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Launch of the Palladium Total Market Approach Framework

Achieving the promise, cutting through the hype

What if the Ministry of Health, multi- and bilateral donors, pharmaceutical companies, commercial distributors, and public, private and NGO health service providers came together to discuss and work toward better health outcomes?

What if these different actors shared data and evidence and agreed on concrete and coordinated steps to improve the way they work in reproductive health, HIV/AIDS, malaria or other health service leading to improved access and sustainability in those markets?

These are some of the principles common to the Total Market Approach (TMA) currently being engaged by donors, development partners and developing country governments in need of improved efficiency in delivering health products and services. In driving forward best practice, Palladium is pleased to launch its own Total Market Approach (TMA) framework that provides a pathway for achieving the promise of greater health equity and impact.

The promise of a Total Market Approach is that coordination and targeting of limited resources will improve health impact by effectively reaching all segments while allowing different stakeholders to meet their own increasingly shared interests of health impact, sustainability and profitability. This platform requires repeat engagement of many different stakeholders, extensive data and evidence generation and sharing, improved capacity of governments for stewardship, coordinated market interventions, and ongoing iteration of all of the above. Ben Light, Senior Technical Advisor in the Contraceptive Security Branch at the UNFPA, put it this way:

"With fewer funds and more competition for those funds, family planning stakeholders at global and especially country level have to be ever smarter in maintaining and sharpening the focus on rights-based, quality family planning services. Drawing inspiration from total market thinking is an important foundation in ensuring that FP services are used by all who need them in line with the goal of universal health coverage."

The hype is that a new acronym, jargon or re-positioning of coordination and partnership will immediately achieve these objectives. It’s not that simple. The private sector often doesn’t like to participate in infinite coordination sessions, sharing data between stakeholders has myriad challenges, and many governments don’t have the political will to invest in such intensive efforts. This is further complicated by organisations applying TMA as an attempt to improve only their own market performance, and donors insisting on performance targets that are inconsistent with growing interests in sustainability and private sector partnerships.

At Palladium, we approach TMA as an ongoing process, which is linked to the stakeholder engagement, private sector approaches, policy and advocacy work that is the heart of Palladium’s 50 year legacy. This pathway is being tested and applied in our work as a market agent, where we work to optimise the market performance of products and services to ensure proper segments are reached—and in countries where we work as policy and advocacy advisors to build and communicate evidence, build capacity of governments, and facilitate the coordination of different actors.

In achieving the promise of a total market approach, it is vital that different market actors come together and make strategic decisions that accelerate health impact while also meeting their needs to continue operating efficiently and on the market.

Our vision of this pathway is described in the TMA document ready to view by clicking the download button. To provide any feedback on our TMA framework, please contact Stephen Rahaim, Director for Private Sector Health & Social and Behavior Change, at