Introduction

Social marketing has been used very effectively in P/RH programmes with respect to service delivery and public communications, and in reaching men. By using commercial marketing and distribution techniques, it has, in many instances, succeeded very well in making selected contraceptive methods available, accessible and affordable to target groups.

Social marketing harnesses private sector resources, such as advertising firms, commercial distributors, market research firms, and private sector doctors and paramedics, in order to increase usage. A social marketing programme complements government, NGO, and commercial sector P/RH activities while increasing the use of condoms, oral and injectable contraceptives, and IUDs. It also improves the quality and quantity of P/RH services provided by private sector clinics.

Specifically by marketing condoms widely and cheaply, often using very innovative and creative methods, the potential of social marketing in changing the attitudes and behaviours of men is tremendous. The following three case studies by country affiliates of DKT International, Inc. and Population Services International, Inc. (PSI), both US-based non-profit social marketing organizations, indicate that putting men on the agenda is achievable if the [social] marketing strategy is right. The case studies are based on social marketing programmes in Pakistan, the Philippines and Vietnam. (In Pakistan, the affiliation is with PSI. In the Philippines and Viet Nam, the affiliation is with DKT.)
 

Population Services International (PSI) and its local NGO partner, Social Marketing Pakistan (SMP), have been successful in targeting men in their family planning (FP) campaigns and motivating them to take more responsibility. As a result, the PSI/SMP Pakistan Social Marketing of Contraceptives Project, which is funded by the German government through the German Government Development Bank, the Kreditanstalt fur Wiederaufbau (KfW), is now the fifth largest (out of more than 50) social marketing projects in the world. In 1995 alone, social marketing of Sathi condoms provided nearly 600,000 couple-years-of-protection (CYP), contributing more than 15 percent of all modern method contraceptive use in Pakistan.

Background of Project

In response to a critical need for an innovative approach to family planning, the Government of Pakistan and the USAID launched the Social Marketing of Contraceptives Project in January 1986, with technical assistance from PSI. Initial results were positive, and the project grew to be one of the largest social marketing efforts in the world. In early 1991, USAID began to withdraw its financial assistance from Pakistan, prompting PSI to found Social Marketing Pakistan (SMP), a local non-profit organization designed to ensure institutional sustainability of social marketing activities in Pakistan.

In late 1994, the KfW began providing interim funding to PSI, and by early 1995, had signed a five-year, multimillion-dollar trilateral agreement with the Government of Pakistan and SMP to expand the project. PSI continues to provide consultancy services to the Government, KfW and SMP.

The purpose of the KfW-funded PSI/SMP Pakistan Social Marketing of Contraceptives Project is to increase the availability and use of modern contraceptive methods. The target group for the project is low-income married women of reproductive age and their husbands. PSI/SMP contraceptives are positioned for FP and birth spacing purposes, although condoms have the added benefit of preventing HIV and other STD transmissions. In particular, PSI/SMP targets couples with a household income of between Rs 1000 (US$25) and Rs 4000 (US$100) per month.

Targeting Men

The overriding dominance of men as decision-makers in Pakistan, and the restrictions on women's movements outside the home, have fueled the need to target men in national FP campaigns. Condoms, the premier male contraceptive method, have traditionally been promoted to men. As a result, PSI/SMP has tailored its multi-media condom social marketing messages and educational campaigns to appeal to men and address their resistance points.

a. Sense of Male Responsibility

The objective of these campaigns is to increase a man's sense of responsibility for family size and for his wife's reproductive health. An increased sense of male responsibility - combined with appropriate knowledge about the benefits of family planning, messages which motivate action, and clear instructions on where to go for quality FP products and services - should lead to increased contraceptive use. PSI/SMP has used multiple strategies to motivate men to purchase Sathi condoms. One way is to have men identify with a successful role model, such as Zahid, the owner of the garage (Box 1). Spin-off communications materials from the television/cinema spot include press advertisements and shop posters which also feature Zahid.

