DKT International is one of the largest providers of contraceptives and family planning services in the world. The company set up in Pakistan towards the end of 2012 and officially launched Heer intrauterine devices (IUDs), Josh condoms and other contraceptives in early 2013. While Josh quickly caught the public’s attention following their controversial ads featuring Mathira, Heer IUDs have only recently started to make headway in Pakistan’s female contraceptives market with over 390,000 product sales in 2018 alone.

According to Fatima Khalid, Head of Marketing, DKT Pakistan, Heer IUDs are minuscule (T or O shaped) birth control devices that are 99% effective in preventing unwanted pregnancies. They are available in five variants, depending on the length of time a woman wants to stay protected. For example, Heer Copper Y Cu 380 provides protection for up to five years, while Heer Cu 200 Ag Silverline provides protection for three years. Heer is available under different names (such as Andalan, Lydia and U-Kare) in 40 countries, including Ghana, India and Mexico.

According to the Social Marketing Report 2018, DKT is ranked as the leading family planning organisation in Pakistan, with 2,392,985 ‘couple years of protection’ (CYP), slightly ahead of Greenstar Social Marketing with 2,381,525 CYPs. Khalid adds that Heer’s product sales in 2018 contributed 72% to DKT Pakistan’s total CYPs.

Khalid explains that CYP is a globally recognised measure that estimates the protection afforded to a couple by different contraceptives in a one-year period. She points out that different types of contraceptives have different values (for example, an IUD can earn up to four CYPs, while 120 condoms will earn one CYP). This measure helps organisations monitor the scale of their family planning services and compare their data against that from other companies and countries.

Heer’s core target audience consists of married women of reproductive age (MWRA); in other words, women between the ages of 15 and 45 and who live in remote areas. “We focus on the poorest of the poor,” says Khalid, adding that by virtue of the fact that Heer provides such a wide range of IUDs, women from all income groups are consumers of the brand, which costs between Rs 200 and 1800. These prices are subsidised for women who cannot afford them.

Heer’s strategy is centred on creating product awareness and more importantly, encouraging women to visit one of the 1,200 DKT Dhanak Health Care Clinics across Pakistan. In addition to these clinics, about 3,000 to 4,000 trained community midwives (CMW) sell Heer as well.

When asked how DKT manages to convince these women to visit Dhanak clinics, Khalid says that there are several ways to convince them and that behaviour change communication is key. “Just knowing about family planning doesn’t work. You have to constantly remind women why it is good for them individually. Also, once they are aware of these products, we need to ensure their availability, and at an affordable cost.”

According to Dawar M. Waraich, Country Head, DKT International, “Heer and Dhanak go hand in hand because when women discuss their needs and preferences with another woman, it brings a different level of comfort altogether compared to a woman awkwardly purchasing a contraceptive from a man who will tell her what’s best for her, instead of asking her. The woman-to-woman model of communication is necessary.”

Waraich adds that DKT has a 24/7 helpline which all DKT customers (Heer and Josh) can call upon for product or clinic related information. In areas where there are no Dhanak clinics, they have set up mobile health camps. “We do everything we can do to reach these women,” says Waraich.

He also talks about how DKT is providing CMWs the opportunity to run their own businesses. DKT will set up a clinic for them along with the necessary training and Heer supplies at subsidised rates. “After about five years, a CMW is able to financially sustain the clinic.”

Given that contraception is more often than not a taboo subject in Pakistan, was Josh’s campaign perhaps a bit too aggressive? Waraich responds that “we know our limits and we know how not to cross the line. However, we wanted to bring a touch of romance while remaining culturally sensitive to our audiences. In the last three years, we have successfully created brand awareness for both Josh and Heer. Their communication approaches may be different but the message is the same: we are available everywhere and you can call us for assistance.”

In this respect, DKT continues to experiment with different approaches to break a mindset that avoids speaking about family planning issues. For example, in the last couple of months, Josh held an awareness event at Dow Medical College on World Contraception Day, aimed at encouraging students to talk about contraception. The event included mascots dressed up as Josh boxes and a vending machine dispensing Josh condoms, along with items such as water and snacks. On the Heer front, DKT has started to promote the product on Facebook. In Khalid’s opinion, although the best way to reach their audiences is through outreach programmes, social media cannot be ignored as other audiences, such as CMWs and middle and upper-middle class females use it.

In fact, DKT have turned the illustration of Heer (from the eponymous folktale Heer Ranjha) on their pack into an interactive two dimensional character for their Facebook page, who through comic-style images in Urdu, introduces herself as a companion to help women make the right choice for their family’s future.

On the TV front, due to the fact that advertising female contraceptives directly is problematic, DKT have opted to promote Heer via their Dhanak clinics; furthermore, the objective of the communication is to encourage women to visit the clinics before purchasing the product.

So far, a total of four TVCs have been aired (produced by different agencies; DTK was reluctant to disclose their names) run under the theme of Kadam Kadam Par Dhanak. Another TVC is in the works to be released shortly, focusing on the need for family support in the decision-making process. The TVCs are aired on entertainment channels, such as Hum TV, ARY Digital as well as regional channels in Sindh and KP, during morning shows and drama serials. Heer used to be advertised in print up to three years ago, but the focus now is on TV, digital, radio and OOH (billboards and streamers). In Waraich’s opinion, although there will always be people who will take issue with their communication methods, their job is to keep pushing the envelope and persuade people to open up to the idea of contraception, no matter how long this will take.