Social Franchising

1. Social Franchising welcome introductions thanks review agenda

2. A few points in history NewStart, Lesotho New Start, S.Africa Dushishoze Centres, Rwanda ProFam, Cameroon Well Family Midwife Clinic, Philippines PSI, Uganda ProFam, Benin GreenStar, Pakistan Blue Star,Vietnam ProFam, Mali Janani, India Top Reseau, Madagascar Amua, Kenya Blue Star, Ethiopia Congo 2000 2004 2008 1994 1996 2002 2006 1998 PSI,Cambodia Smiling Sun Bangladesh PSI,Togo Blue Star, Ghana SEWA/PSSN/Sangini, PSI, Nepal Blue Star, Malawi New Start, Zimbabwe New Start, Swaziland Blue Star, Philippines MSI Honduras Blue Star, Sierra Leone MSI Nicaragua SkyHealth Centers (WHP), India

3. A few points in history The effect of social franchising on access to and quality of health services in low- and middle-income countries Koehlmoos, Gazi, Hossain, Zaman The Impact of Franchised Family Planning Clinics in Poor Urban Areas of Pakistan; Hennink and Clements Public policy and franchising reproductive health: Current evidence and future directions; WHO Franchising Reproductive Health Services Stephenson, Tsui, Sulzbach, Bardsley, Bekele, Giday, Ahmed, Gopalkrishnan, and Feyesitan Social Franchising as a Strategy for Expanding Access to Reproductive Health Services McBride, Ahmed 2000 2004 2008 1994 1996 2002 2006 1998 Private Provider Networks; PSP-One Social Franchising Health Services: WFMC Case Study. Jones and Moore Private sector, human resources and health franchising in Africa Prata, Montagu, Jefferys Franchising Health Services in Developing Countries. Montagu Changes in preceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal Agha, Gage and Balal The impact of a reproductive health franchise on client satisfaction in rural Nepal Agha, Karim, Balal and Sosler Options EU Report on Social Franchising; Smith Social franchising of TB care through private GPs in Myanmar Lonnroth, Aung, Maung, Kluge and Uplekar MSI Report on Franchising FP and RH services Smith Reaching Youth through Franchise Clinics Decker and Montagu Social Franchising to Improve Quality and Access in Private Health Care in Developing Countries; Bishai, Shah, Walker, Brieger, Peters http://homepage.mac.com/domdiep/FileSharing15.html

4. A few points in history The effect of social franchising on access to and quality of health services in low- and middle-income countries Koehlmoos, Gazi, Hossain, Zaman The Impact of Franchised Family Planning Clinics in Poor Urban Areas of Pakistan; Hennink and Clements Public policy and franchising reproductive health: Current evidence and future directions; WHO Franchising Reproductive Health Services Stephenson, Tsui, Sulzbach, Bardsley, Bekele, Giday, Ahmed, Gopalkrishnan, and Feyesitan Social Franchising as a Strategy for Expanding Access to Reproductive Health Services McBride, Ahmed 2000 2004 2008 1994 1996 2002 2006 1998 Private Provider Networks; PSP-One Social Franchising Health Services: WFMC Case Study. Jones and Moore Private sector, human resources and health franchising in Africa Prata, Montagu, Jefferys Franchising Health Services in Developing Countries. Montagu Changes in preceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal Agha, Gage and Balal The impact of a reproductive health franchise on client satisfaction in rural Nepal Agha, Karim, Balal and Sosler Options EU Report on Social Franchising; Smith Social franchising of TB care through private GPs in Myanmar Lonnroth, Aung, Maung, Kluge and Uplekar MSI Report on Franchising FP and RH services Smith Reaching Youth through Franchise Clinics Decker and Montagu Social Franchising to Improve Quality and Access in Private Health Care in Developing Countries; Bishai, Shah, Walker, Brieger, Peters http://homepage.mac.com/domdiep/FileSharing15.html

5. Geneva meeting on Franchising for Reproductive Health • Comparative studies of franchises with other types of health interventions • Reaching a consensus on uniform indicators, e.g. CYPs or disability adjusted life years (DALYs) • health-care provider behaviours ... motivational factors for joining and retaining membership in a franchise. • Cost-effectiveness and cost-benefit studies • Operational research studies for: • optimal mix of services • cross-subsidization of different services within a franchise • diversification of funding sources

6. Clinical Service Franchises

7. Health Franchise Programs Current None Unknown status

8. Type Location Referrals-in

9. Services

10. Number of Clinics 2500

11. Financing

12. Quality Control Benin Burma Cameroon MadagascarMali Rwanda Sierra-Leone Togo

13. Outcomes

14. What makes a franchise?one possible definition • Outlets are operator-owned • Fee for service delivered • Standardization

15. Clinical Service Franchises

16. Clinical Service Franchises all free services all free services all free services may meet our franchise definition

17. Goals for today • Prioritize research needed to improve franchise operations • Commit to collaborate across programs to answer these questions • Begin defining how a study can be put into operation