3 Reasons to Launch your Maternal and Reproductive Health Products in Diverse Global Markets
Cover photo courtesy of IPPF, Cameroon
Propelevate recently co-led with Catalyst Global a 2-part Masterclass organized by Rhia Ventures on Scaling Reproductive & Maternal Health Technologies in Diverse Global Contexts.
You can watch the first webinar “Understanding the Opportunity: Exploring the Potential for Impact and the Market Opportunity in Diverse Global Contexts for Reproductive and Maternal Health Innovators.” To summarize the highlights, there are three major reasons to include diverse global markets as soon as possible in your product/service development strategy.
Reason 1: It’s where your customers are
Reason 2: You can address need and inequity
Reason 3: There are partners that can make it easier
We also share thoughts on how to incorporate a health equity lens in new markets.
Reason 1: It’s where your customers are
The public health community defines women of reproductive age (WRA) as 15-49. Currently about half of all women of reproductive age reside in Asia, which reflects population trends as a whole. Birth rates are causing this to change fairly rapidly, and by 2100 it’s estimated that approximately 40% of WRA will live in Asia, 40% in Africa and 20% will be dispersed throughout the rest of the world.[1]
Graphs by Propelevate. Data from Statista. “Global Age Distribution by Region in 2021,” updated Feb 2, 2023
This is because approximately 40% of the African population is aged 15 or younger compared to the global average of 25%.[2] As these girls age, the number of WRA in Africa will increase significantly. As these girls age, the number of WRA in Africa will increase significantly. The three population pyramids from representative countries in Africa, Asia and the rest of the world illustrate this trend.
Graphs by Propelevate. Data from PopulationPyramid.net, accessed May 9, 2023.
So, if you are only focused on the North American or European markets, you are ignoring potentially 80% of your market.
Reason 2: Addressing need and inequity
Ensuring your products and services are designed for - or even better with - and provided to women in diverse global markets can help reduce inequities in maternal and reproductive health, and fill an enormous need.
To highlight some specific, acute inequities:
Approximately 287,000 women died during and following pregnancy and childbirth in 2020. Almost 95% of all maternal deaths occurred in so-called “low and lower middle-income countries”, and most could have been prevented.[4]
“Levels and Trends of Maternal Mortality”. Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division, Accessed April
In 2019, 163 million women had unmet need for contraception; 29.3% of those were in sub-Saharan Africa and 27.2% were in south Asia.
Globally, an estimated 500 million people lack access to menstrual products and adequate facilities to wash or change menstrual products, which translates to ¼ of women of reproductive age.[5] While data in this space is limited, as many as 19% of all Samoan and 25% of rural Laotian people who menstruate used no menstrual products at all during their last period; no cloth, no paper, nothing.
There is rich data available for many health areas, much of it consistent across countries, to make it easier to understand where there is the greatest need for your product and service in diverse global markets. The Countdown to 2030 document provides a list of the indicators that are commonly collected. Some good data sets to start with in the maternal and reproductive health space are the Demographic and Health Surveys (DHS), Performance, Management and Accountability (PMA) surveys, Multiple Indicator Cluster Surveys (MICS) as well as some good data aggregation using these and other sources by various UN agencies (WHO, UNFPA, etc.)
Ensuring that health innovations reach the people who need them most could accelerate global efforts to ensure all people are able to exercise their rights to living a long and healthy life.
Reason 3: There are partners that can make it easier
Who pays for healthcare varies across countries. For example, donors account for almost a third of health care financing of so-called “low-income” countries (defined in 2020 as GNI per capita of less than US$1,045). In 2021, donors provided $5.3 billion USD globally for reproductive and maternal health. The top international donors in this space are the US government, the Bill and Melinda Gates Foundation and the UK government, followed by the governments of Germany, Canada, France, Japan and Australia.[6]
Sources of Health Care Financing According to Country Income, 2020
WHO. “Global Health Expenditure Database.” Accessed March 20, 2023.
