1. The Role of the Private Sector and Social Franchising in UHC: A Case Study from Kenya Joyce Wanderi, PS Kenya September 18 th, 2015

2. A refresher: What is social franchising? Branding Training Standards Commodities

3.  Approximately 43% of Kenyan’s rely on the private sector for FP (KDHS 2008)  Private sector especially the lower levels that serve majority of Kenyans have varied quality  Social franchising, organizes the private sector reducing variability in quality of care  It also offers a way of scaling up successful solutions to meet a greater need Why social franchising?

4. Typical Profile of Tunza clinic 4  ~55% are in urban areas serving urban & peri-urban  ~60% of facilities are small, outpatient only ~80% are run by a nurse and refer complicated cases

5.  Text SIFPO support in Kenya  Expanding competence of providers to include LARC – Implants and IUCDs  Strengthening quality monitoring to ensure client safety and informed choice  Increase in scale of the network to increase access points  Addressing demand for services

6. Impact: Changes in IUCD & Implant Method Mix in Tunza -

7. Impact: Increase in the Scale of the Network

8. H TC/ HIV care & treatment Cervical cancer ANC, Skilled delivery, PNC One key lesson learned - Integrated Service Delivery

9. Challenges encountered….  Managing quality efficiently in the context of increased scale and scope  Skills erosion through staff turnover  Patient management – referrals and follow up systems due to lack of automated record keeping

10. The Future 1: Supporting Integrated Service Delivery and Evidence Based Decision Making ASSESS: undertaking quality assessments IMPROVE: provision of structured feedback PLAN: Work planning / scheduling of visits MONITOR: Monitoring performance of network providers over time

11. The Future 2: Navigating New Health Financing Towards Universal Health Coverage A maternal health focused savings card The expanding National Hospital Insurance Scheme An out- patient oriented micro insurance scheme

12. The Future 3: Coordination! Coordination! Coordination!

13. Thank you