been
given to building an internal structure, developing an identity and objectives, and
defining policies and procedures. PROMESA has implemented numerous
activities to address sustainability, including: developing a mission and logo;
implementing a public relations plan, developing printed materials describing the
organization and its activities; and getting media coverage of its activities.
PROMESA has an informal structure and management style. A strength of
PROMESA’s informality is that employees are given the freedom to manage their
own time and projects without excessive oversight. Division managers report that
the director is open to staff input and seriously considers managers’ suggestions
when offered. PROMESA employees are creative and motivated and are crucial
to the organization’s successes. However, most are young and still developing
their leadership and management skills. Employees at all levels commented that
they could benefit from more hands-on guidance in carrying out their
responsibilities.
The PSMP was designed to be a joint effort of PSI and PROMESA, and one of
PROMESA’s strengths is its relationship with the experienced and well￾established PSI. PSI staff have made numerous trips to Paraguay to offer short￾term training and technical assistance. However, less formal communication links
between PROMESA staff and PSI are weak. The Executive Director is in close
contact with PSI/Washington, but PROMESA staff have limited direct
communication with PSI/DC. Despite the available expertise at PSI/Washington,
PROMESA staff are not in the habit of directly seeking technical assistance from
that office when the Executive Director cannot provide the needed assistance.
Until recently informal communication between PROMESA and PSI/Washington
was hampered by the fact that few PROMESA staff had access to the internet.
Since August, 2000 however, all staff have had access to internet; this should
facilitate considerably communication between the two offices.
PROMESA is a young organization and thus still in the process of building
internal cohesion and an institutional identity. Within PROMESA there is clear
segmentation based on the organization’s different projects, and many staff
identify more with their project than with overall goals of PROMESA. Most
employees below the manager level (and some of the division managers) are
poorly informed about what projects other than their own are doing.
22
Most of the staff commented that communication between the director and lower
level staff, and between division managers and other staff could be improved.
Division managers have regular contact with the director in weekly meetings.
Other staff, on the other hand, have very limited interaction with the director, as
all-staff meeting are held only a couple of times per year. Many staff have poor
understanding of PROMESA’s goals and objectives. When asked, most staff,
including several division managers, could not identify PROMESA’s target
groups. Nor were many staff (other than division managers) able to define the
concept of social marketing.
PROMESA has made clear efforts to strengthen and formalize its structure. In
March 1999, the organization contracted with a human resources consultant
company, JOBS, to develop a personnel manual to standardize policies and
procedures. JOBS also helped write job definitions, revise the organizational
chart, and develop a training plan. However, some staff do not seem aware of
the manual’s contents; nor does its use seem well integrated into PROMESA. In
practice, some policies and guidelines are unclear. For example, the manual fails
to offer guidelines for employees dismissals. Guidelines are needed to guarantee
that issues of high priority or that require immediate response are handled
expeditiously. PROMESA staff interviewed expressed concern that that decisions
requiring quick responses from management are frequently delayed.
One of PROMESA’s strengths is its dedicated staff. Numerous interviewees
commented that PROMESA staff are hard-working, professional and committed
to social change. However, PROMESA’s staff are young and still developing their
job skills. In response to staff needs, PROMESA developed a training plan for the
year 2000, with assistance from JOBS. Several staff members, mainly division
managers, have received training in recent months. The training plan indicates
that other staff, such as Pantera salesmen, are scheduled to receive training.
Staff who participated in training reported that it helped improve their skills in the
workplace and also motivated them.
Training in a few technical areas is still lacking, however. For example, the
financial and administrative manager feels that she has only limited knowledge of
Quick Books, the financial management software she uses. Only one PROMESA
employee has received any training in how to write proposals. An important
aspect of PROMESA’s quest for financial sustainability is diversification of
funding, and developing key staff’s skills in the development and writing of grants
would facilitate this process.
In a little over one year, PROMESA is scheduled to have its first Paraguayan
director. It does not appear that the organization has begun seriously planning for
this major transition. It is not apparent that a current employee is being prepared
for the position, nor has there been formal discussion of the difficulties and
challenges that PROMESA will face in the transition. Several persons
interviewed commented the opinion that none of PROMESA’s current staff
23
members were ready to take on the Executive Director position and that the
position would need to be filled from outside the organization. A division manager
at PROMESA reiterated this opinion.
