Social marketing is a process that applies marketing principles, tools and techniques to create, communicate and deliver value that influence target audience behaviour for societal benefit. In Rwanda, this is a new concept—pioneered by the Society for Family Healthy (SFH), a non-profit corporation established last year and affiliated to Population Services International, the Government of Rwanda through the Ministry of Health and USAID. SFH Health Programmes Senior Manager Concessa Mukamusoni explains to Mansur Kakimba why it is important that institutions involved in providing health services ought to adopt a component of social marketing. Excerpts;-How would you explain the operations of SFH and how are they relevant to Rwanda?Our programme focus is in five areas; malaria control, family planning, safe water, HIV/Aids prevention and nutrition. These areas are priorities of our country, meaning we are in line with government’s vision on health. We also work closely with the Ministries of Health and Local Government. We are part and parcel of different health-related technical working groups to ensure that we observe national and international guidelines and policies in implementing our programmes. In all our grassroots interactions, we keep in touch with the local leaders and we substantially contribute to their annual individual performance contracts (Imihigo). This way, we ensure that we fit into their work plans. Clearly this is a noble job SFH is doing but requires huge amounts of resources. How do you manage?Since our focus areas are national health priorities, we have found it a lot easier to work with donors extending both technical and financial support to our country. More so, SFH has a department in charge of programme development, including resource mobilisation. We are writing proposals to source for more support to implement our programmes. But note, we manage our programmes in cost-effective manner, mindful of the fact that funders need results; they want to see real impact on the ground. But changing health behaviour is long-term and an uphill task. If the taps of donor funding ever dries, how would SFH ensure sustainability of these programmes?That is indeed key to us. Sustainability is a key element for the development of our country. As a social marketing organisation, our approach to work ensures that Rwanda is able to sustain its health sector programs and initiatives not only in the near future but forever. Take an example of one of our health products, Sur’ Eau. We are now in the process of producing 100,000 bottles of Sur’ Eau using income generated from sales. We plough back incomes generated from the sales of our health products. For other programmes like HIV/Aids and family planning, we are working in partnership with local public institutions. We’re keen on introducing social marketing at national level, through a solid partnership with the Ministry of Health. Currently, there is free distribution of family planning products at all health centres in the country. We have to advocate for social marketing of these and other health products because that is the only sustainable way.   The biggest problem with NGOs working with communities is programmes overlaps. How do you avoid this?Taking a closer look at the model of our operation, you will realise that we don’t implement in isolation. We do it through partnerships. For instance, on the aspect of Behaviour Change Communication, we work very closely with Rwanda Health Communication Centre (RHCC). All our key messages are approved by RHCC. This means that we address specific health problems identified at the national level; and SFH works in complement other players on the ground.How do you tell SFH is making an impact on ground? Behavioural change is an outcome not an output.  Basically, we have a strong monitoring and evaluation department armed with data collection tools that form part of the management information system of SFH.  True, these can be insufficient in measuring impact. Currently, we are working on an exit interview with key populations, including men who have sex with men and female sex workers. We did a pilot recently and it was successful. We leverage on the works by PSI to establish solid baselines in the research and studies that we conduct. Through surveys or studies we are able to measure the impact. We ensure quality control in all our operations, guided by various technical committees. Now over a year in operation, how is SFH fairing on its mandate and what’s high on the agenda? SFH is doing well. We have over scored on some targets because for some projects we did not have targets. So maybe we underestimated in some areas. What is evident is that people are happy about our approach and like our programmes. The use of CBOs, which ensures effective community participation is a new approach by SFH and is appreciated by communities. Going forward, we envisage reinforcing our network of CBOs. They are important to us in terms of disseminating key messages to communities. Again, through CBOs we are establishing a network of community-based distributors (CBDs) for health products starting with Prudence condom. It is an approach that we believe will ensure more effective distribution of our products other than restricting ourselves to only wholesalers and retailers. That way, we are providing them (CBDs) with seed stock and conducting training to facilitate them in distributing SFH health products.How does SFH position itself then?You see, health is a sensitive and complicated sector. Rwanda has many health players; local and international NGOs, and, of course, the public sector. SFH is unique in its approach to work. Unlike other institutions, we combine distributing health products with social marketing—the total market approach. We are the only indigenous NGO involved in social marketing. We’re seriously advocating for social marketing to ensure that institutions go beyond just giving free health products because it’s not sustainable. Our people need to start spending a little on these (subsidised) products. That way, we can be sure they are using them as opposed to just giving them for free.