Chapter 5 Implementation and management - How will we accomplish our goals?
5.3 How to create demand
In many developing countries, only a fraction of patients in need of eye-care services actually comes forward to make use of these services. This is not entirely due to lack of resources.
Social marketing is the process of generating demand for health-care services in the community from those who need health interventions but are not seeking them. In order to generate this demand, it is important to understand the current perceptions about disease, services, and the barriers that prevent people using the services. Perceptions and barriers may vary by disease and place. In the links under “Articles”, a detailed example is given of social marketing for cataract services in India.
Eye-care services in the district should be assessed for:
- availability (distance from patients)
- accessibility (transport facilities, open to all?)
- affordability (costs)
- acceptability (quality of care, approach to patients).
Even when all of the above conditions are met, lack of awareness and current health behaviour may prevent patients from seeking timely care. Qualitative analysis of possible barriers to accessing eye-care services, as provided in the RACCS package, will provide the understanding needed to design and conduct effective social marketing campaigns.
When planning for social marketing, use the following steps and strategies.
- Define priority areas (e.g. cataract, eye-screening in schools, xerophthalmia).
As resources are limited, be realistic in deciding on priorities. - Define priority populations (e.g. rural poor, children). This is partly determined by the disease intervention and availability of resources.
- Community involvement.
- Design case-finding and clinical service delivery strategies that
reflect priorities, and consider barriers. Examples of such strategies
are:
- case-finding through diagnostic camps and village volunteers
- CBR staff case-finding and referral
- village health committees in trachoma control
- involvement of local communities in all outreach activities
- use of aphakic patients (‘satisfied customers’) for promotion
- use of counsellors for patient education
- provision of free food and/or free transport to and from hospital. - Monitor patient involvement and satisfaction.
Checklist
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Articles
People
who don’t use eye services: ‘Making the invisible visible’
Awareness
of eye diseases in an urban population in southern India