2001 NMB: Report on Rapid Assessment Related to HIV/AIDS and Condom Use
Author: GITEC Consult
In June 1999, the UN Technical Working Group on HIV/AIDS for Communications and Youth conducted a media training workshop. Out of this workshop, the Task Force for the Namibian HIV/AIDS Media Campaign was established. Members from various media institutions, ministries, UN agencies, and other organizations cooperated with a wide range of partners. The Task Force chose "Take Control" as the theme for a comprehensive media campaign and "Safe Sex Saves Lives" as its first message. Various channels of communication (such as TV and radio adverts, posters, billboards etc.) had been prepared. On October 21, 1999, the "Take Control" campaign was launched officially. During the year 2000, the National Social Marketing Program (NaSoMa) commenced sales of its main condom product "Cool Ryder". Shortly afterwards, "Life's Choice" and the female condom "Femidom" followed.
Purpose / Objective
A first aim of the 2001 Rapid Assessment had been to gain information about condom use in general, and knowledge and experiences with the NaSoMa condoms in particular. This information should be helpful to streamline NaSoMa's strategy for the next phase of the project.
The second aim of the 2001 Rapid Assessment had been to follow up on major issues of the 2000 study, namely awareness of the Take Control campaigns and changes in attitude towards HIV/AIDS. One major player in efforts to achieve behavioral changes among young people in Namibia is UNICEF, in particular through its "My Future - My Choice" (MFMC) program, which has been attended by over 80,000 young people over the last years. For this reason, attendance of MFMC had been included as background information about respondents, to look at its influence.
Four teams of interviewers conducted 1,268 interviews in 27 places in Namibia. During the field work, interviewers were brought to places where a lot of young people of the prime target age could be found (e.g. markets, bus stops, youth clubs, shebeens). Then, interviewers randomly approached potential respondents. Only in a negligible number of cases was an interview denied.
Field supervisors also conducted a random outlet survey. They had randomly asked shop managers in 57 outlets, who had been recorded as sellers of NaSoMa products, about their sales experiences and stocks. An additional source of information for this report are interviews conducted by the consultant with key players in Windhoek, Rundu, Oshakati, Karasburg, Mariental, Keetmanshoop and Lüderitz.
Key Findings and Conclusions
28 percent of respondents had ever attended the "My Future - My Choice" training conducted by UNICEF's Youth Health Department. Over 80,000 young Namibians have attended these training sessions since 1997. Basic issues of reproductive health and the use of condoms had been taught in MFMC. Of those respondents ever having attended MFMC, 72 percent had completed the training with a certificate. Another characteristic of the sample population is given by the fact that 59 percent of respondents had experienced the loss of a family member or friend dying of AIDS.
Knowledge about "Safe Sex Saves Lives" and "Take Control" has become more widespread in Namibia within the last 12 months. While in 2000, only 83 percent of people had ever heard of "Safe Sex Saves Lives" and 73 percent had ever heard of "Take Control"; by 2001, 91 percent of respondents were aware of "Safe Sex Saves Lives" and 91 percent had heard of "Take Control".
TV remains to be the most important medium for "Safe Sex Saves Lives" and "Take Control" to spread information about these campaigns. The "Take Control" campaign posters appeared to be an effective medium too.
Comparison of response to questions in RA2000 and RA2001 shows that risk perceptions about HIV/AIDS have not changed much between 2000 and 2001. 89 percent of respondents had seen AIDS as a serious problem in Namibia in 2001 (2000: 90 percent). 93 percent of respondents knew that one-time, unprotected sex could be enough to get infected by HIV (2000: 86 percent).
Risk perception is influenced by personal experiences. While only 38 percent of all respondents had seen themselves at risk of infection, 43 percent of those who had a family member or friend dying of AIDS saw themselves at risk.
The large majority of Namibians has at least some personal experience with condoms. 81 percent of respondents who ever had sex had, at least once, used a condom. It is remarkable that this share is much higher among young people (85 percent in age group 12-18) than among mid-aged people (61 percent in age group 30-39). However, patterns of permanent and consistent use are more difficult to measure in a quantitative survey like RA2001.
There are substantial regional variations in condom use. While in Grootfontein, only 46 percent of the respondents who had ever had sex stated they had used a condom, at least once (Katima Mulilo 60 percent, Oshikango 71 percent and Karasburg 73 percent); in Khorixas, it was 95 percent (Opuwo 98 percent, Lüderitz 87 percent). Further research should establish the degree differences in the supply of condoms have contributed to these variations.
Until now, health facilities and hospitals are the most common source of condom supply. 54 percent of respondents usually get their condoms there. Another 16 percent of respondents named pharmacies as the most frequent source of supply. Supermarkets rank at third place, with 14 percent.
Although three out of four respondents claimed it is always easy to get free condoms, half of the respondents had at least once bought a condom. Younger people have even more experience with commercially sold condoms, with 55 percent in the age group 12-18 ever having bought a condom.
After less than a year on the market, "Cool Ryder", NaSoMa's first product, is already quite well known in Namibia. When respondents had been asked to name some brands of condoms, "Cool Ryder" had received 41 percent of all responses among those who could give at least one condom brand name. Second in brand awareness was the commercial product "Rough Rider" (18.4 percent), third "Life's Choice" (also a NaSoMa product, 14.5 percent).
A remarkably high share of respondents already had first-hand experience with "Cool Ryder". 35 percent of all respondents ever bought this condom, 8 percent ever bought "Life's Choice". However, there is a substantial regional variation. In Okakarara, 74 percent of respondents had, at some point, bought "Cool Ryder", 69 percent in Gobabis, 68 percent in Keetmanshoop, compared to only 14 percent in Grootfontein, 13 percent in Oshakati and 5 percent in Ohangwena.
The random outlet survey showed that in 45 of the 57 outlets interviewed, "Cool Ryder" had ever been sold. However, only 26 sites had it currently in stock. Only 7 places had ever sold "Life's Choice". Delivery problems were evident in the regions Omusati, Oshana, Ohangwena and Oshikoto, where NaSoMa had established a regional representative.
Supermarkets are the most important sales channel for "Cool Ryder", with 43 percent of respondents having bought their most recent pack of "Cool Ryder" there. The second most important sales channel were pharmacies (28 percent), and gas stations third (13 percent).
NaSoMa advertisements for "Cool Ryder" had been seen by 43 percent of respondents but, in the case of "Life's Choice", by only 24 percent. As for "Cool Ryder", radio and posters were the most advertising media.
This Rapid assessment could document a successful introduction of "Cool Ryder". It should not be taken for granted that this already implies a stable market share. Additional efforts in advertising and an effective distribution strategy will help to make the initial success stable. "Life's Choice" had a difficult start and does not yet play an important role in Namibia's condom market.
NaSoMa should look into the reasons for regional variations in condom sales and establish a system to constantly monitor their sales by location with a management information system (MIS).
NaSoMa should analyze the experiences with its first regional representative before defining terms for other regional representatives.
NaSoMa should reconsider its distribution strategy and consider strategic partnerships with other organizations (i.e. wholesalers, NGOs) to make its products available countrywide.
The marketing strategy for "Life's Choice" should be substantially revised. Even a discontinuation of this product should be considered as an option.
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