building public/private partnership for health system strengthening social franchising
DESCRIPTION
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. - PowerPoint PPT PresentationTRANSCRIPT
Building Public/Private Partnership for Health System Strengthening
Social FranchisingDominic Montagu
Bali Hyatt Hotel, Sanur, Bali21-25 June 2010
Context
Source of HealthcarePublic Private
Public Private
Public Private
Public Private
Public Private
Place of DeliveryBy Wealth Quintile - South Asia
7.4% 12.9% 22.1% 29.2% 27.6%
poorest richest
Other Person’s Home
Home
Religious HospitalPrivate Hospital/Clinic
Public Facility
10.4%10.6%
9.7%7.0% 3.5%
78.1% 69.0% 56.3% 40.0%
17.8%
0.1% 0.2%0.4%
0.8%49.1%
3.9% 7.3% 11.4% 22.8%
1.7%
N = 72,333 women reporting births in DHS Surveys in South Asia since 2000. Data is Population-Weighted. Countries included: Bangladesh, India, Nepal, Pakistan
Place of DeliveryBy Wealth Quintile - Southeast Asia
7.0% 12.8% 20.0% 24.1% 22.2%
poorest richest
Other Person’s Home
Home
Religious HospitalPrivate Hospital/Clinic
Public Facility6.1%
4.7%3.2%
2.2% 1.3%
82.8% 70.0% 54.3%37.0%
18.9%
2.9%8.5%
13.7%
19.2%
35.9%
1.2% 4.1% 8.8% 17.5%
21.5%
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’
One response: organize the private
sector
• “…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.”
Social Franchising
clinicclinic pharmacy
Franchise ProgramsFranchise
Organization(Franchisor)
Directlymanaged clinic
Product testing,
gold standard
FranchiseFranchise Franchise
clientsSpecialist (X-RAY, Lab Tech)
Results
Franchise feeadherence to standards
•Brand Equity•Advertising•Training•Standards•Commodities
Service Provided
More Clients
Private providers value training
Client choice of provider
• Outlets are owner-operated
• Payment is for services delivered»vouchers»out-of-pocket» insurance / 3rd party payer
• Services are standardized
What makes a franchise
Services and Clients Served
One in threesocial franchisesare in Asia
24.5M
who are they
why this structure works
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
What Can Governments Do?•Determine when a social franchise
is an appropriate response•Invite, subsidize, or create a
supportive environment•Monitor, evaluate, contract
Learn Morewww.sf4health.org