Social franchising:Growth, challenges and opportunities

Brendan Hayes

Head of Social Franchising, Marie Stopes International

2

Why work with the private sector to expand FP choice, quality and access?

• Close to the client: women already using private providers for MCH services

• Investment in existing healthcare infrastructure

• Continuity of care

• Often already providing some short term methods

Marie Stopes International

Can social franchising address constraints and increase FP access,

choice and quality for women?

4

Increasing FP access: Service provision growth through SF

Marie Stopes International

2008 2009 2010 2011 2012 2013 20140

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

4,500,000

71,606CYPs

3,829,193CYPs

Permanent Methods Short-Acting MethodsLARCs CYPs

No

. of C

lien

ts (

tho

usa

nd

s)

5

Increasing FP quality: progress and learning

Marie Stopes International

Clinical audit results

Proportion of franchisees scoring over 80% increased

from 40% in 2011

to 84% in 2014

• We require constant innovation in QA at scale to keep pace with SF growth

• We need the right balance of value creation for providers and the right providers

• Do we have the right quality metrics?

6

Improving equity: who are we reaching with SF?

Marie Stopes International

• Half of MSI SF FP clients live on less than $2.50/day, but only 14% live on less than $1.25/day

• SF infrastructure can be leveraged to reach the most underserved, but only if access barriers (geographical, financial) are addressed

7

Addressing geographical barriers: working with franchisees in poor areas in Pakistan

Marie Stopes International

Suraj Social Franchising

National FP users in Pakistan – 2013

DHS

National public sector FP users in

Pakistan

Poorest 16.4% 11.4% 15.9%

Poor 28.1% 16.4% 20.1%

Medium wealth 28.2% 21.2% 23.8%

Wealthy 20.8% 24.2% 22.6%

Wealthiest 6.5% 26.8% 17.7%

SF clients by wealth quintile

8

Addressing financial barriers: vouchers

Marie Stopes International

Demonstrate how we can use purchasing mechanisms to work with the private sector

USAID supports MSI voucher services in Uganda, Madagascar, Pakistan, Zimbabwe and Ethiopia

9

Linking SF with social health insurance

Marie Stopes International

• Philippines: linking midwives with NHIP to expand maternal and FP service access for the poor

• Ghana, Kenya and Nigeria – Emerging national insurance programmes. What’s important?

– Coverage

– Right package

– Right provider

10

Looking ahead

Marie Stopes International

“Small is beautiful”Go small

Go local

Go to midwife/nurse run businesses