Egypt
Private Sector Partnerships - The Ask, Consult Program
Activity Dates
2004-2007
Activity Summary
 The "Ask, Consult Program" (AC) for Family Health is built upon the momentum of the USAID-supported Private Sector Project (PSP) for Family Planning, implemented from 1994 to 2002 under the auspices of the Ministry of Health and Population. The goals of the PSP were twofold: 1) to contribute to an increase in contraceptive prevalence by increasing the use of family planning services and products in the commercial sector, and 2) to contribute to the sustainability of the national family planning program by growing the private sector market. The PSP conducted an integrated marketing program carrying the message to consumers to "Ask and Consult" for family planning where they saw the PSP brand logo displayed by affiliated providers. This key message was carried in mass media, in retail outlets, sales promotion, and public relations activities, supported by research to plan, monitor, and evaluate activities. More than 10,000 pharmacists and 3,000 physicians voluntarily participated in the "Ask Consult" network, gaining increased sales from the marketing communication program as well as increased expertise and credibility through educational program where most participating providers received short "Continuing Medical Education" (CME) courses, which were later changed to Evidence-based Medicine (EBM) courses with learning supplements.
Program Goals
Egypt’s "Ask, Consult" Program (AC) is an advanced social marketing program with a graduation plan, using donor inputs to transition the sector to market independence. The "AC" seeks to increase the private sector role in achieving the Government of Egypt's goal to improve the health status of Egyptians. The AC has two main goals:
- to improve the health status of Egyptians across all areas of Family Health, including:
- Family Planning and Reproductive Health
- Maternal and Child Health
- Reduction of Infectious Disease, including HIV/AIDS
- Improvement of Healthy Lifestyles (including reduction of tobacco use)
- to strengthen consumer demand and service supply in private sector, such the sector is sustainable in marketplace without donor assistance.
Strategic Component Strategy
 The continuation of the "Ask-Consult" Program in Egypt aims to accomplish its objectives through a demand-driven "manufacturer’s model." (See Attachment 1)
The commercial sector provides non-subsidized affordable family health products, an advanced distribution capacity, and an extensive network of sales outlets among Egypt’s private pharmacists (and select referral doctors).
The AC provides marketing communication to create demand and training, or continuing medical education (CME) to improve specific health knowledge among pharmacists (as well as some referral doctors). In addition, the AC develops a social marketing "graduation" plan, which includes the establishment of a self-sustaining marketing association among pharmacists, driven by collective member benefits.
The program will thus be organized according to a pattern familiar to the pharmaceutical sector, where Marketing Representatives provide communication and promotional support, Medical Representatives provide training, and Retailers form marketing or trade associations according to the benefits that accrue from membership.
1. Marketing:
The objective of marketing is to increase consumer demand for health products and health information from the private sector.
For the Egypt "Ask, Consult" Program, "Promotion," or the communication function of marketing, is the most important element of the ‘four Ps’ of the marketing mix. The other three elements are given: "Products" of interest in the pharmacy have mostly been agreed upon by the USAID health program [e.g., hormonal contraceptives, sterile syringes, ORS, etc.]; "Price" is set by the government; and "Placement" is determined by the sector [prescription drugs and OTCs in the pharmacies]).
"Ask, Consult" promotion uses the basic elements of integrated marketing communication under the unified brand, "Ask, Consult."
Unified "Ask, Consult" Brand:
One of the key promotional tools of the AC is the "Ask, Consult" brand. Like all brands, "Ask-Consult" has multiple purposes, but the most important is to telegraph a key promise to consumers. The explicit message of "Ask, Consult" is to invite consumers to seek information, products and services where they see the sign (in advertising, and at the point of sale). Brand attributes include credibility, "under the auspices of the MOHP;" trust, "this is the mark of confidence," (based on trained providers); and access to affordable, beneficial products and health information through participating pharmacists, "Ask, Consult where you see this sign." According to surveys, recognition of the "Ask, Consult" brand had reached 92% in 2002, representing ‘brand equity’ of considerable value. The benefits of this USAID investment can be consolidated and increased by using the brand in the current phase of the program to promote the full range of family health products and services available through affiliate network of "Ask-Consult" private pharmacies and doctors.
Integrated Marketing Communication:
Under the "Ask, Consult" umbrella, AC conducts campaigns using the basic tools of integrated marketing communication: advertising, public relations, interpersonal communication, and sales promotion.
 Advertising includes such activities as TV spots, radio spots, print ads for local and national press; - Public Relations elements includes local and national media coverage, contests, launches, and events, such as the Group Wedding for newlyweds, concerts for youth, or sports activities;
- Interpersonal communication includes many types of face-to-face communication with special populations such as catchment-area promotions of pharmacy health information and products, meetings and seminars among special groups (such as police and military, for HIV/AIDS, etc.)
