Franchising Private Franchising Private Sector MidwivesSector Midwives

for FP/MCH Service Deliveryfor FP/MCH Service Delivery

THE PHILIPPINE SETTINGTHE PHILIPPINE SETTINGFP/MCH MarketFP/MCH Market------------------------------------------------------------------------------------------------• 22 million Women of Reproductive Age (WRA)1

• 7 million WRA at high risk for pregnancy2

• 2.6 million expected to become pregnant each year2

• 1 in 6 pregnancies ends up in abortion due to unwanted/unplanned pregnancies2

• 2 million married WRA have unmet need for FP2

• An estimated maternal mortality rate of 172 deaths/100,0003

___________________________

Sources: 1 NSO, 2000 2 DOH, 2001 Report 3 1998 NDHS

THE PHILIPPINE SETTINGTHE PHILIPPINE SETTINGDemand-Supply Gap in the FP/MCH Demand-Supply Gap in the FP/MCH MarketMarket-------------------------------------------------------------------------------------------------------------------------- • Middle-income competing with lower-income population

for government services;1

• 40% of public sector clients have the ability to pay;1

• 54% of women go to nurses/midwives for pre-natal care services;2

> 43 nurses/midwives for every 100,000 Filipinos

• High fertility rate and low contraceptive prevalence;3

> Modern Methods: 33%; All Methods: 49.5%

• Difference of one child between actual and desired family size.4

___________________________Sources: 1 1998 Market Segmentation Study 2 2001 MCHS 3 2001 FPS 4 1998 NDHS

The Well-Family Midwife Clinic

THE STRATEGY:THE STRATEGY:COMMUNITY-BASED ENTERPRISE MODELCOMMUNITY-BASED ENTERPRISE MODEL

The WFMC is a specially designed ambulatory health facility for the efficient & effective provision of family planning services and maternal and child health services that serves the working poor.

At the core of the project is the consistent theme of entrepreneurship, ownership and empowerment as epitomized in a franchise-type health service delivery approach that combines business and social development.

The Well-Family Midwife ClinicThe Well-Family Midwife Clinic

Waiting/Reception AreaWaiting/Reception Area Recovery RoomRecovery Room

Counseling & Procedure Counseling & Procedure RoomRoom

Delivery RoomDelivery Room

The Well-Family Midwife ClinicThe Well-Family Midwife Clinic--------------------------------------------------------------------------------------------

Menu of Menu of ServicesServices

Family PlanningFamily Planning• IUD Insertion/Removal/Check-up• Pill Supply• Condom Supply• DMPA Injection• Referrals for Bilateral Tubal Ligation (BTL) & Vasectomy• Referrals for Natural Family Planning• Counseling

OthersOthers• Blood Pressure-Taking• Weight-Taking• Wound Dressing• Ear Piercing• Other Services

Maternal and Child Maternal and Child HealthHealth• Physical Exam• Breast Exam• Pelvic Exam• Pregnancy Test• Safe Delivery• Pre-natal Care• Post-natal Care• Pap Smear• Well-Baby Care - Deworming - Cord Dressing - Weight-Taking

Expanding FP/MCH Service Expanding FP/MCH Service Delivery:Delivery:The Franchising OptionThe Franchising Option------------------------------------------------------------------------------------------------------------------------------Franchising.Franchising. A method of product or service delivery distribution governed by a contract between the franchisor and the franchisee.

Franchising ElementsFranchising Elements

• Product or service with a brand identity• Partnership between a franchisor and a franchisee• Payment of franchise fee/royalties• Defined market for the product or service• Presence of operations system and training program• Central system for certain business support systems

Franchising Midwives for FP/MCHFranchising Midwives for FP/MCHService DeliveryService Delivery----------------------------------------------------------------------------------------------------------------The transformation processThe transformation process

• Clinic Site Selection

• Midwife Selection

• Midwife Training

• Product Range

• Product Standards

• Product Supplies

• Customer Targeting

• Pricing of Products and Services

• Product Positioning

• Marketing Efforts

LIGHTED SIGN

MENU BOARD

FP POSTER

STICKER

FLYER BROCHURE

BUSINESS CARDOTHERS – FROM NETWORK PARTNERS

The Well Family Midwife Project:The Well Family Midwife Project:Lessons LearnedLessons Learned----------------------------------------------------------------------------------------------------------------------• Continuous search of key determinants of Continuous search of key determinants of

the”model clinic”the”model clinic” Utilize evidence/research-based data for decision-making.

• Establish clear indicators and milestonesEstablish clear indicators and milestones Install a performance-based payment mechanism.

• Be very selective in the choice of partnersBe very selective in the choice of partners Deselect NGO partners and midwives, if necessary.

• Introduction of the business planning processIntroduction of the business planning process Transform benchmarks into meaningful business-oriented results and midwives into entrepreneur-clinic managers.

Well-Family Midwife Well-Family Midwife ClinicClinic------------------------------------------------------------------------------------------------Recent SuccessesRecent Successes

• Over 200 WFMCs in-place nationwide

• Over 250,000 MCH services provided every year

• 30,000-40,000 CYPs generated every year

• Average clinic income of $670 per month with 13% coming from FP services

• WFMC Partnership Foundation, Inc. in-place

Thank You!For more information, contact:For more information, contact:

Nilda Perez / USAID Philippinesrperez@usaid.gov