4
Working with the Salt Industry
______________________________
| Salt comes from many sources -- from rock, lakes, and seas. It is traded over borders and comes from abroad in ships. Some countries have government control or regulatory power over a few large producers. Other countries have many small producers. And then there are completely open places like Indonesia with thousands of producers making it almost impossible to regulate the iodization of salt. And even where there is strong national control, without public education, you cannot stop people from taking salt from the mountains, lakes and seas if they prefer it to processed salt. |  |
Meanwhile, the benefits of iodized salt are not immediately apparent to the people who most need it. And while adding iodized salt to food is a relatively simple act, it is easy to underestimate the complexity of getting populations, especially those most vulnerable, to use iodized salt on a permanent basis. Changing dietary habits is never a simple task.
Health messages are designed to reach individuals, especially mothers and cooks, but there are other important household members. In some cultures, programs may have to consult fathers, mothers-in-law, or other influential figures in the household and address their interests. These people need to understand that using iodized salt is natural and normal, and good for children’s growth and education. If decision-makers in the household know they need iodized salt for their children, they will look for and demand iodized salt. Knowing the household, therefore, makes it possible to design messages that will create demand -- a marketing objective that is critical to sustaining programs.
|
Box 4 - Promotion through Retailers (Pakistan) A social marketing group developed a "Retailer’s Kit" and distributed it through salt processors and distributors. The kit included a trade promotion brochure (including a quiz game with prizes based on consumer’s most frequently asked questions about iodized salt), a calendar (with the iodized salt logo and slogan), a mobile (usually more visible, more likely to be displayed and displayed longer than posters), a sticker (for display at the counter or on the door of the retail outlet), a rapid test kit (with instructions for the retailer on how to check supplies of salt before purchase and to convince customers skeptical about the iodine content), and a poster for rural markets reminding customers of the health benefits of iodized salt. When rumors spread connecting iodized salt with contraception and loss of energy, the marketing team decided to repackage these materials together with new materials designed to refute harmful rumors through the retail chain. PSI (August 1996) |
Tapping the resources of salt producers
Sustaining programs also depends on encouraging salt producers to advertise, promote, market and demonstrate efficiency on their own. Many salt producers are willing to spend their own resources on worthwhile social communication, but need perhaps some technical help to design appropriate health messages that meet with the approval of the health community leaders. Certainly producers in Europe and North America did their own advertising, and major producers in other places can do so also.
In most countries, at least the large ones, salt companies compete with each other for market share. Each usually aims at a market in a geographic area or an economic group. We need to help these producers design messages that sell the value of iodine, not the value of salt (since they already know how to do that). Through this arrangement, companies will pay for their own social communication. They sometimes can do a better job than government agencies, although there will need to be oversight to be sure children and young women as well as other vulnerable groups, isolated by barriers of geography, language or tradition, are given special attention.
Delivery of health messages
Besides school teachers and community health workers, there is a quick, direct route to the key people who use salt -- through the retailer. Retailers are in direct contact with homemakers, cooks, or older children running errands for their families. Almost everybody gets salt from the retailer in shops or markets. There are thousands of retailers; in some countries, many hundreds of thousands of them. The educational message for IDD is not so complicated that you need a five-hour lecture or an expert to present it. Someone with a few graphics can explain the main ideas in a couple of minutes.
But to take advantage of the retailer’s direct contact with mothers and whoever else does the cooking or buys the salt, you need some information about customer preferences and behavior. A point-of-purchase study (as opposed to a point-of-sale study that focuses on "selling the seller") is designed not just to sell iodized salt but to ensure its use. A point-of -purchase study asks such questions as:
- Who buys the salt? Where? (Open markets? Small shops?)
- What do they buy with the salt? (Oil? Rice?)
- How much time do they spend buying? (An hour roaming around? Do they wait in line to pay?)
- How do they store salt at home?
- What do they think about processed salt and its packaging?
- Are they willing to pay a little more for better quality salt (without saying iodized)?
- And if they knew the salt had a health benefit, would they pay more?