b. Providing Relevant and Correct Information to Men

Even with female contraceptive methods - such as Green Star IUDs, oral contraceptives (OCs), and injectables - PSI/SMP targets its messages for male as well as female clients. It is critical to get the men on board since they have an important role not only in the decision to purchase contraceptives, but because they are often the ones to buy the products. In some cases, when a woman's movements are restricted by purdah, for example, her husband will visit the doctor or pharmacist and may be the only source of information on oral contraceptives and their potential side effects.

c. Small Family Norm

The PSI/SMP television and cinema commercials which promote Green Star hormonal contraceptives and FP clinics prominently feature men. In one scene, a husband is at first reluctant to discuss family planning with his wife, or permit her to visit a Green Star clinic. After a dream sequence, in which the husband is overwhelmed by rowdy, noisy children, he immediately agrees with his wife that there should be an adequate period between births in order to give each child the time and attention she/he deserves. The commercial closes with the couple visiting a Green Star FP clinic together.

d. Male Providers

While PSI/SMP is engaged in intensive efforts to train female medical practitioners, it will also train thousands of male doctors and pharmacists. Research indicates that men are more likely to go to other men - particularly male doctors and pharmacists - for information about family planning. It is therefore important that these male medical practitioners provide correct information to men, so that misconceptions can be dispelled and men can assist and even motivate their wives to begin practising contraception.

e. Inter-spousal Communication

PSI/SMP also communicates more generic messages to the public, those which do not promote a specific contraceptive method or brand, but instead aim to change behaviours in ways that encourage family planning practice. For example, television, radio, and other media promote inter-spousal communication, with a husband and wife discussing family planning options. Research in other countries has shown that couples who discuss family planning are more likely to use modern contraceptives than those couples who avoid the subject.

f. Girl Child

Throughout its communications campaigns, PSI/SMP has strived to improve the status of women in Pakistan through positive and empowering images and messages. In all PSI/SMP advertisements, for example, a couple is shown with only one child - a girl - with the father obviously loving and caring for the girl. By consistently showing a girl child, PSI/SMP hopes that this will decrease Pakistani men's preference for a male child, and show that girls are equal in value to boys. Improving the status of women in the eyes of men and in the eyes of the society will lead to increased female empowerment, ultimately resulting in women asserting more control over their reproductive health and family size.

Main Project Activities
If the social marketing project achieves the sales and CYP objectives described above, PSI/SMP will need to procure and package more than 400 million condoms, nearly six million oral contraceptive cycles, over two million injectable contraceptives, and nearly 200,000 IUDs (Diagram 1). After procuring and over-packaging its products, PSI/SMP oversees the distribution of contraceptives to a national distributor, more than 150 regional distributors, to wholesalers and retailers - with products ending up in more than 30,000 retail outlets throughout urban and rural Pakistan. In the near future, SMP will distribute oral and injectable contraceptives to more than 15,000 pharmacies and thousands of private medical practitioners throughout the country. At present, Green Star (Multiload) IUDs are only provided to certified private medical practitioners.
 

a. Developing Brand Identity

PSI/SMP has developed the Green Star logo as a unifying symbol for SMP-supplied contraceptives (Touch condoms, Nova oral contraceptives, Nova-inject injectables, and Multiload IUDs), and quality private sector clinics and pharmacies. Demand-creation communications activities focus on three objectives: 1) Generic family planning communications campaigns to increase the overall demand for, and use of, contraceptives in Pakistan; 2) Green Star-specific campaigns to increase trust in, demand for, and use of the Green Star clinics and contraceptive products; and 3) Brand-specific communications to increase awareness and use of specific brands (ie; Sathi) supplied by the KfW-funded project.

