Social franchising: Growth, challenges and opportunities Brendan Hayes Head of Social Franchising, Marie Stopes International

Why work with the private sector to expand FP choice, quality and access? Close to the client: women already using private providers for MCH services Investment in existing healthcare infrastructure Continuity of care Often already providing some short term methods Marie Stopes International2

Can social franchising address constraints and increase FP access, choice and quality for women?

Increasing FP access: Service provision growth through SF Marie Stopes International4

Increasing FP quality: progress and learning Marie Stopes International5 Clinical audit results Proportion of franchisees scoring over 80% increased from 40% in 2011 to 84% in 2014 We require constant innovation in QA at scale to keep pace with SF growth We need the right balance of value creation for providers and the right providers Do we have the right quality metrics?

Improving equity: who are we reaching with SF? Marie Stopes International6 Half of MSI SF FP clients live on less than $2.50/day, but only 14% live on less than $1.25/day SF infrastructure can be leveraged to reach the most underserved, but only if access barriers (geographical, financial) are addressed

Addressing geographical barriers: working with franchisees in poor areas in Pakistan Marie Stopes International7 Suraj Social Franchising National FP users in Pakistan – 2013 DHS National public sector FP users in Pakistan Poorest16.4%11.4%15.9% Poor28.1%16.4%20.1% Medium wealth28.2%21.2%23.8% Wealthy20.8%24.2%22.6% Wealthiest6.5%26.8%17.7% SF clients by wealth quintile

Addressing financial barriers: vouchers Marie Stopes International8 Demonstrate how we can use purchasing mechanisms to work with the private sector USAID supports MSI voucher services in Uganda, Madagascar, Pakistan, Zimbabwe and Ethiopia

Linking SF with social health insurance Marie Stopes International9 Philippines: linking midwives with NHIP to expand maternal and FP service access for the poor Ghana, Kenya and Nigeria – Emerging national insurance programmes. What’s important? – Coverage – Right package – Right provider

Looking ahead Marie Stopes International10 “Small is beautiful” Go small Go local Go to midwife/nurse run businesses