Transcript Social Franchising - Private Healthcare in Developing

Social Franchising
welcome
introductions
thanks
review agenda
A few points in history
NewStart, Lesotho
Dushishoze
Centres, Rwanda
Well Family Midwife
Clinic, Philippines
PSI, Uganda
ProFam, Benin
GreenStar,
Pakistan
1994
New Start, S.Africa
ProFam, Cameroon
Janani, India
1996
1998
Amua, Kenya
Blue Star,
Vietnam
Congo
Blue Star,
Ethiopia
ProFam, Mali
Top Reseau,
Madagascar
2000
2002
2004
2006
2008
PSI,Cambodia
Smiling Sun Bangladesh
PSI,Togo
SEWA/PSSN/Sangini,
PSI, Nepal
Blue Star, Ghana
Blue Star, Malawi
New Start, Zimbabwe
New Start, Swaziland
Blue Star, Philippines
MSI Honduras
Blue Star, Sierra Leone
MSI Nicaragua
SkyHealth Centers (WHP), India
A few points in history
The Impact of Franchised Family
Planning Clinics in Poor Urban Areas
of Pakistan; Hennink and Clements
Social Franchising as a Strategy for Expanding
Access to Reproductive Health Services
The effect of social franchising on access to and
quality of health services in low- and middle-income
countries Koehlmoos, Gazi, Hossain, Zaman
Franchising Reproductive Health Services
Stephenson, Tsui, Sulzbach, Bardsley, Bekele,
Giday, Ahmed, Gopalkrishnan, and Feyesitan
McBride, Ahmed
1994
1996
1998
2000
2002
Social Franchising Health Services:
WFMC Case Study. Jones and Moore
Franchising Health Services
in Developing Countries.
Montagu
Public policy and franchising
reproductive health: Current
evidence and future
directions; WHO
2004
2006
2008
Private Provider
Networks; PSP-One
Private sector, human resources and
health franchising in Africa Prata,
Montagu, Jefferys
Changes in preceptions of quality of, and access to,
services among clients of a fractional franchise network in
Nepal Agha, Gage and Balal
Options EU Report on Social
Franchising; Smith
The impact of a reproductive health franchise on client
satisfaction in rural Nepal Agha, Karim, Balal and Sosler
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
http://homepage.mac.com/domdiep/FileSharing15.html
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
A few points in history
The Impact of Franchised Family
Planning Clinics in Poor Urban Areas
of Pakistan; Hennink and Clements
Social Franchising as a Strategy for Expanding
Access to Reproductive Health Services
The effect of social franchising on access to and
quality of health services in low- and middle-income
countries Koehlmoos, Gazi, Hossain, Zaman
Franchising Reproductive Health Services
Stephenson, Tsui, Sulzbach, Bardsley, Bekele,
Giday, Ahmed, Gopalkrishnan, and Feyesitan
McBride, Ahmed
1994
1996
1998
2000
2002
Social Franchising Health Services:
WFMC Case Study. Jones and Moore
Franchising Health Services
in Developing Countries.
