Implementing Total Market Approaches: Family Planning and Beyond

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A Total Market Approach (TMA) is commonly referred to as a process to bring together the public and private health sectors for the purpose of coordinating policies and programs for greater health impact and sustainability. This approach to achieving public health goals, particularly in the area of reproductive health, is increasingly being adopted by donors, governments, and health organizations. The TMA literature has been growing rapidly, offering theoretical frameworks, implementation guidelines, and performance indicators, as well as experiences from country programs.7,8 Because multisectoral coordination is relatively recent in the context of social marketing programs, TMAs tend to focus on getting the process right in order to generate a plan that all stakeholders can live with, typically using the following steps:

• Market research, particularly market segmentation using population-based data;
• Analysis of the impact of the policy environment Introduction on the provision of products and services by various sectors;
• Stakeholder engagement through a coordinating mechanism; and
• Development and monitoring of a TMA plan.

Moving from planning to practice, however, can be very challenging, particularly when it comes to building incentives for the private commercial sector and a stewardship role for the public sector. Investments in financing, enabling policies, and institutional strengthening may be needed to achieve the goals outlined in total market plans. TMAs are likely to be more successful and sustainable if they are grounded in lessons and best practices from two decades of private sector engagement under family planning and other health programs. This commentary focuses on multisectoral approaches that have been implemented in family planning and in other health areas over the past several decades because they provide relevant lessons learned for today’s TMAs.