b. Communications Strategies

Communications messages are directed at a number of target groups including: potential female contraceptors and their husbands, private medical practitioners, pharmacists, retailers, journalists, community leaders, and so on. PSI/SMP uses reinforcing messages and a multi-media approach, including television, radio, newspapers and magazines, point-of-sale materials, billboards, shop signs, detailing to doctors, trade and consumer promotions, and non-traditional media. Formative research is integral to nearly all project activities, such as developing communications materials and messages, and monitoring sales, distribution, and training activities. Evaluative research, such as periodic Knowledge, Attitude, and Practice (KAP) studies, assists the GOP, KfW, and PSI/SMP in monitoring progress toward project objectives and measuring the project's impact on Pakistan's population programme.

c. Training

In order to ensure quality of care, the Pakistan project places a premium on training. Doctors, pharmacists, and other health providers - both men and women - play a critical role in educating clients in the decision to use modern contraceptives. PSI/SMP trains female medical practitioners in family planning counselling, IUD insertions, and infection prevention. The trainees undergo approximately two weeks (half days) of intensive training. These practitioners are evaluated and certified before joining the "Green Star" network of family planning clinics. This network should include 2000 trained female medical practitioners and their clinics throughout Pakistan by the end of 1999. PSI/SMP aims to expand this training activity to include a shorter course for male doctors (GPs), paramedics, and pharmacists on FP counselling, with a particular emphasis on condoms, OCs, and injectables. PSI/SMP aims to train between 10,000 to 15,000 of these (mostly male) FP service providers from the last quarter of 1996 through the end of 1999.

Private sector female doctors are trained in family planning counselling and IUD insertion, using a "Green Star" logo to promote their clinic and improved services. Touch condoms and Multiload IUDs are also sold under the Green Star banner, with this symbol providing the linkage between the family planning product, service delivery point, and information. In late 1996, with additional KfW funding, PSI/SMP will begin to social market Green Star oral and injectable contraceptives.

Project Management

The SMP is the executing agency for the Pakistan Social Marketing of Contraceptives Project, while PSI provides consultancy services to SMP and KfW. The SMP has managerial autonomy, subject to the policy guidance of the GOP Ministry of Population Welfare and KfW. It sub-contracts as many activities as possible in order to harness private sector resources already available in Pakistan, keeping the project staff small and efficient. It also manages sub-contracts with a commercial distributor, packaging facility, advertising agency, research firms, family planning NGOs, and training organizations.

Training and skills transfer occur in two ways: from PSI to SMP, and from PSI/SMP to commercial sector partners and sub-contractors. This transfer of skills helps ensure that social marketing is institutionalized in Pakistan, and that commercial firms understand how to target low-income consumers. The PSI and SMP can also transfer state-of-the-art training methodologies, curricula, and techniques to local training organizations.

The PSI/SMP evaluates its activities in a number of ways. Sales of contraceptives are an important indicator of success. Equally important, PSI/SMP monitors the overall market size for the various contraceptive methods, since the project aims to create new contraceptors and expand overall usage rather than have consumers merely switch contraceptive brands. Monthly retail audits track changes in contraceptive distribution and availability in towns throughout Pakistan. Periodic KAP surveys track changes in knowledge and behaviour, and the impact of communications campaigns. The PSI/SMP also closely monitors both the quality and increases in the number of family planning clients served by the Green Star clinics.

Lessons Learned

In Pakistan, men are the primary reason why family planning is not a priority and contraceptive use is so low. In a country with about 130 million people, only 12 percent of Pakistani women report using a modern contraceptive method, and Pakistan has the highest total fertility rate among the ten most populous countries.

Men's concerns, beliefs, and practices must be addressed; failure to do so will relegate Pakistan, and its women, to continued high birth rates and unnecessary maternal and child deaths. Men must be motivated to act, to be concerned about their family's and their wife's health. Only when men act, or at least do not interfere when their wives desire to act, will the situation improves.

