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1 PSI Social Franchising Research Steven Chapman November 20, 2008.

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Presentation on theme: "1 PSI Social Franchising Research Steven Chapman November 20, 2008."— Presentation transcript:

1 1 PSI Social Franchising Research Steven Chapman November 20, 2008

2 2 Current Studies Quality of Care Monitoring mystery client surveys exit interviews site assessments of client audits and monthly reports TRaC surveys (household or intercept samples) measure: behavior behavioral determinants exposure to social marketing franchising campaign Management information systems (clinic and client records) Focus Group Discussions

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4 4 Mystery Client Jones, Chris & Dianna Long. 2007. Family Planning TRaC-M Study Evaluating Quality of Care Among Social Franchising Providers in Kampong Thom and Kampot, Cambodia. PSI Research Division: Social Marketing Research Series Report. Mystery clients found that social franchise clinics performed better than other providers in terms of product availability and quality, provider knowledge, and general counseling for family planning. Social franchise clinics did not meet franchise standards in assuring confidentiality and privacy during consultations, taking medical history, conducting medical examinations, explaining the side effects of oral contraceptives, and having promotional materials available. Did meet franchise standards in terms of having private consultation rooms, and having sufficient inventory and supplies Prices of products consistent across the clinics, but all products sold at prices higher than the recommended price. Consultation fees were not displayed.

5 5 Mystery Client Kassegne, Sethson & Georges Koumagnanou & Jerome Ahlegnan. 2007. Evaluating the Quality of Services in VCT in Togo. PSI Research Division: Social Marketing Research Series Report. VCT mystery clients visited 5 government and 11 social franchises in 2006 and 2007 (256 visits) Positive trend (both networks). Post-test counseling indicators (asking questions about risk behavior, motivation, and support) No trend: Promising confidentiality, encouraging the client to ask questions, and the explanation of test results. Negative trends: Counselor compliance with protocol for delivering test results. Social franchise vs government. Clients were more likely to be greeted properly, to receive information, to be informed about privacy and confidentiality, and to receive a condom use demonstration.

6 6 Evaluation Plautz, Andrea & Dominique Meekers & Josselyn Neukom. 2003. The Impact of the Madagascar TOP Réseau Social Marketing Program on Sexual Behavior and Use of Reproductive Health Services. PSI Research Division: Working Paper 57. Two TRaC (household) surveys in 2000 and 2002 among youth 7% of youth had visited a social franchise clinic. Exposure: 31% attended a peer education session, 37% a mobile video unit presentation, 41% had heard a radio advertisement for the franchise, 64% had seen a television advertisement. Exposure to the campaign not associated with seeking STI treatment. Condom use among males and females improved significantly. Program exposure is associated with male consistent condom use and female use of modern family planning, and various determinants such as perceived access, outcome expectations, and improved social norms.

7 7 Evaluation Plautz, Andrea & Dominique Meekers & Josselyn Neukom. 2003. The Reach and Impact of the PSI Adolescent Reproductive Health Program in Butare Province, Rwanda. PSI Research Division: Working Paper 56. Two TRaC (household) surveys in 2000 and 2002 among youth During the first 18 months, significant improvement in knowledge and use of VCT among male and female youth, as well as fewer reported social barrier that prevent youth from buying and using condoms. Exposure to the program contributed to some of these positive changes.

8 8 MIS Hatzold, Karin & Lukasz Czerwinski & Dvora Joseph & Mathew Rupanga&Willington Mushayi. 2008. A Comparison of Four Client-Initiated HIV VCT Models in Zimbabwe. PSI Research Division: Working Paper 69. Data from management information systems--monthly expense reports and receipts Cost per client decreased from $18.12 in 2004 to $14.10 in 2006 Number of clients spike as a result of major communication campaign programs (World AIDS Day). Mobile outreach: women, unemployed, youth (16-19) more likely to use. Static outreach: people testing as part of a couple, HIV positive more likely to use. Gap: Intake records not recorded every time, static sites are within health facilities (people came because they have HIV symptoms, which is why more are HIV-positive).

9 9 MIS + Survey Lönnroth, Knut & Tin Aung & Win Maung & Hans Kluge & Mukund Uplekar. 2007. Social Franchising of TB Care through Private GPs in Myanmar: An Assessment of Treatment Results, Access, Equity and Financial Protection. Health and Policy Planning 22: 156-166. Management information systemsquarterly reports, and patient survey conducted in 2004 and 2005 Highly subsidized TB care through a social franchise network helped deliver quality services to the poor while keeping patient costs low. Extended outreach may reduce diagnostic delay and patient costs further. Sustaining social franchising through user charges is unlikely to meet the objectives of reaching the poor and protecting them financially.

10 10 Underway Womens Health Project (aka LAD) Qualitative research among providers in up to 14 countries identifying determinants to service provision for: IUDs and Implants Post-partum hemorrhage treatment Medical abortion Producing other inputs for planning and implementing large scale interventions that will include social franchising Myanmar Pakistan Survey MIS Voucher pilot

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