First National Conference on Social Franchising in Pakistan was held last week

Marie-Stopes-SocietyThe First National Conference on Social Franchising in Pakistan hosted by the Marie Stopes Society (MSS) in Bhurban concluded after two days of deliberations on 28 August. The participants at this event were drawn from both the public and private sector entities that are providing reproductive health (RH), family planning (FP) and Maternal and Child health services in Pakistan. Also attending were representatives from Donor organizations and multinational firms that have successfully demonstrated franchise models in Pakistan.

As a brief introduction, Social Franchising (SF) applies commercial franchising strategies to the non-profit health sector to efficiently expand access to quality health care that is affordable for under served communities.

The basic principle of SF is closely patterned on the social marketing concept that of selling a social good as a commodity using standard commercial practices to achieve non commercial goals. SF works by creating a network of health care including RH and FP providers that are contractually obligated to deliver specified services in accordance with franchise standards under a common brand
SF improves access, equity and cost effectiveness of health and family planning services through the private sector

Many groups benefit from SF:
– Low  income communities have access to quality services at affordable prices
– Private providers benefit from increased clinic revenues that are generated through an expanding clientele
– Governments have better health and FP indicators
– A stronger and better regulated private health sector

A successful franchise is usually measured according to the four globally accepted objectives of social  franchising:
– Increased access to providers (scale) services offered (scope)
– Improved quality standards
– Increased equity in serving all population segments
– Maximized cost effectiveness

Based on the above Marie Stopes Society (MSS) an NGO that has been active in Pakistan for the last twenty years in the provision of RH and FP services launched its Suraj Social Franchising Network in 2008 to engage the private sector in expanding access for the provision of quality voluntary FP services. The model is essentially a partnership between MSS and private local health service providers and aims to improve quality of RH and FP services, increase informed demand, access and choices for poor and underserved communities.

This innovative scheme has been piloted with 100 private health care providers in 18 districts. The number has since then increased to almost 400 private service providers in over 50 districts.
Central to this SF scheme is the demand-side supply, comprising ‘vouchers’ redeemable for free quality services provided by the SF. These vouchers address women’s financial, social and cultural barriers that may have impeded her from using family planning services. According to information provided by MSS these vouchers have significantly facilitated addressing women’s contraceptive needs and 94% of these vouchers have been redeemed for services. Additionally the SF programme has provided a sustainable livelihood to local private health care providers by raising their provision and business skills.

Addressing the inaugural session on 27 August in her Keynote Address Dr. Sania Nishtar Founder and President of Heartfile highlighted the role of SF for improved service delivery from a health systems strengthening perspective. She stated that the Government, as an important stakeholder for the provision of Health and Family Planning services in Pakistan needs to harness the private sectors contractual arrangements to extend these to the larger health sector. These arrangements can lead to enhancing quality of services as part of a reform approach involving both the existing Government infrastructure and its management practices eventually bringing both the Health and Family Planning services together. This was the need of the hour as the development approaches were changing and vertical programmes could no longer be sustained. Referring to the country’s population explosion as a ‘significant security threat’ she stated that security agencies were now a stake holder in finding a solution to this problem.

The ‘Bhurban Declaration’ agreed to at the conclusion of the Conference calls for the extension of maternal health coverage across Pakistan under Social Franchising.

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