The evaluation team interviewed four members of PROMESA’s Board of
Directors. The members are all pleased with PROMESA’s growth and
development and proud to be associated with the organization. However, all
would like to feel more involved in major decisions made by PROMESA and
more informed about PROMESA activities. Members expressed that they would
like to be involved in major decisions, such as staff firings for example, or at least
informed a priori. Building a good relationship with the Board is traditionally very
helpful in terms of institutional development due to members’ connections as
individuals that help promote PROMESA’s image.
b. Recommendations: Institutionalization
1. PROMESA should hold meetings of all staff on a regular basis, at least
once per month. This would help create a sense of unity as an
organization and help ensure that all employees are aware of
PROMESA’s mission and full range of activities. These meetings could
also help improve communication within PROMESA.
2. As suggested by the human resources consultant, JOBS, PROMESA
should ensure that all of its products and activities are clearly identified as
PROMESA outputs. For example, printed materials should clearly display
the PROMESA logo. This would help PROMESA develop a clearer image
in the eyes of the public, donors and other NGOs. (As of September 1,
2000, PROMESA had already begun to institute this change.)
3. PROMESA should reinvigorate its efforts to maintain an active relationship
with the local press to help ensure increased coverage of PROMESA
activities. Maintaining a more active and positive relationship with the
press could help PROMESA reach a wider audience and broaden its
impact.
4. PROMESA, as a young organization still in the process of formation, could
benefit from a more hands-on style of leadership. Closer guidance and
direction would help PSI/PROMESA employees be more focused and
effective in fulfilling their responsibilities.
5. PSI/Washington is a valuable source of information and assistance for
PROMESA, and staff should be encouraged to establish e-mail
communication with staff in Washington and consider PSI/Washington as
a source of assistance when needed information is not available locally.
24
6. It is imperative that all PROMESA employees, from division managers to
staff who package condoms, be aware of PROMESA’s mission and target
groups.
7. In the upcoming year, PROMESA should begin developing a plan for the
organization’s transition to Paraguayan leadership, specifying when and
how this will take place. The plan should specify the specific types of
technical assistance from PSI that would be most helpful in the transition.
3. Sustainability
a. Findings: Sustainability
· Financial Status
The cost recovery figures in Table 3 result from dividing total revenues, including
income received from USAID and non-USAID donors, by total expenses. Total
expenses include all expenses of all projects, including micronutrients and
adolescent IEC, and not just those of condom social marketing.
Table 3: PROMESA Cost Recovery
Lower Level
Result
Indicator %Cost
Recovery
Year 1
(97-98)
Year 2
(98-99)
Year 3
(99-00)
Year 4
(00-01)
Result 1: Target 3 % 10% 16% 19%
PROMESA
institutionalized
and progressively
sustainable
No. 2:
Financial
strategies
institutionalized Actual 2.7% 4.3% 5.1%
(6 mos.)
Year 1 represents an entire year of expenses but only two months of condom
revenues, as Pantera was launched in September, 1998. The 1998-99 cost
recovery goal originally proposed by PSI for PROMESA was 10%. PROMESA
achieved only 4.3% due to lower than expected condom sales, the lack of cross￾subsidy products introduced in 1999, the low revenue base from the first year,
and the increase in expenses due to the implementation of micronutrient, non￾revenue producing communications projects in 1998 and 1999.
At the end of the first six months of Year 3, PROMESA’s cost recovery stands at
5.1%. This rate is expected to increase by the end of 2000, with increased sales
of Pantera and with the introduction of the multivitamin VitalDía and an oral
contraceptive. PROMESA estimates that VitalDía and the oral contraceptive will
25
bring in approximately US$60,000 each in net revenues during their first 12
months on the market.
Table 4 indicates PROMESA’s condom revenues. Pantera revenues (total
revenues less sales commissions) have exceeded the PSMP proposal forecasts
in both Year 2 and Year 3 due to PROMESA owning the brand and therefore,
keeping 100% of revenues.
Table 4: Pantera Condom Net Revenues
Lower Level
Result
Indicator Condom
Revenues
Year 1
(97-98)
Year 2
(98-99)
Year 3
(99-00)
Year 4
(00-01)
Result 1: Target $22,150 $30,234 $39,682 $51,250
PROMESA
institutionalized
and progressively
sustainable
No. 2:
Financial
strategies
institutionalized
Actual $12,025
(2 mos.)
