Many women in low- and middle-income countries seek health care from providers in the private sector. Even when publicly-run facilities exist, private providers are often closer to where women live, provide services or products that may not be otherwise available, and may even provide better quality services or products than their public counterparts. However, these private sector providers are often micro-enterprises with just a few employees and limited cash-flow. They face challenges related to sourcing commodities, accessing training, attracting clients, and following regulations.
Social franchise networks are one solution to these problems and have supported providers in the private sector for over twenty years. This support can come in many forms: subsidized or free commodities, trainings, branding, and quality assurance services. But social franchisors—entities organizing these networks—typically rely on donor funding to offer this support, and struggle to ensure that providers and services are available in areas and to clients with the greatest need. Without sustainable options for future financing, franchisors will not be able to support care for those who need it most and adequately adapt in response to health needs and new health system constraints.
As part of the USAID-funded Support for International Family Planning and Health Organizations (SIFPO2) project, Results for Development (R4D) is working with Population Services International (PSI) to link franchisors and private sector health care providers with new sources of funding to expand family planning and reproductive health services to the poorest women and girls. Starting with PSI franchisors in Tanzania, Uganda, and Nigeria, R4D analyzed the key needs of the franchise networks, identified potential sources of health financing and clarified their policy context, and proposed new financing options.
The framework for this Health Financing Option Analysis can be used by franchisors to access diversified funding sources and increase their financial sustainability with direct benefits for:
- Women and girls: Health financing options can enable more poor women and girls to access high-impact health services without paying out of pocket.
- Health care providers: Providers may be embedded into overarching payment systems like insurance, stand to increase client and service volumes, and benefit from increased training and quality support.
- The franchisor: Better financed social franchise platforms can redefine their role as strategic partners for strengthened health care service delivery, and improve against social franchising goals (equity, quality, cost effectiveness, additionality, and impact).
- The public sector: The government can reduce fragmentation in the health system, get better value for public funds, and improve performance against population health goals.