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252 CHAPTER 11 ■ Socialism Meets Social Marketing

country approaches, warped to fit the truly unique nature of the failed Soviet Union
and the time-limited window in which to apply them.

Social Marketing’s Fit in the “Second World”
The U.S. Agency for International Development (USAID), the top U.S. foreign assis-
tance supplier, has long been a proponent, funder, and believer in the efficacy of so-
cial marketing initiatives (USAID, 2007). Its worldwide Social Marketing for
Change (SOMARC) project was, at the time of the work described in this case study,
the agency’s principal global social marketing effort in the field of reproductive
health and the culmination of several decades of public health social marketing pro-
gram design and funding evolution. Models were well established and typically cal-
ibrated to the needs and economies of USAID’s traditional clients—less-developed
countries (LDCs)—with a goal of reducing high population growth rates. Time
horizons for the success of these models were often measured in decades, with a cor-
responding requirement for donor funding to support the project infrastructure
and supply subsidized products for the expected lifetime of the effort.
However, for the second world of the former Soviet Union, few, if any, of these
models were a good or direct fit. Nor were the traditional time lines appropriate. The
United States, recognizing that the window of opportunity was small for the new re-
publics to successfully implement the massive changes anticipated by the transition
from a command economy to one based on demand, structured foreign policy and
the aid that accompanied it as never before. Assistance efforts needed to be able to
both show substantial results quickly and maintain those results when the short-term
donor funding ended. These two parameters were largely new to the social marketing
discipline as it had been applied to reproductive health. Meeting them necessitated
both fresh approaches and implementers, with a standard “test” for the usefulness of
a traditional tactic or program component being whether it could be expected to be
maintained on a commercial basis once U.S. assistance ended.
The Kazakhstan SOMARC project, the “Red Apple Program” and the subject of
this chapter, represents just such a revolutionary approach and implementation team.

TH E RE P RODUC TI V E H E A LTH CRISIS I N K A Z A KHSTA N

For most of the twentieth century, the principal method of birth control in the former
Soviet Union was abortion (Popov, 1990). Although the Central Asian Republics did
not have a population problem, the reliance on abortion for fertility regulation had
created a reproductive health crisis (Darsky & Dworak, 1993). This continued through
the early to mid-1990s, when Kazakhstani women nationwide were having an average