$46,388 $26,135
(6 mos.)
In addition to PSI’s original counterpart contribution of US$200,000,
PSI/PROMESA has raised, as of March 2000, US$486,822 from non-USAID
sources. PSI also received $352,719 through USAID’s FOCUS on Young Adults
program between 1997 and 1999 and US$206,139. through USAID’s
Sustainability Matching Grant project.
· Financial Strategy
PROMESA’s financial sustainability depends on its ability to develop alternative
streams of income, maximize cost efficiency and remain solvent. The following
strategies for financial sustainability were proposed in the PSMP:
1. Establish revolving fund for revenues
Income from Pantera sales totaled US$84,548. by the end of March 2000. And,
while PROMESA’s condom revenues exceed the projection for condom revenues
at this date, overall revenues are low. This is due to the fact that no cross￾subsidy products have been introduced to the market yet.
2. Conduct feasibility studies to identify potential cross-subsidy
products
PROMESA is behind schedule in launching cross-subsidy products. PROMESA
commented that several factors have slowed the launching of cross-subsidy
products. First, identifying high margin, cross-subsidy products has been difficult
for PROMESA as products produced locally and from neighboring Brazil and
Argentina are readily available in Paraguay at affordable prices. In addition, a
26
feasibility study conducted by an outside agency has taken longer than expected,
and registering new products in Paraguay is a lengthy process.
PROMESA states that it will have three cross-subsidy products on the market by
the end of Year 4. As a result of feasibility study results, PROMESA is planning
to market VitalDía multivitamins this year and flavored oral rehydration salts
(ORS) in 2001. It will also market the female condom in FY2001. PROMESA is
also considering the possibility of marketing a pap smear kit, as described in the
proposal.
PROMESA has decided to sell VitalDía at the low end of the price scale in order
to make it accessible to most women of reproductive age. Revenues will cover
commodity and packaging costs and, since it will require some investment in
advertising and promotion, will only make a small contribution to PROMESA’s
overhead. It was not clear at the time of the evaluation if PROMESA plans to
introduce any cross-subsidy products that will make a substantial contribution to
its revenue account.
3. Receive fees for services and merchandise
PROMESA’s only revenue generated by fees for service and merchandise has
been US$1,558. received for conducting reproductive health seminars in private
schools and selling blue jeans, soccer balls and T-shirts with the Pantera logo. In
2000-2001, PROMESA plans to formally offer reproductive health seminars in
private high schools for a profit. In addition, PROMESA is considering selling
advertising space on its Mobile Video Unit.
4. Achieve donor diversification
PSI/PROMESA’s reliance on USAID as its main donor has decreased from 94%
in 1997 to 82% in 2000. To date, USAID funding totals US$3,075,830, and non￾USAID donor funding totals US$466,822. PSI has received funding from a
variety of international donors including, The Bergstrom Foundation (three
separate grants, including one to introduce a social marketed oral contraceptive),
The Weyerhaeuser Family Foundation, Campbell-Hall Charity Fund and The
Brush Foundation. Most of these grants were relatively small in size and were
awarded to PSI for activities in Paraguay. Locally, PROMESA has received
several small grants from UNICEF and the Fundación Ricardo Boettner.
5. Implement cost-saving measures
PROMESA has begun to institute some cost-saving measures including: control
of usage of telephone, cellular phone and office supplies; negotiating media
discounts for advertising and promotion; obtaining free radio spots for airing
generic family planning messages for every Pantera spot sold; improving
geographic coordination of MVU presentations; and conducting its own focus
27
groups to validate product messages. However, while training PROMESA staff to
conduct focus groups may lower costs, the quality of the focus group facilitation
and data analysis is almost certain to be of questionable quality. PROMESA was
not able to achieve duty-free status for its non-USAID products.
· Financial Management and Systems
PROMESA hired a local accounting consultant in 1998 to establish its financial
operating system, provide accounting services, and train and supervise someone
to take over the accounting responsibility of the organization. This arrangement
ended in December 1999, when PROMESA felt sufficiently prepared to carry out
its own financial management without outside supervision.
PROMESA uses QuickBooks accounting software package, utilized by PSI
worldwide, follows the practices outlined in the PSI Financial Manual and utilizes
standard accounting controls. PROMESA has also installed an accounting
system that corresponds to local accounting practices. PROMESA’s
Administrator has been trained in the basic use of QuickBooks and has
expressed the desire for more extensive training. She enters the financial data
into the system, but any changes in data entry can only be done by PROMESA’s
Executive Director.