If the health benefits of your product or service align with country and donor priorities, donors or country governments may pay for them, making them free or low cost for potential users. Donors can also negotiate bulk purchasing of products, which could guarantee a certain volume of sales in return for a lower price for all countries accessing the product.
The 17 Sustainable Development Goals (including Good Health and Well-Being, Gender Equality, Clean Water and Sanitation, etc.) act as an important tool to align the efforts of governments, non-profits, activists and donors to focus on the most important needs. Understanding how your product or service furthers these goals can help unlock the partners and donors who are working towards the same goal.
International non-governmental organizations (INGOs) that work across many countries can provide an opportunity for economies of scale while furthering your business and impact objectives. If you had, for example, a new contraceptive product, you could look at the INGOs that would use it in their own clinics or clinics they support, those that sell into markets, and those that provide services in humanitarian or relief settings. Examples of some of the larger INGOs include:
● International Committee of the Red Cross (ICRC)
● International Planned Parenthood Federation (IPPF)
● Médecins Sans Frontières/Doctors Without Borders (MSF)
● Population Services International (PSI)
These organizations generally procure products in bulk, and can facilitate product introduction and scale because of their existing marketing and distribution infrastructure. They are committed to ensuring access to products and services regardless of a person’s income, and do this through either donor subsidy or a cross subsidy from their own product sales.
Entering a new market, especially one in a less familiar context, can seem daunting. Thankfully, there are opportunities for streamlined entry and economies of scale; including partnering with donors, INGOs and governments that buy and support maternal and reproductive health products.
Incorporating a health equity lens in new markets
Typically health products have been developed for and in countries such as the US and UK and then rolled out in countries in Africa, Asia and the Pacific and Latin America and the Caribbean. This is linked to the legacy of colonization, with some countries better resourced, and certain people prioritized. Assuming you are now chomping at the bit to explore how you can launch your product in diverse global markets, how can you extend efforts to increase health equity beyond your “typical markets?”
People experiencing health needs are the experts in what they need and how they need it delivered. You can partner with local nonprofits and community groups who are made up of your potential consumers to get important insight and feedback during R&D. Researchers at in-country universities are a great resource to better understand the landscape and what is already known about the needs and priorities of your target customers. Think about partnering with professional associations if you’d like to work through pharmacists or other health care providers to understand their perspectives. There are often technical working groups at the national ministry of health on key topics that can help you better understand national priorities and how your product or service might fit.
The earlier in the process you can involve these groups the better. Products and services co-designed with potential in diverse contexts can result in better products for everyone and ensure that your innovation will work in their situations.
Be aware of power dynamics. While donors and INGOs provide important funding and services, their priorities are not always those of the community. Make sure you have local partners, with direct roots in to make sure there is real demand for your product or service.
In sum, it’s important that global consumers have both a choice of what’s prioritized for them and a voice as to how it’s delivered.
If you’ve seen the opportunity to introduce your product or service into new markets, are excited to address the needs and inequities that exist, see that there are entry points that can make it feasible, are passionate about centering reproductive equity and justice in your approach and you’re ready to take the next step, please email Propelevate at info@propelevate.global and we’d be happy to set up a free 30 minute consultation call to discuss what you might need and how to find the resources to get you started!
[1] UNICEF: “Generation 2030 Africa,” 2014.
[2] Statista. “Global Age Distribution by Region in 2021,” updated Feb 2, 2023.
[3] PopulationPyramid.net, accessed May 9, 2023.
[4] WHO, “Maternal Mortality Factsheet”, February 2023.
[5] The World Bank. “Menstrual Health and Hygiene Brief,” May 12, 2022.
[6] Institute for Health Metrics and Evaluation. “Financing Global Health.” Accessed March 20, 2023.
[7] WHO. “Global Health Expenditure Database.” Accessed March 20, 2023.