The widespread social marketing of condoms in Pakistan has been useful in exposing men to modern methods of avoiding unwanted pregnancies. In Pakistan, men dominate all activities outside the household, including shopping. Thus, men see Sathi condoms at local shops, learn from the media or from friends that it is a simple and affordable means of preventing an unwanted pregnancy, and are inspired to purchase it. Sathi can thus be seen as an introduction to modern contraception, with some couples then graduating to more effective or permanent methods.

A total of 51 million condoms have been distributed in the Philippines since the start of the programme through 1995. The condom market has tripled in size from almost 10 million pieces in 1990 to nearly 30 million in 1994, an encouraging sign of increasing acceptance and usage. This phenomenal growth has been pushed by the DKT Social Marketing Programme together with the Department of Health. The Philippine experience is proving that social marketing is an important strategy in condom promotion and utilization in the context of a national STD/AIDS prevention and control programme as well as enhancing male participation in a population/reproductive health programme.

Establishment of the Programme

DKT Philippines is a non-government organization which seeks to improve public health through pro-active social marketing interventions that enhance continued effective family planning practices as well as contain the spread of sexually transmitted diseases (STDs), specifically the Acquired Immuno-Deficiency Syndrome (AIDS). The organization has been serving the Philippine market since 1990. DKT International, Philippines, is affiliated with DKT International Inc., headquartered in the US.

a. Objectives

The programme aims to influence more eligible couples to voluntarily and continuously practise family planning and prevent further occurrences and spread of AIDS and other STDs. More- over, the programme makes more readily available and affordable to potential and actual users, good quality condoms and oral contraceptives for family planning and STD/AIDS prevention. In addition, the programme aims to generate favourable widespread public opinion regarding the acceptance of condoms for both family planning and the prevention of the spread of AIDS/STDs, and oral contraceptive pills for family planning (Diagram 2).

b. Target Groups

Specific segments of the population have been selected to communicate the STD/AIDS prevention and family planning message so that they can act upon it in a positive way (Diagram 2). The Trust Quality Condoms are targeted towards the young (18-35 years of age) sexually active men and women in both rural and urban communities, primarily of the C/D economic (i.e., low-income) class. Panther condoms target a similar consumer as that of Trust Quality Condoms, but more among of those who want additional excitement in their sexual activities, primarily among the A/B economic (upper-income) class in the urban areas. On the other hand, Micropil oral contraceptive pills are marketed to young couples (18-30 years of age), also in the lower-income (C/D) brackets, both urban and rural.

The couples targeted are non-users of family planning methods, or users of less effective methods and who have not yet achieved their ideal family size.

The PATH/USAID-supported ASEP Project, a Condom Education and Promotion project for individuals in the entertainment industry, has the following target groups: female and male freelance sex workers (FLSW) and their clients; men who have sex with other men (MSMs) and their sexual partners; those injecting drug users (IDUs) and their sexual partners; as well as registered sex workers and their clients.

Activities Targeted Specifically Towards Men

a. Educational/Promotional Campaigns

Recent surveys have consistently indicated that the motivation to practise family planning is greatly influenced by the male partner. Local family planning NGOs, taking a cue from such studies, started conceptualizing and developing programmes that target male involvement in population activities. DKT initiated target-specific projects primarily for male target groups.

In early 1993, Trust Express, a door-to-door condom delivery activity was conceptualized with the urban, young professionals as its primary target. The project's operational concept was based on door-to-door delivery systems found in popular food chains. This concept addressed the issue of lingering apprehensions of the target audience to purchase condoms in public. This apprehension is brought about by the negative attitude of a lot of people with respect to condoms. Real or perceived, the target audience held the belief that buying condoms in public may place them in a negative position in the eyes of their colleagues and peers.

Though the project was only a pilot activity operated for a short period of three months, it generated so much publicity that the negative attitude of people towards condoms in general was greatly diminished. Orders were primarily made by men but a good percentage (10%) were made by women.