In August 1998, PSI Systems Analyst Neil Boisen spent a week in Paraguay
setting up a Sales Information System within QuickBooks and training
PROMESA staff in its implementation. Sales data are entered in the Accounting
Department but can be shared with others such as the Marketing and Sales
Manager and Executive Director. The system allows the data to be analyzed in a
variety of ways such as by salesman, by region and by outlet type. This tool
allows PROMESA to monitor sales trends and make needed changes in sales
management.
In October 1998, PSI Financial Consultant Peg Bartel provided technical
assistance to PROMESA under the Sustainability Matching Grant in cost and
revenue analysis. This skill has been transferred to PROMESA’s Organizational
Development Manager who analyzes costs and revenues and tracks cost
recovery. Until now however, this information has not been sufficiently utilized in
the planning phases of marketing and sales activities.
The Executive Director makes all financial decisions of the organization with
input from the department managers. He then provides the division managers
with an annual budget with which to plan their activities. Each manager manages
his or her budget according to the annual workplan, consulting with the Executive
Director for large expenditures and changes in activities. Division managers may
not yet be comfortable with the level of financial responsibility they have. The
28
Executive Director reports that managers sometimes unnecessarily request
permission for small expenditures.
It is notable that while PROMESA has a financial administrator charged with the
organization’s financial and accounting responsibilities, her responsibilities are
limited. For example, the financial administrator said that she does not have
copies of the Financial Status Reports. These are kept by the Executive Director,
and financial administrator does not have access to them in his absence.
PROMESA had an annual audit conducted by Ernst & Young for 1998. The audit
made 24 recommendations, and PROMESA reports that all but two of the audit
suggestions were implemented within three months. PROMESA is currently
awaiting the 1999 audit report.
b. Recommendations: Sustainability
1. PROMESA needs to present officially a revised financial plan with new
financial indicators and detailed explanations for any changes to
USAID/Paraguay. It should consider preparing comparative cost recovery
figures for all projects as well as separate figures for social marketing
projects.
2. Net revenues from the sale of cross-subsidy products (gross revenues less
cost of goods sold) are a crucial tool to cover the cost of core condom social
marketing activities and help supplement USAID funds.
PROMESA needs to clarify its definition of a cross-subsidy product and price
products accordingly. If a product is intended to generate income to help
support the social marketed products, it should be priced competitively rather
than given a deliberately low price in order to reach the low-income
populations that the social marketed products aim to reach. PROMESA
needs to be more aggressive in introducing cross-subsidy products that will
render a higher profit margin. Some possible options include:
a) Exploring the possibility of distributing other pharmaceutical or mass
consumer products on a commission basis, especially to rural areas, for
international laboratories and/or local laboratories that will be involved in
the production of PROMESA’s oral contraceptives and multivitamins.
b) Reviewing the feasibility study results again. Are there any possible
cross-subsidy products that respond to a niche market, do not require a
major investment in advertising and promotion and would generate income
that would help cover some general costs of the organization?
3. PROMESA should strengthen its efforts to promote its image through more
and continued press coverage, collaborations with other NGO and MOH
29
efforts, etc. This will help attract additional donor funding for PROMESA as a
local NGO, thereby contributing to its sustainability.
4. PROMESA needs to take a harder look at how it can reduce its operating
costs. It might consider: developing a Pantera three-pack instead of the
existing two-pack; reducing the quality of paper used for printing materials
(the best is nice but not always necessary); invest more in local promotional
activities rather than national or Asunción-oriented ones; and pursue selling
advertising time on its MVU to commercial distributors, for example.
5. Future sustainability assessment should include a measure of the
effectiveness and cost efficiency of various activities, including mass media
advertising, Arte y Parte, MVU, etc., against other interventions.
