REVIEW OF LITERATURE
According to Giddings, et al. (2002), the society ,'embraces the multitude of human actions and interactions, which takes place within a physical environment' which includes the socio-cultural environment (Aycan, et al., 2000). Social and cultural factors constitute the socio-cultural environment and they include everything, which is not a part of the political and economic system of an individual, society and a country as a whole. The socio-cultural environment also consists of the whole range of behaviours and relationships in which individuals engage in their personal and private lives, including the demographic characteristics of the population (e.g. age, sex, race or ethnicity, class, etc.), values and attitudes, lifestyles and relationships and reference groups.
Ross et al. (2006)have identified the role of culture at various levels of social marketing. They have listed few author and practitioners including Pawtucket (1995), who used culturally relevant material for people with low literacy.
Social marketing and social marketing mix have been discussed pri- marily in context of health sector in the expansive literature that is available in the public domain. Issues including smoking, TB, HIV, Polio, maternal and infant safety, vaccination, etc. have been the focus of all the social marketing exercises since 1951.
Many authors have identified influences of socio-cultural factors in-health related behaviour change processes around the world. Nader, et al. (1992) pondered on culturally appropriate media-led information and education for smoking cessation campaigns.
Dunn et al (2011) considered the malaria risk behaviour in the light of socio-cultural aspects in Tanzania and found that aspects such as lack of employment opportunities near the home, rituals including funeral and other ceremonies, carrying out outdoor socialization activities, routine household activities with specific gender involvement, etc. were the key factors responsible for this behaviour. According to the ESC Rights Committee of United Nations,health is influenced by social determinants like class and racial inequalities, poverty, employment and housing facilities (Yamin, 2008). This observation finds support in a study relating to school dropouts in Zambia by Henning (2009) where factors viz. school type(community/private and/or government) influenced the school dropout rate especially, among those girls who had family members infected with HIV. Another study conducted in Tanzania by Wight et al,(2012) discussed that the young women were concerned more about restricting sexual behaviour rather than focusing on the HIV threats. They also observed that the youth who were more focused on education and their careers were unenthusiastic about sexual activities and hence the possibility of an HIV infection was drastically low. In addition, due to threat of the religious punishments and disapproval, the possibility of fidelity towards partners was high and hence low scope for the spread of the disease. This not only reduced the scope for HIV spread but also the need for contraceptives. An interesting aspect was highlighted by Agha, et al. (2006) in Wightet al.(2012), while studying the epidemic of HIV in Zambia, that though use of contraceptives was desirable to control the spread of HIV, in case of youth, this might not be possible as they were constrained by religion which not only prohibited infidelity,it also discouraged the use of contraceptives. Therefore, the use of contraceptives on the other hand could relate to promoting infidelity.
In a study by Alhassan (2008), it was found that the since 94% of mothers had no education about what constituted good nutrition this resulted in malnutrition and infection in their children. Also, the religious and cultural norms were controlled mostly by the males which add more miseries for the women in their understanding about the education and health. In a study on the African migrants in Australia, Polonsky et al. (2010) discussed that varying levels of acculturation existed among various segments of population, and the attitudinal influence on blood donation was effected due to cultural changes e.g. migration from rural to urban areas and the level of health literacy.
Studies conducted by Crawford and Jeffery (2005); and Tapp et al. (2008), clearly state that life style diseases like obesity are influenced by various socio-cultural factors like gender, age, income, race, ethnicity, household configuration, employment conditions, etc. These in turn influence the social marketing solutions.
Various other authors have also pointed out to the influence of socio cultural factors on numerous other aspects of the society. Scholars and researchers including Brookover and Ericson (1969), and Morrow and Torres (1995), were of the belief that environmental and cultural factors have a profound influence on human behaviors, including academic performance. These, findings were later corroborated in the studies conducted by Gallimore and Reese (1999) and Van Steensel (2006) about development of home learning environment in the impoverished Mexican and Dutch families and called it a form of acculturation, because the parents were aware that this type of behaviour was favoured in the Dutch society.
McPhee, et al.(1995) in his study of San Diego Family Health Project, carried out culturally sensitive intervention by using bilingual speakers for Mexican American, Black and Anglo American families. This view finds support with Van Duyn, et al. (2007) who have concluded that social marketing messages need to be tailored to the unique cultural and socio demographic characteristics of each community. They also reflect policy changes at the community level as crucial, because they feel that social marketing interventions, which target the socio-cultural, physical, and economic environment of a community, are more effective than interventions that target individuals.Caballero, et al. (2003) while segmenting and targeting the consumers considered cultural heritage during programmedevelopment.
Jones and Boyd (2011) researched on social adaptation to climate change in Nepal and discussed three kinds of barriers - cognitive, institutional structure and governance, and normative. They further explained that the effect of caste-based discrimination is socio-political in nature and the adaptive capacity of the people in different castes is governed politically and aimed at supporting the interests of the higher castes. The determinants of political discrimination includes caste based groups, gender and social status and families, who interestingly encourage an individual to change a particular behaviour or lifestyle. McKee et al., (2004) added that the lack of knowledge isone of the major factors along with other socio-cultural factors in any health related initiative involving social marketing exercise.
Grier and Bryant (2005) list these socio-cultural factors under 'other factors' that motivates or deters a consumer from adopting the recommended behaviour. Evans (2008) on the other hand refers to Bandura (1977) in Bandura (1986) while explaining the role of social modelling in social learning and socialcognition; that is, the formation of knowledge, attitudes, and beliefs, etc.
On the other hand, Quarry and Ramírez, (2009) comment that many people despite having been exposed to knowledge still exhibit risky behavior. This point towards an interesting insight that behaviour change is not just dependent on the lack of exposure to information but it is also due to differences in attitudes, motivation and perception (Fukuda and Ebina, 2011)