The ASEP Project

In January, 1995, DKT was given a sub-grant by the Program for Appropriate Technology in Health (PATH), through the USAID/DOH-sponsored AIDS Surveillance and Education Project (ASEP), to undertake a condom education and promotion outreach activity targeting individuals in the entertainment industry, including their partners and clients.

The project's activities include the dissemination of correct information on HIV/AIDS, condoms and their proper use for the prevention of HIV infection. The IEC materials were developed specifically to target male clients of sex workers. Sample condoms are given away in brochures that describe in detail (with graphic illustrations) the proper way to use condoms. Condom promoters/educators are deployed in key cities nationwide to undertake this activity. Setting up distribution points within and around entertainment establishments is a key component of the project. Condoms are made more accessible by penetrating non-traditional outlets where actual sexual activities happen. These distribution points include motels, inns, bars, massage parlors and many others.

In establishments where it is not possible to set up distribution points, secondary points are identified. These secondary distribution points include 24-hour convenience stores (like 7-11), cigarette vendors selling around the entertainment establishments, as well as small-time food stalls and similar outlets where possible contacts between a sex worker and a client can occur. Management and proprietors of establishments are, likewise, given enough "monetary motivation" to get into the act. Schemes such as inclusion of condoms into "service" charges have been introduced. For establishments that have institutionalized "take-out" procedures covering their women, the procurement of condoms is a prerequisite to being allowed to bring their women out of the establishment. For the ASEP project, targeting male clients is a priority undertaking.

b. Distribution/Sales Efforts

For 1996 (January to August), a total of 7.5 million condoms have already been distributed nationwide. With the added project focus on high-risk establishments, there is a significant increase in the distribution to non-traditional establishments. Prior to the ASEP Project, distribution was generally focused on traditional outlets, primarily drugstores which average 65 percent of the total sales. After a year of the project's implementation, 1995 data reveal that drugstores now account for 50 percent of the total sales, with the increase in distribution to target outlets, namely, bars (5%) and NGOs (5%). (1994 data show that these establishments accounted only for 1 percent share of the total distribution.) There was, likewise, an increase of two percent in distribution to massage parlours. It is estimated that, with the support of such projects, a greater proportion of sales would be to non-traditional outlets.

c. Others

Due to the nature of the coverage of the ASEP Project, condom promoters are all males who have been provided comprehensive training on HIV/AIDS, including inter-personal communication and counselling skills and techniques. The skills help them to interact with the target audiences. Males were hired for the job due to the possible security risk to women involved in the covering these outlets at night.

Main Activities

The DKT Philippine programme has two main components: (1) Condom and Oral Contraceptive Pill distribution, and (2) Information, Education and Communication (IEC). The programme complements the government's efforts in commodities distribution by making its products widely available nationwide, using its own cash van promoters as well as the commercial distribution network of Metro Drug Distribution. The retail price is subsidized by donor support.

Before the introduction of Trust Quality Condoms into the Philippine market, condoms were generally distributed and purchased through drugstores, doctors' offices, clinics and hospitals. Through the efforts of DKT International, with the assistance of the Department of Health, the Bureau of Food and Drugs authorized and opened the mass distribution and sale of condoms to "all legal outlets". This opened up the opportunity for Trust Quality Condoms to be sold commercially in supermarkets, groceries, sari-sari stores, gasoline stations, motels, bars, sauna baths, massage parlours and other similar establishments.

In 1996, the programme started expanding commercial selling of Trust Quality Condoms and oral contraceptive pills in collaboration with the Department of Health. This has been made possible by a grant from the KfW.

