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Building Public/Private Partnership for Health System Strengthening Social Franchising

Building Public/Private Partnership for Health System Strengthening Social Franchising Dominic Montagu Bali Hyatt Hotel, Sanur , Bali 21-25 June 2010. Context. Source of Healthcare. Public. Private. Public. Private. Public. Private. Public. Private. Public. Private.

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Building Public/Private Partnership for Health System Strengthening Social Franchising

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  1. Building Public/Private Partnership for Health System Strengthening Social Franchising Dominic Montagu Bali Hyatt Hotel, Sanur, Bali 21-25 June 2010

  2. Context

  3. Source of Healthcare Public Private Public Private Public Private Public Private Public Private

  4. Place of DeliveryBy Wealth Quintile - South Asia poorest richest Public Facility 7.4% 12.9% 22.1% 29.2% 27.6% 10.4% Other Person’s Home 10.6% 9.7% 3.5% 7.0% 17.8% Home 78.1% 69.0% 56.3% 40.0% 1.7% 0.8% 49.1% 0.4% 0.2% 0.1% Religious Hospital 22.8% 11.4% 7.3% 3.9% Private Hospital/Clinic N = 72,333 women reporting births in DHS Surveys in South Asia since 2000. Data is Population-Weighted. Countries included: Bangladesh, India, Nepal, Pakistan

  5. Place of DeliveryBy Wealth Quintile - Southeast Asia poorest richest Public Facility 7.0% 12.8% 20.0% 24.1% 22.2% Other Person’s Home 6.1% 4.7% 3.2% 1.3% 2.2% 18.9% 37.0% 54.3% 70.0% Home 82.8% 21.5% 19.2% 35.9% 13.7% 8.5% Religious Hospital 2.9% 17.5% 8.8% 4.1% 1.2% Private Hospital/Clinic N = 11,654 women reporting births in DHS Surveys in Southeast Asia since 2000. Data is Population-Weighted. Countries included: Cambodia, Indonesia, Philippines (note: Vietnam data is not available with wealth quintiles) * ‘East Asia and the Pacific’

  6. One response: organize the private sector

  7. Social Franchising • “…is an attempt to use franchising methods to achieve social rather than financial goals, influencing the service delivery systems of the private sector similarly to the way in which social marketing has adapted traditional outlets for commodity sales.”

  8. •Brand Equity •Advertising •Training •Standards •Commodities Directly managed clinic Franchise Organization (Franchisor) Franchise Franchise pharmacy Franchise clinic clinic Results clients Specialist (X-RAY, Lab Tech) Franchise fee adherence to standards Product testing, gold standard Franchise Programs Service Provided More Clients

  9. Private providers value training

  10. Client choice of provider

  11. What makes a franchise • Outlets are owner-operated • Payment is for services delivered • vouchers • out-of-pocket • insurance / 3rd party payer • Services are standardized

  12. Services and Clients Served

  13. One in threesocial franchisesare in Asia

  14. 24.5M

  15. who are they

  16. why this structure works

  17. why this structure works • incentives are well aligned • need for oversight is limited • most healthcare services are low-volume, so a distributed high-number of SDPs is key • there are economies of scale • adding structure to the private healthcare market reduces transaction costs and benefits both patients and providers • use of intermediary institutions

  18. What Can Governments Do? • Determine when a social franchise is an appropriate response • Invite, subsidize, or create a supportive environment • Monitor, evaluate, contract

  19. Learn More www.sf4health.org

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