Communication Took Kits 2 and 3 contain sample questions to include in a point-of-purchase questionnaire
In most countries iodized salt is priced just slightly higher than non-iodized salt which may indicate to consumers its better quality without pricing it out of the market. With the information from a point-of-purchase study, you can design simple messages for retailers to get basic information to people. In small shops there might be wall space. In open mountain markets there may be nowhere to hang even a small poster, so you may have to depend on the package itself to carry the educational messages. But at least you have a direct route to the cooks and the information you need to design messages for the retail situation.
|
Box 5 - Promotion through Markets and Fairs (Ecuador) In Ecuador, the high costs of intensive educational activities -- including village meetings, audio-visual presentations and home visits -- for communities at greater IDD risk were offset by the relatively low cost of radio spots broadcast nationally. Even so, the cost per person of the mass communications program was reevaluated in 1990, and it was decided that publicity in weekly retail markets and fairs in moderate to severe risk areas permitted better message flexibility with the same or greater effectiveness than radio broadcasting, at less than half the cost. Vanormeligen, K. and Vanderheyden, J.M. (1994) |
Contracting social marketing firms
Iodized salt is a commercial product, so in many countries IDD programs hire a marketing company to guide their communication efforts. This arrangement has been very successful, using effective pricing, packaging and advertising. Marketing firms are set up to work with private industries, whereas government agencies generally are not. The problem is that social marketing groups too often take their cues from commercial marketing methods, which firstly ask for a market share, and secondly tend to avoid unpleasant images. These two tendencies sometimes cloud the vision of marketing groups in dealing with a public health issue like iodized salt.
Measuring success through market share can ignore small, but extremely vulnerable groups. And since marketers working with the mass media are usually unwilling to present unpleasant ideas or images, information can be hidden from consumers -- information that may be vital to program success.
|
Box 6 - Positive and Negative Images (Pakistan) In Pakistan, where education is highly valued, the IDD program has used endorsements of religious leaders and health workers to market iodized salt as a way of enhancing children’s capacity for learning. Interpersonal contacts stressed the positive results of using iodized salt rather than the negative consequences of not using it. On the other hand, an evaluation of television ads found that the picture of a weak and disabled child was the most effective element influencing viewers in Pakistan to start using iodized salt. Researchers concluded that the impact of the advertisement stemmed from the viewers’ fear of disorders caused by iodine deficiency, especially among children. Clearly we need to learn what motivates people in different cultures and circumstances to change their eating habits, but we do not always have to paint a pretty picture. PSI (August 1996) |
Despite these caveats, marketing has tremendous strengths. Both commercial marketing and social marketing are geared to meet the needs perceived by the different groups of users, not just the needs of program heads. Making extensive use of audience segmentation, focus groups, pretesting, and other formative evaluation methods, marketing is one of the most important tools we have to design messages and choose communication channels for particular target groups. For example, Ecuador’s IDD program used formative research and marketing concepts to help convince a small, resistant segment of the target population to use the healthier, iodized salt.
|
Box 7 - Tailoring Messages to Resistant Groups (Ecuador) A group of small indigenous cattle farmers in Ecuador purchased non-iodized salt for their animals and themselves. This segment of the target population refused to consume iodized salt despite direct face-to-face educational activities and radio broadcasting coverage. A focal group study found that, in the farmers’ view, higher milk production and earnings were benefits that would offset the higher cost of iodized salt. The benefits of animal health and human health improvements through iodized milk and cheese were not enough to make them change their habits and traditions. Researchers consulted with cattle farmers and veterinarians to formulate a marketing program. Each week the farmer would feed his livestock a handful of iodized salt, purchased for the family from local stores and on regular market days at the usual market price. Since farmers had already formed a trusting relationship with NGO veterinarian promoters, communication was primarily interpersonal, supported by a foldout brochure and radio spots prepared with the help of the farmers. Vanormeligen, K. and Vanderheyden, J.M. (1994)
|
Communication Tool Kit 4 contains basic facts about IDD as well as key messages and supporting information for consumers.