Montagu
Public policy and franchising
reproductive health: Current
evidence and future
directions; WHO
2004
2006
2008
Private Provider
Networks; PSP-One
Private sector, human resources and
health franchising in Africa Prata,
Montagu, Jefferys
Changes in preceptions of quality of, and access to,
services among clients of a fractional franchise network in
Nepal Agha, Gage and Balal
Options EU Report on Social
Franchising; Smith
The impact of a reproductive health franchise on client
satisfaction in rural Nepal Agha, Karim, Balal and Sosler
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
http://homepage.mac.com/domdiep/FileSharing15.html
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
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
Clinical Service Franchises
Chemonics International
Bangladesh (Smiling Sun)
Janani/DKT International
India (Surya Clinic)
Marie Stopes International
Ethiopia (BlueStar)
Ghana (BlueStar)
Kenya (AMUA)
Malawi (BlueStar)
Philippines (BlueStar)
Sierra Leone (BlueStar)
Vietnam (BlueStar)
Population Services International
Benin (ProFam)
Burma
Cambodia (Sun Quality Health)
Cameroon (ProFam)
Congo
India
Lesotho (New Start)
Madagascar (Top Reseau)
Mali (ProFam)
Nigeria
Pakistan (GreenStar)
Rwanda (Dushishoze Centres)
South Africa (New Start)
Swaziland (New Start)
Togo
Uganda
Zambia
Zimbabwe (New Start)
World Health Partners
India (SkyHealth Centres and SkyCare Centres)
Health Franchise Programs
Current
None
Unknown status
Type
Location
Referrals-in
Services
Number of Clinics
2500
Financing
Gov't reimbursement
Insurance
Direct Subsidy
Voucher
Out-of-pocket
0
5
10
15
20
25
Quality Control
Government Accreditation
Benin
Burma
Cameroon
MadagascarMali
Rwanda
Sierra-Leone
Togo
Mystery Clients
Franchisor Assessment
Franchisee Reports
0
5
10
15
20
25
Outcomes
CYP Year-to-Date
Chemonics International
Bangladesh (Smiling Sun)
Janani/DKT International
India (Surya Clinic)
Marie Stopes International
Ethiopia (BlueStar)
1486
Ghana (BlueStar)
10121
Kenya (AMUA)
165600
Malawi (BlueStar)
3952
Philippines (BlueStar)
5246
Sierra Leone (BlueStar)
Vietnam (BlueStar)
Population Services International
DALYs Year-to-Date
0
20294
Benin (ProFam)
Burma
Cambodia (Sun Quality Health)
Cameroon (ProFam)
Congo
69391
India
Lesotho (New Start)
60106
Madagascar (Top Reseau)
Mali (ProFam)
Nigeria
Pakistan (GreenStar)
1400000
Rwanda (Dushishoze Centres)
South Africa (New Start)
72009
Swaziland (New Start)
6007
Togo
Uganda
Zambia
1340
What makes a franchise?
one possible definition
–Outlets are operator-owned
–Fee for service delivered
–Standardization
Clinical Service Franchises
Chemonics International
Bangladesh (Smiling Sun)
Janani/DKT International
India (Surya Clinic)
Marie Stopes International
Ethiopia (BlueStar)
Ghana (BlueStar)
Kenya (AMUA)
Malawi (BlueStar)
Philippines (BlueStar)
Sierra Leone (BlueStar)
Vietnam (BlueStar)
Population Services International
Benin (ProFam)
Burma
Cambodia (Sun Quality Health)
Cameroon (ProFam)
Congo
India
Lesotho (New Start)
Madagascar (Top Reseau)
Mali (ProFam)
Nigeria
Pakistan (GreenStar)
Rwanda (Dushishoze Centres)
South Africa (New Start)
Swaziland (New Start)
Togo
Uganda
Zambia
Zimbabwe (New Start)
World Health Partners
India (SkyHealth Centres and SkyCare Centres)
Clinical Service Franchises
Chemonics International
Bangladesh (Smiling Sun)
Janani/DKT International
India (Surya Clinic)
Marie Stopes International
Ethiopia (BlueStar)
Ghana (BlueStar)
Kenya (AMUA)
Malawi (BlueStar)
Philippines (BlueStar)
Sierra Leone (BlueStar)
Vietnam (BlueStar)
Population Services International
Benin (ProFam)
Burma
Cambodia (Sun Quality Health)
Cameroon (ProFam)
Congo
all free services
India
Lesotho (New Start)
Madagascar (Top Reseau)
Mali (ProFam)
Nigeria
all free services
Pakistan (GreenStar)
Rwanda (Dushishoze Centres)
South Africa (New Start)
all free services
Swaziland (New Start)
Togo
Uganda
SHEF/CFW
ProRedesSalud
World Health Partners
AED
Zambia
Kenya (HealthStore)
Zimbabwe (New Start)
Peru (ProRedesSalud)
India (SkyHealth Centres and SkyCare Centres)
Nepal
may meet our
franchise
definition
Goals for today
1. Prioritize research needed to improve franchise
operations
2. Commit to collaborate across programs to answer
these questions
3. Begin defining how a study can be put into
operation