• Julius Omona.
• omonaj@yahoo.co.uk
• East Afr J Public Health. 2009 Dec 1; 6 (3): 317-25.

AbstractThis textual analyses on Social marketing, Insecticide Treated Nets (ITNs) and Population Services International (PSI) were undertaken to achieve two objectives: (a) to contribute to the continuing debate and search for a better strategy for combating malaria in sub-Saharan Africa; and (b) to contribute to theory building on social marketing. The analyses revealed that Malaria has reached an epidemic proportion and despite major inroads by PSI in combating malaria on the principles of social marketing, the strategies of pricing and segmentation of the clients are not appropriate for Sub-Saharan African countries that are mired in absolute poverty where majority of the rural communities eke a living on less than a dollar per day and the health sector does not receive priority attention from policy makers and politicians. The descriptive statistics and a one sample t test for the sampled countries suggest that sub-Saharan countries have not even met the hypothesized 5% investment of their GDP on health, compared to their counterparts, the developed countries, who are all above this figure. The null hypothesis that there is no significant different between the population and the sample means of both developed and a developing country in their investments in the health sector was also tested and rejected. Though the elements in some of the existent models and theories of social marketing such as Health Belief Model, Theory of Reasoned Action, Social Cognitive Theory and Trans-theoretical Models all attempt to advocate for elimination of constraints and barriers to effective access to a service or product, PSI is adamant to these and try to generalize these principles in all contexts, including in Sub-Saharan Africa. The African scenario, where about 90% of Malaria related deaths cases in the world occur, demands more than what these theories present. Accordingly, it was concluded that however good intentioned social marketing is, in the case of ITNs in this region, it is counter productive as the pricing de-motivates clients who usually have other pressing needs to address and segmentation limits coverage. Social marketing is thus more relevant to developed economies where absolute poverty no longer exist and people can afford to pay for health services. Malaria in sub-Saharan Africa needs a "carpet bombing" strategy. It was also concluded that for Sub-Saharan countries to effectively address the MDG six on malaria, and implement the Abuja Summit and the Roll Back Malaria partnership declarations, it requires a high degree of political commitment, amongst others, to enable the vulnerable communities have access to free malaria treatment related drugs. Partners in the fight against malaria such as PSI should adopt a more eclectic intervention strategy, and be cognizant of the fact that the strategy that works for Africa should be that which is based on strict equity and stimulates demand for ITNs. The paper concludes by agreeing with Professors Curtis and Sachs that comprehensive malaria control in Africa is achievable by 2010, at the minimal cost if sound principles of public health and economics are observed. Millions of lives can be saved and Africa will be given vital help in escaping from the viscous circle of poverty and diseases that continue to grip the continent. The target for all intervention efforts should be to eliminate the cost factor and ensure free distribution of all malaria related treatment products.

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