All too often, nonprofits take a “build it and they will come” approach to delivering programs and services, then express surprise when their efforts go begging for participants. As nonprofits brace for potential federal spending cuts and diminished charitable-giving tax incentives under the incoming Trump administration, they simply cannot afford business as usual.
Failure to fill programs is a pervasive problem. Among nonprofits responding to a 2015 survey by the Bridgespan Group, 70 percent reported shortfalls in program participation, and half said matters had gotten worse over the previous five years.
One nonprofit leader summed up the frustration experienced by many: “We have scaled up a [youth job-training] program we are very proud of, but people are not coming through the doors.” Intended beneficiaries aren’t aware of programs in many cases, or they lack interest in taking part.
Changing the status quo will require nonprofits to borrow from the same techniques businesses use to sell products and services. The business world is steeped in this kind of thinking, grounded in the notion of “diffusion of innovation.”
Diffusion theory seeks to explain how and why innovations spread among different groups. Businesses use this work to shape strategies for product design, sales, and classification of customers based on their interests and behavior.
It also applies to the nonprofit world. In a famous example, Everett Rogers, the father of diffusion theory, told the story of a Peruvian public-health agency that sent an employee to live in a remote village to teach its residents how to boil water to avoid a number of health risks.
The effort failed for several reasons: It turned out that boiling water conflicted with local beliefs, and villagers trained to do so were unlikely to adopt the practice or to advise others to. The health agency also dispatched the wrong messenger, relying on an expert from outside the village rather than peer-to-peer conversations or entrusting a local authority to spread the word.
This failure of good intentions in rural Peru offers important lessons for any nonprofit vexed by disappointing participation, starting with recognition that innovative social programs don’t sell themselves. Persuading people to adopt a new idea, even when — like boiling water — it has proven to be effective, is often very difficult.
Good Planning
Selling social change is not impossible, particularly if nonprofits follow three critical steps:
1. Design a program for “spreadability,” not just effectiveness.
Marie Stopes International, a London nonprofit that provides global family-planning and reproductive-health services, learned the importance of designing for spreadability as it struggled to boost birth-control usage in Zambia. Eager to reach more young women in need of contraceptives, Marie Stopes worked with IDEO.org, the nonprofit arm of international design company IDEO, to understand why more teenagers weren’t using readily available birth control.
IDEO.org found that young women shy away from being seen discussing or seeking contraceptives. To make accessing contraceptives less public, the design group suggested that Marie Stopes open pop-up nail salons where the manicurists, trained as counselors, engage customers in discreet conversations about birth-control options. Women were soon lining up outside the doors to have their nails done and pick up contraceptives.
The program’s success demonstrated classic principles of diffusion theory, which call for designing “spreadable” programs that are:
- demonstrably better than existing programs
- compatible with beneficiaries’ values
- simple to use
- testable for beneficiaries without having to commit
- observable, in that others can see the benefit of joining.
2. Aim for the potential beneficiaries who are most likely to participate.
In any group, research indicates, a small number will show interest in a social innovation without much regard for the cost or ease of participating. These are the early adopters. Next is a large swath of more skeptical individuals who prefer something simple and proven — the early majority and the late majority. Finally, a small group of laggards will ignore or resist the innovation. Together, these groups constitute the classic adoption curve that illustrates how an innovation grows in acceptance. What can nonprofits learn from this?
First, it’s important to know whom you are targeting. Satisfied early adopters become promoters who, as trusted sources, talk with friends and peers and help persuade others to follow. Conversely, targeting all potential beneficiaries at once (or targeting none specifically) is inefficient and often ineffective.
The nationwide spread of cardiopulmonary resuscitation demonstrates the power of aiming for the early adopters and the drawbacks of starting too broadly or picking the wrong segment. CPR gained national recognition in 1960 but spread slowly, first to a small group of medical providers, then to volunteer firefighters — a group that eagerly embraced the practice but that had limited reach.
The real breakthrough came years later when a doctor began training emergency dispatchers to instruct callers to administer CPR. Those dispatchers became the springboard to training thousands of callers across the country — the ultimate example of a sizable group with a problem in need of a solution. It’s now estimated that about 18 million people are trained in CPR each year.
3. Develop a sales and marketing capability and allocate sufficient resources to carry it out.
Nonprofits need to reach out to potential beneficiaries and entice them to use a program or service. This is something that for-profits have understood for decades.
Take the pharmaceutical industry, a paradigm of both innovation and marketing savvy. Even with product portfolios full of proven remedies that meet demonstrated medical needs, the 10 leading drug companies spent nearly $100 billion on sales and marketing in 2013 — that’s $33 billion more than on research and development.
Sales and marketing also have a place in generating demand for nonprofits’ programs and services. Consider the case of oral rehydration.
In 1971, a team of American researchers confirmed that a solution of water, salt, and sugar could replace the lost fluids in patients with cholera-induced diarrhea, but the remedy remained largely unused for years. It finally took off in the early 1980s, when BRAC, a Bangladeshi nonprofit, recruited and deployed thousands of workers to “sell” villagers on oral rehydration, showing them they could make the solution from ingredients on hand in even the humblest of homes.
BRAC’s success underscores the value, even for nonprofits, of investing in sales. It’s time nonprofits and their donors heeded the message and paid as much attention to selling social programs that have been proven effective as they do to creating them.
While generating demand for services remains unfamiliar territory for most nonprofits, embracing it starts with rejecting the fallacy that need equals demand. Only when that happens can nonprofits and their supporters get comfortable with the idea that selling social change is a vital link in philanthropy’s quest to achieve breakthrough results.
Taz Hussein is a partner in Bridgespan Group’s Boston office and head of the consulting firm’s public-health practice. Matt Plummer is a manager in the Boston office.