- Sales promotions include all the communications elements to create client demand through the pharmacist and pharmacy point of sale. Marketing representatives will detail pharmacists on agreed cycles to provide new client education and motivational materials, branded point of sale materials (like signage), as well as pharmacist aids to improve consumer communication. Sales promotion also includes special activities to focus demand, such as contests, discount programs, etc.
2. Training
Just as marketing departments conduct the communication functions in the pharmaceutical sector, medical representatives conduct the training. Typically, medical representatives in the Egyptian pharmaceutical sector focus attention only on physicians, not pharmacists. After Egyptian pharmacists are certified to practice through the degree received under the Supreme Council, they have few additional opportunities to be trained.
The USAID PSP made a very important contribution to the pharmacy sector under the previous program by extending Continuing Medical Education (CME) to a critical mass of pharmacists. Opportunities were extended to approximately 10,000 pharmacists and 3000 selected physicians. By participating voluntarily in the training (no perdiem was offered), pharmacists gained two important benefits: 1) improved knowledge of new products or issues (such as new hormonal contraceptives or medical advice about delaying the first birth) and 2) the benefit of affiliation with the Ask, Consult network, to be discussed in more detail below.
The current "Ask, Consult" Program (AC) for Family Health strengthens the knowledge base of commercial pharmacists on family health products through systematic Continuing Medical Education (CME) interventions. The Training component includes both the "Face to Face training" and "Distance Education training". This training, among other activities of "AC", will give the chance to private pharmacists to become affiliated with "Ask, Consult" network which could be the first step to develop a social marketing association.
Monitoring and Evaluation
 AC/CHL will monitor implementation of the program and evaluate the outcomes by measuring changes in the target behaviors and their predictive factors. AC/ CHL will regularly monitor performance according to the Performance Monitoring Plan (PMP).
AC/CHL will monitor communication activities (outputs) and evaluate their impact (outcomes) using a variety of qualitative and quantitative studies, routine data monitoring as well as baseline, mid-term, and end-of-project research. The EDHS-2000 and EDHS-2003 Interim Survey, the National Maternal Mortality Study (NMMS: 2000), as well as the SIS/IEC Impact Evaluation Survey (2001) and other project-specific studies will provide baseline data.
To measure program outputs and outcomes, AC/ CHL will use the EDHS, periodic omnibus surveys, national population-based surveys, community surveys, a media monitoring index, pharmaceutical sales and prescription indices, service statistics and qualitative case studies. The following activities will be used:
- Planned research and monitoring
- Collect current health market data (IMS Pharmaceutical Index and other data resources, as available).
- Pre-testing of TV and Radio Spots
- Pretest client support materials
- Campaign monitoring report
- Campaign Video Documentation Services
- AC Pharmacies Auditing.
Conclusion and Partnership with Manufacturers:
In the Egypt PSP model, the donor program leverages pharmaceutical sector support by increasing demand for their products. Market growth, itself, is a pathway to sustainability. An "Ask, Consult" Marketing Association may also contribute to sustainability. Whether the PSP is increasing demand for health products or facilitating the development of a trade association, long-term success depends on the partnership of private sector health product manufacturers. Such partnerships have been successfully established in the past and continue to be active in the present program.
Manufacturers must play a play a key role in partnership with PSP. With increased demand, manufacturers should invest additional resources in marketing, in introducing new products, and in participating in a trade association with retailers to develop a stronger market for health products in Egypt. The prospect for full engagement of the private sector is greatly increased as the USAID Private Sector Program expands beyond reproductive health to include an emphasis on family health products, such as smoking cessation aids, condoms and hormonal contraceptives, oral rehydration salts, and plastic disposable syringes. Within the framework of family health, private sector partnership can become a major force for sustainability.
- Data Sources:
- PARC - Reach and Frequency of TV spot exposure
- EDHS, SPA - market segmentation, behavioral and service indicators
- Omnibus - for campaign recall and message comprehension.
- EHCS: Egypt Health Communication Survey 2005, 2006
- Village Health Surveys (VHS)
- pre/post, treatment/control, panel design (CHL focal villages)
- Monitoring System: monitoring of interventions in select villages
- Service Statistics: MOHP, CSI
- IMS Pharmaceutical Index
- Sales Data: Disp. syringes; contraceptives; zinc syrup; condoms.
- Qualitative Research: Formative; Pretesting; Case Studies
- Results Graphs and Charts
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