Programme Management

a. Policy Making and Planning

DKT Philippines has a four-level organizational structure (Diagram 3) for policy making and planning: (1) the Board of Trustees in Washington DC, USA; (2) the Philippine Directorate, where local policies are developed and monitored; (3) the Operations Management Committee where local operational plans and decisions are developed and monitored; and (4) the Operating Units.

b. Execution

All operating units are headed by a director, assistant director, senior manager or manager. Each department head has full control and management of their respective departments. However, inter-departmental coordination and consultations at all levels is the principal thrust of this organizational structure towards improved performance.

c. Training/Skills Transfer

DKT Philippines has recently put in place through its Human Resources Development Unit, a continuing programme for skills and capacity development. At the start, external trainers and training sessions are being tapped for both the officers and rank-and-file. A comprehensive manual of policies and procedures has been compiled and developed which will serve as the basis for future activities and undertakings within this context.

d. MIS/Evaluation

A full-scale Management Information System (MIS) has been set in operation since the end of 1995. Presently, the system has a Local Area Networking (LAN) system as well as external networking with both local and international servers of the Internet. Sales data, accounting and inventory data are but a few of the information and data that are now present and accessible in the system. Expansion programmes are being conceptualized and planned to meet the needs of both in-house and external projects. Internal evaluation systems are also being considered to monitor and evaluate organizational undertakings such as, but not limited to, special projects, IEC and promotional campaigns and the like.

Diagram 3 Management Structure for DKT Philippines

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Achievements and Lessons Learned

Trust is still the number one selling condom in the Philippines. It continues to enjoy the highest brand recall among the surveys conducted. A KAP survey conducted in 1995 reveals that 75.9 percent of the total respondents have Trust as the top-of-the-mind condom brand. Moreover, 97.3 percent are aware of the brand. Trust is the number one brand in the commercial market, with Trust now used as a generic name for condoms.

• The 1993 National Demographic Survey shows significant increase of condom usage (+43 percent from 1988).
• DKT has quickly become the largest distributor of condoms in the commercial sector with the Trust brand. This was achieved without affecting the sales volume of other commercial brands. The entire condom market has increased, including in the public sector.
• Surveys show that usage of condoms is primarily for STD protection (56% of responses) and for family planning purposes (67%).
• DKT Philippines has received more foreign assistance, especially KfW, AUSAid, USAID and JICA.
• DKT Philippines is accredited as an NGO by the Department of Health Accreditation Board.
• A total of 51 million condoms have been distributed since the start of the programme through 1995. Of the total condom market in the Philippines, 1994 data indicate that the programme provided 27 percent of the total condoms distributed nationwide. The condom market has tripled in size from almost 10 million pieces in 1990 to nearly 30 million condoms in 1994, which is an encouraging sign of increasing acceptance and usage. This phenomenal growth has been pushed by the DKT Social Marketing Programme together with the Department of Health. Together they represent over 87 percent of the total market. This indicates an expansion of the market through new users.

The programme is designed to improve the health of mothers and children through the adoption of family planning methods, as well as the prevention and control of STDs, including HIV, in order to help curb the AIDS epidemic. It seeks to fill the gap between the public sector which intends to provide free products and services to the poorest couples, and the private commercial sector which targets the richer segments of the population. In addition to the distribution and promotion of contraceptive products, the programme also engages in market research, training and NGO support activities.

Starting 1996, in line with the expansion of the programme based on the agreement with KfW, DKT Philippine aims to achieve, within five years, sales of 88 million condoms and 2.8 million cycles of low-dose oral contraceptive pills. Approximately 1,080,000 CYPs will be generated by the end of this particular programme. Moreover, number of outlets is projected to increase from 5,000 outlets in 1994 to 23,000, with the largest increase in sales to non-traditional outlets (e.g. motels, bars, massage centres, and so on.). Male participation in disease prevention and decision-making on reproductive health goals will continue to be enhanced.

The Philippine experience is proving that social marketing is an important strategy in condom promotion and utilization through men's involvement, and should be a component of any National STD/AIDS Prevention and Control Programme.

