Franchising to increase access Franchising to increase access and use of LTFP and SA in and use of LTFP and SA in

GhanaGhanaCynthia Eldridge, Global SF Manager, MSI

International Conference on FPKampala, Uganda

Tuesday November 17, 2009

Amua, Kenya

ProFam, Benin

ProFam, Cameroon

NewStart, Lesotho

Blue Star, Ethiopia

Blue Star, Vietnam

20021994 1998 200620042000 20081996

GreenStar, Pakistan Janani, India

Well Family Midwife Clinic, Philippines

Suraj, MSS Pakistan

Blue Star, Ghana

Blue Star, Malawi

Blue Star, Philippines

Blue Star, Sierra Leone

Top Reseau, Madagascar

ProFam, Mali

Dushishoze Centres, Rwanda

New Start, S.Africa

New Start, Swaziland

PSI,Togo

New Start, Zimbabwe

SkyHealth Centers (WHP), India

SEWA/PSSN/Sangini, PSI, Nepal

Congo

PSI,Cambodia

PSI, Uganda

MSI Nicaragua

MSI Honduras

The global view of franchising

Smiling Sun Bangladesh

Source: Slide from Montagu and Montagu, D., et al. (2009) Clinical Social Franchising: An annual Compendium of Programs, 2009. San Francisco: The Global Health Group, Global Health Sciences, University of California San Francisco.

CentersCenters

Centers

MSI Partner

Outreach

Outreach

OutreachOutreach

Outreach

Technical Support Programme Support

Strengthening Health Systems

Implementing BlueStar

3. Supply Side: Training

Commodity Supply

1. Analyse market and

conduct research

2. Develop Brand, Services and Products. Charge Franchise Fee

4. Demand Side Activities:Branding

Local Demand Generation

5. Supervision and

Monitoring

Increasedaccess

and uptake of services

A System of Quality for BlueStar 1

A. MSI Medical Development Team

• Set clinical standards for franchised services

• Conduct competency based training

• Conduct annual quality technical assistance

• Include 1-2 franchisees in global medical development team quality technical assistance

A System of Quality for BlueStar 2

A. Medical Development Team

• Implement minor and major incident reporting system through Medical Advisory Team

B. Procurement and Logistics Team

• Ensure appropriate commodities and equipment

Ghana Health ContextCountries Non-public

sectorBolivia (2003) 41%

Burkina Faso (2003) 46%Ethiopia (2005) 20%Ghana (2003) 56%

Kenya (2003) 45%

Malawi (2004) 33%Mali (2001) 45%

Mozambique (2003) 30%

Nigeria (2003) 72%Senegal (2005) 28%

Tanzania (2005) 31%

Uganda (2006) 64%Zambia (2002) 38%Zimbabwe (2006) 31%

BlueStar Ghana

• Started April 2008• Greater Accra Region• Service delivery

channel for MSIG• 42 clinics, 26

pharmacies, 32 chemical sellers

• LAFP and SA services

Ensuring quality of service delivery through BlueStar Ghana

Continuity of Care through BlueStar Ghana

CHW CHW

Catchment

Area

MSIGCentre

Referra

ls

Outreach at Govt Clinic

CHW CHW

Outreach

Referrals

Referrals

Lessons Learned

1. Evidence-based decision making is vital2. Pilot allows for “teething problems”3. Demand generation activities must be

strategic, start early and be local4. Franchise fees are part of the business

partnership model5. Integration with other MSI core delivery

mechanisms is essential

SF MSI Team

Dr. Rehana Ahmed – Head of SF (L)Cynthia Eldridge – Global SF Manager (R)

Frank Francisco BlueStar

Philippines

Jamshaid Asghar

Suraj Pakistan

Manty TarawalliBlueStar Sierra

Leone

Senanu ArkutuBlueStar Ghana

Le Thi Kim YenBlueStar Viet Nam

Girma MinasnoteBlueStar Ethiopia

Felistas SibwezaBlueStar Malawi

Ranja RakotomahaninaBlueStar Madagascar

Ferdinand MosehAmua Kenya