Social Franchising welcome introductions thanks review agenda

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

A few points in history MSI Report on Franchising FP and RH services Smith Options EU Report on Social Franchising; Smith Franchising Health Services in Developing Countries. Montagu Private sector, human resources and health franchising in Africa Prata, Montagu, Jefferys Social franchising of TB care through private GPs in Myanmar Lonnroth, Aung, Maung, Kluge and Uplekar Social Franchising to Improve Quality and Access in Private Health Care in Developing Countries; Bishai, Shah, Walker, Brieger, Peters 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 McBride, Ahmed Franchising Reproductive Health Services Stephenson, Tsui, Sulzbach, Bardsley, Bekele, Giday, Ahmed, Gopalkrishnan, and Feyesitan Public policy and franchising reproductive health: Current evidence and future directions; WHO Private Provider Networks; PSP-One Reaching Youth through Franchise Clinics Decker and Montagu The effect of social franchising on access to and quality of health services in low- and middle-income countries Koehlmoos, Gazi, Hossain, Zaman Social Franchising Health Services: WFMC Case Study. Jones and Moore The impact of a reproductive health franchise on client satisfaction in rural Nepal Agha, Karim, Balal and Sosler Changes in preceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal Agha, Gage and Balal

A few points in history MSI Report on Franchising FP and RH services Smith Options EU Report on Social Franchising; Smith Franchising Health Services in Developing Countries. Montagu Private sector, human resources and health franchising in Africa Prata, Montagu, Jefferys Social franchising of TB care through private GPs in Myanmar Lonnroth, Aung, Maung, Kluge and Uplekar Social Franchising to Improve Quality and Access in Private Health Care in Developing Countries; Bishai, Shah, Walker, Brieger, Peters 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 McBride, Ahmed Franchising Reproductive Health Services Stephenson, Tsui, Sulzbach, Bardsley, Bekele, Giday, Ahmed, Gopalkrishnan, and Feyesitan Public policy and franchising reproductive health: Current evidence and future directions; WHO Private Provider Networks; PSP-One Reaching Youth through Franchise Clinics Decker and Montagu The effect of social franchising on access to and quality of health services in low- and middle-income countries Koehlmoos, Gazi, Hossain, Zaman Social Franchising Health Services: WFMC Case Study. Jones and Moore The impact of a reproductive health franchise on client satisfaction in rural Nepal Agha, Karim, Balal and Sosler Changes in preceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal Agha, Gage and Balal

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 Geneva meeting on Franchising for Reproductive Health

Clinical Service Franchises Chemonics InternationalBangladesh (Smiling Sun) Janani/DKT InternationalIndia (Surya Clinic) Marie Stopes InternationalEthiopia (BlueStar) Ghana (BlueStar) Kenya (AMUA) Malawi (BlueStar) Philippines (BlueStar) Sierra Leone (BlueStar) Vietnam (BlueStar) Population Services InternationalBenin (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 PartnersIndia (SkyHealth Centres and SkyCare Centres)

Health Franchise Programs Current None Unknown status

TypeLocationReferrals-in

Services

Number of Clinics 2500

Financing

Quality Control Benin Burma Cameroon MadagascarMali Rwanda Sierra-Leone Togo

CYP Year-to-Date DALYs Year-to-Date Chemonics InternationalBangladesh (Smiling Sun) Janani/DKT InternationalIndia (Surya Clinic) Marie Stopes InternationalEthiopia (BlueStar)1486 Ghana (BlueStar)10121 Kenya (AMUA) Malawi (BlueStar)3952 Philippines (BlueStar)5246 Sierra Leone (BlueStar)0 Vietnam (BlueStar)20294 Population Services InternationalBenin (ProFam) Burma Cambodia (Sun Quality Health) Cameroon (ProFam) Congo69391 India Lesotho (New Start)60106 Madagascar (Top Reseau) Mali (ProFam) Nigeria Pakistan (GreenStar) Rwanda (Dushishoze Centres) South Africa (New Start)72009 Swaziland (New Start)6007 Togo1340 Uganda Zambia Zimbabwe (New Start)20833 World Health PartnersIndia (SkyHealth Centres and SkyCare Centres) Outcomes

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

Clinical Service Franchises Chemonics InternationalBangladesh (Smiling Sun) Janani/DKT InternationalIndia (Surya Clinic) Marie Stopes InternationalEthiopia (BlueStar) Ghana (BlueStar) Kenya (AMUA) Malawi (BlueStar) Philippines (BlueStar) Sierra Leone (BlueStar) Vietnam (BlueStar) Population Services InternationalBenin (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 PartnersIndia (SkyHealth Centres and SkyCare Centres)

Clinical Service Franchises Chemonics InternationalBangladesh (Smiling Sun) Janani/DKT InternationalIndia (Surya Clinic) Marie Stopes InternationalEthiopia (BlueStar) Ghana (BlueStar) Kenya (AMUA) Malawi (BlueStar) Philippines (BlueStar) Sierra Leone (BlueStar) Vietnam (BlueStar) Population Services InternationalBenin (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 PartnersIndia (SkyHealth Centres and SkyCare Centres) SHEF/CFWKenya (HealthStore) ProRedesSaludPeru (ProRedesSalud) AEDNepal all free services may meet our franchise definition

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 Goals for today