30
APPENDIX 1: List of Persons Interviewed
PROMESA
David Olson, Executive Director
Sonia Marchewska, IEC Manager
Patricia Aguilar, Arte y Parte Coordinator
María Inés López, Micronutrients Coordinator
Edgar Colmán, Organizational Development Manager
Susana Nuñez, Administrator/Accountant
Lone Schack, Secretary
Juan Carlos Ferreira, Sales/Marketing Manager
Marcos Frutos, Carlos Oviedo, Roberto Bernal, Salesmen
Santiago Amarilla, MVU Driver
Santiago Frutos, Driver
PROMESA Board of Directors
Cristina Da Re, President
Magaly Avila, Vice President
Marina Petrovic, Treasurer
Blanca Villalba de Servian, Secretary
Ministry of Health
Vicente Bataglia Doldán, General Director of Health Programs
Mirta Benitez, IEC Coordinator
USAID
Gerald Barth
Graciela Avila
ICA (Market Research Firm)
Enrique Chase
Sergio Chase
Nasta Publicidad
Marcos Acosta
Jorge Paglieri
Aconcagua (PANTERA distributor)
Oswaldo Fernández, Sales Manager
Luis Alderete, New Marketing Manager
31
SuperFarm (PANTERA distributor)
César Arrúa Colmán, Commercial Manager
Others
Sandra Benitez, Financial Consultant
Jasmín Mendoza, JOBS (human resources consultant)
Rocio Galiano, public relations consultant
Rosa Javaloyes, Johns Hopkins University/CCP Representative in Paraguay
Gladys Monzon, ex-Sales Manager, Aconcagua
Tana Schémbori and Juan Carlos Maneglia, TV/Video P
32
APPENDIX 2: Documents Reviewed
1. PSI Paraguay Social Marketing Project Proposal to USAID (April, 1997)
2. USAID-PSI Cooperative Agreement (9/30/97)
3. Amendment to the Paraguay Social Marketing Proposal (4/1/98)
4. Personnel Training Plans for 1999 and 2000
5. Selection of printed information, education, and communication (IEC)
materials
6. Final Report: Encuesta Nacional de Salud Materno-Infantil: 1998. CEPEP
and CDC, 1999.
7. ICA Store Audits:
August/September 1999
October/November 1999
January/February 2000
8. PROMESA Sustainability Strategic Plan 2000-2004
9. PROMESA Workplan for 2000
10. PROMESA Sustainability Matching Grant Mid-Term Evaluation
11. PRISSM – PROMESA 1998 and 1999
12. Selection of PROMESA Quarterly Reports to USAID
33
APPENDIX 3: FOCUS/Tulane University’s Recommendations for the Arte y
Parte Project
(1) The weekly radio program “Con S de Sexo” should continue. However, it
is important that the program remain of professional quality if it is to
continue to be effective. It is also recommended that efforts be made to air
the program on stations that have greater reach of lower economic
status/out-of-school youth (e.g., popular Latin music stations).
(2) Given its low level of recall among youth, continuing the “Infosex” would
not seem to be an effective use of scarce resources.
(3) Consideration should be given to developing a radio soap opera,
preferably incorporating Guaraní, in which adolescent sexual/reproductive
health issues and themes are addressed.
(4) The use of mass media needs to continue to be reinforced by
interpersonal communications activities and vice versa. Arte y Parte was
positioned as a product, and promotional items and sponsorships are
needed to keep the name alive.
(5) If PROMESA is not able to undertake more intensive and continuous
interventions in the future, it should consider teaming with other
groups/organizations (e.g., the Municipality’s adolescent reproductive
health project) that can take advantage of Arte y Parte products.
(6) The Arte y Parte Coordinator should concentrate on creating linkages with
community groups to better reach lower income, out-of-school youth.
(7) Street theatre for the current audiences should be discontinued. However,
this modality is potentially important to reach low-income audiences and
audiences in other parts of the country. It might be the case that the same
level of quality is not needed in other settings as was required in
Asuncion, thus reducing the costs involved.
(8) Ways should be found for local institutions/groups to have more ownership
of Arte y Parte. This would both contribute to its sustainability and free-up
some of the Arte y Parte Coordinator’s time to concentrate on lower
income audiences.
(9) PROMESA needs to define a future role for Arte y Parte. While it can
potentially provide an important service to Paraguayan society, a clear
vision and set of expectations are needed in order for the Arte y Parte
brand name to serve such a purpose. The recently completed Arte y Parte
replication manual may be used in conjunction with PROMESA technical
34
assistance to replicate useful ideas both within and outside Paraguay in
the future.
35
APPENDIX 4: Monthly Operating Costs of Mobile Video Unit
716 (communicator salary)
449 (driver salary)
578 (vehicle fuel & maintenance)
370 (per diem for communicator & driver)
 $2113 (TOTAL)