Voices and Viewpoints on Implementing the Market Development Approach to Improve Health Markets

How countries choose to implement a market development approach (MDA) may be varied. To bring forward thoughts and contribute to a conversation of what market development may entail and why it’s important, we are collecting voices and viewpoints to create connections and communities among stakeholders that are a part of strengthening markets. We begin with responses from three perspectives.

Susan Ross
Sr. Private Sector Engagement Advisor
Global Health Bureau, USAID

What does market development mean to you?
At its core, market development is about creating an ecosystem of buyers and sellers who can effectively interact to provide high quality and affordable health information, products and services, meeting the needs of different consumer market segments. There are four foundational market functions that need to be aligned for efficient market operations.

Stewardship: ALL the market players (government, for-profit, non-for- profit) need to be able to effectively coordinate their efforts to ensure optimal market operation and performance of the entire market, not just one sector.

Rules, Regulations and Norms: The private sector needs to understand the “rules of engagement”. Given high levels of mistrust between the public and private sector, the private sector is often not involved in discussions about rules or regulations that impact them, and they often are not aware of what is required of them.  While this is a government function, given that they are charged with protecting public safety, the public sector is often unaware of the private sector challenges.  Understanding their concerns could go along way in increasing adoption and enhance access to more health service options for consumers.

Market Intelligent: Data is essential for markets to function effectively.  Consumers need data to understand health products and service options.  Suppliers- who could be health care providers, pharmaceutical manufacturers, distributors, need many types of data (e.g., pricing, labor costs, quality of care) to procure key inputs as well as improve their own business performance enabling them to offer high-quality, affordable services to consumers.

Financing: Financing is essential for businesses to operate and grow.  This can take on many forms including government schemes (e.g. social insurance), private insurance and access to private capitol.

Why is it important?
USAID prioritizes market development efforts to enable countries to meet their health goals and achieve lasting impact. Data show that healthy, well-educated populations are the engine for economic growth and long-term sustainability. In addition, a strong private health sector enables government resources to better target vulnerable citizens, while those who can afford to pay can access high quality health information, products, and services in the private sector. 

What is unique about a market development approach?
Market development includes all the market players in a particular market (e.g. family planning) rather than an entire health system. These stakeholders include both health and non-health actors (e.g. investors) with the goal of efficient market operations. Interventions focus on market facilitation, to improve transactions between buyers and sellers, that enable consumers to easily access high quality, affordable health information, products, and services.

Mariya Saleh
Chief of Party, Nigeria
FHM Engage

What does market development mean to you?
As a Nigerian, having context-specific and locally driven solutions is extremely important to me. It is an important predictor for sustainable health programs. FHM Engage utilizes a market development approach to expand healthcare markets and improve health outcomes. To me, this involves taking a holistic look at existing health markets with equal consideration for public and private sector actors. It means an in-depth examination of the supply and demand factors affecting specific health areas and the systems affecting them in health care delivery. 

Why is it important?
In Nigeria, the low coverage of essential family planning and maternal, newborn and child health interventions has kept the country from reaching universal health coverage (UHC). The market development approach (MDA) provides a framework for identifying underserved segments of the health markets, designing, and delivering locally driven solutions to reach that portion of the population. The MDA will ensure existing opportunities to improve market performance are optimized to close the current coverage gaps and contribute to the achievement of UHC.

Another important aspect of the MDA being implemented by FHM Engage is that it is facilitatory, working through local actors. This hands-on, capacity-building approach is key for the long-term sustainability required to bring about long-lasting changes to improve Nigeria's family planning, and maternal, newborn, and child health outcomes.

What is unique about a market development approach?
The market development approach is a holistic and very practical approach to sustainably improving the performance of health markets. An important aspect of the MDA is the focus on direct implementation by local actors within existing health markets rather than creating new structures. The MDA is different from market shaping which is primarily focused on population-level utilization of essential health commodities. Commodities delivered through market shaping tend to be funded and driven by donors and governments and new structures may sometimes be required to deliver the new products at scale.

Shyami de Silva
Acting Director
Office of Population and Reproductive
Health, USAID

What does market development mean to you?
Market development means designing and implementing market-based solutions that address underlying root causes of market underperformance and failure at the level of the local markets, whether for family planning, maternal and child health, or other health areas. It has several essential characteristics, including taking a long view of market progress, market facilitation by local/national stakeholders, active government participation and stewardship, and a local orientation, with ownership by local champions and players, supported by regional/global expertise.

Why is it important; why is USAID investing in this approach now?
The market development approach represents a culmination of decades of support and testing of specific interventions related to private sector engagement and private sector service delivery in family planning. As a market-based approach, it places clients (of family planning, maternal and child health services, and so on) at the center, in order to design and deliver sustainable solutions at scale. 

Market challenges are inherently local and therefore USAID’s Localization Strategy is a central pillar of the market development approach. FHM Engage’s work delivers on the commitment to put ‘local voices at the center of everything we do’. To that end, all FHM Engage activities will involve partnering with local or regional organizations to describe and diagnose market performance and design market-based strategies to improve markets and deliver services, in order to improve health outcomes.

What is unique about a market development approach?
The market development approach is predicated on understanding local markets, and identifying and addressing market shortcomings and root causes that limit the private sector’s ability to deliver high-quality, and affordable family planning information, products, and services to all types of clients across different market segments. As a systemic and agile approach, market development is well suited to family planning programming and ensures efficiency of donor investments and sustainability of health outcomes.

The market development is inherently focused on local markets, with clients at the center.  While it addresses supply and demand as core market functions, it does so at the local level, which may be in contrast to market shaping, which tends to be more centralized around supply conditions and organized at a global or regional level. Both market development and market shaping are utilized to improve a market’s health outcomes, and to do so by targeting the root causes of market shortcomings. The difference is in scope, as market shaping is often designed at macro levels of countries, donors, and procurers, as opposed to the localization of market development.

With a localized and private sector approach to family planning markets, market development considers demand and supply side actors (users and providers) alongside key market functions, including financing, data and market intelligence, rules and norms, and stewardship. This local, holistic, and systems-level approach facilitates deeper understanding of market performance and opportunities for development.

By taking this approach, our goal is to deliver locally oriented solutions that enable markets to work more effectively to increase the availability of high-quality information, services and products, and thereby, drive family planning outcomes.