Before 1993, condoms were available in Viet Nam, mainly for family planning purposes; there were, however, practically no systematic promotional activities geared towards increased usage and improving the contraceptive method mix. From a marketing point of view, it was a wide-open field. In the four years since 1993 (including projected 1996 figures - see Table 1), DKT would have sold about 60 million pieces of its Trust and OK condoms in Viet Nam, making it one of the "fastest-starting" social marketing contraceptive programmes in the world.

Establishment of the Project

DKT International has been active in Viet Nam since 1993. From 1993 to July 1994, DKT International implemented a pilot social marketing project in seven provinces under the authority of the Ministry of Health. In August 1994, government recommended the transfer of this project to the National Committee for Population and Family Planning (NCPFP). A project document outlining activities and responsibilities was signed by NCPFP and DKT later that same month. As part of this agreement, the project was expanded to operate nationwide. In September, 1996 DKT International was authorized by the Government of Viet Nam to establish a representative office in Hanoi.

DKT International currently does social marketing of two condom brands (Trust and OK) and one brand of oral contraceptives (Choice). These products were introduced in the following order :

Reduction in population growth and controlling the spread of AIDS and other sexually transmitted diseases are the explicit policies of the Government of Viet Nam. Increasing the availability and use of condoms and oral contraceptives support these policies.

In particular, the family planning strategy of the Government of Viet Nam specifies:

1. the importance of increased IEC activities, and
2. the need for the widespread availability of an adequate supply of diversified choices of high-quality contraceptives.

Specific Objectives:

• To make available condoms and OCs for family planning purposes (and, in the future, other health products as authorized by the government) to low-income and rural consumers.
• To promote and distribute condoms to high-risk groups as part of a comprehensive effort to prevent AIDS.
• To design and disseminate educational and promotional materials (such as posters, pamphlets, TV and radio messages) dealing with family planning, AIDS prevention, contraceptive use and other public health issues.

Involving Males

DKT International's social marketing project in Viet Nam began at a time when condom promotion was limited to generic public health messages mostly focusing on family planning/population control. Condoms were available but there was virtually no brand awareness or associated product image. From a marketing point of view it was a wide-open field.

With no real competition (in terms of marketing), DKT had the opportunity to approach its advertising and promotion activities in a very general way. The primary strategy was to make the DKT brand very visible . From 1993-95 all condom ads produced by DKT included messages for family planning and AIDS prevention.

Nearly all of the research conducted that relates to condoms focused on men. In particular, the research for developing condom brand names and the brand awareness survey for condoms involved only male respondents. Information from these surveys was also used to develop advertisements. For example:

• In response to research which reported that men were shy about buying condoms, DKT developed an advertising campaign with the slogan, "Don't say condom, just say Trust". The TV advertisement showed a man in a pharmacy nervously stuttering when asking the female pharmacist for a condom. As he does this, another man enters the pharmacy and confidently asks the pharmacist for Trust.
• Informal research conducted in a variety of bars and clubs found that men considered using condoms as a 'modern' or 'sophisticated' thing to do. Based on this information, a series of TV advertisements depicting a modern lifestyle were produced. The slogan for these ads was 'Trust condoms - for the modern man'.
• The condom brand awareness survey conducted in 1994 found that men considered strength and sensitivity to be the two most important qualities. From this information, the advertisement campaign for OK condoms incorporated body-builders and the word 'Champion' to established its brand image.

As part of DKT International's regular various market research, activities are conducted by appropriate organizations. Market research activities include KAP surveys, tracking surveys and brand awareness surveys.

The primary research activities already conducted include:
 

Feedback from the public has been generally positive, but also controversial. Many people, both male and female, are uncomfortable with any advertising for condoms, especially on television. Despite the controversy, Trust and OK have become generic words for condoms in Viet Nam.

Informal feedback from pharmacists (and other shopkeepers who sell condoms) indicates that shyness is less of an issue that it was in the past. And while it still exists, it is partially resolved by men buying from male pharmacists and women buying from female pharmacists.