Unjani Clinics: meeting the need for scale through social franchising

The Kenyan private health sector is one of the most developed in Sub-Saharan Africa and is highly critical in healthcare delivery. It is estimated 47 percent of the first quintile of income earners utilize the private facility for healthcare needs and 33 percent of women seek family planning (FP) services in this sector. However, the cost of healthcare services has been a great impediment to service utilization. To improve service quality and increase access, social franchising, interventions on the demand side such as the use of insurance and vouchers, and supply of subsidized medical products on the supply side are intended to reduce the cost of services. This study sought to investigate the impact of interventions of social franchisors on the cost of healthcare in private facilities in Kenya. The study used primary data collected from 215 individuals living within catchment areas with private health facilities using researcher-administered questionnaire. The main franchisors included in this study were Sustainable Health Foundation (CFW) and Population Services Kenya (Tunza). Results revealed that women whose primary motivation to visit private facilities included FP services, need of a lower cost of treatments, and quality services had higher odds of choosing franchised health facilities. Propensity score matching (PSM) using three matching criteria—nearest neighbor, kernel matching, and radius matching of 0.01—indicated that individuals seeking children’s health services and 3-month FP methods paid similar amounts in either franchised or nonfranchised health facilities. However, there was a huge cost variance for long-term FP methods where women paid significantly less, implying that social franchisors’ main impact is on long-term FP methods. The cost variance was due to vouchers utilized by some respondents hence, incurring zero cost in franchised facilities. Therefore, the study recommends the expansion of social franchising membership and the use of the voucher system for financially incapable consumers.

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User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya

BMC Health Services Research ◽

10.1186/s12913-015-0709-3 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Maia Sieverding ◽

Christina Briegleb ◽

Dominic Montagu

Keyword(s):

User Experiences ◽

Social Franchising

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Social Franchising

International Encyclopedia of Civil Society ◽

10.1007/978-0-387-93996-4_616 ◽

2010 ◽

pp. 1420-1426

Author(s):

Samiul Hasan ◽

Ruth Crocker ◽

Damien Rousseliere ◽

Georgette Dumont ◽

Sharilyn Hale ◽

...

Keyword(s):

Social Franchising

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Demonstrating the effectiveness of social franchising principles: the emptying of household ventilated improved pits: a case study from South Africa

Journal of Water Sanitation and Hygiene for Development ◽

10.2166/washdev.2013.309 ◽

2013 ◽

Vol 3 (4) ◽

pp. 623-628 ◽

Cited By ~ 1

Author(s):

K. Wall ◽

O. Ive ◽

J. Bhagwan ◽

F. Kirwan ◽

W. Birkholtz ◽

...

Keyword(s):

South Africa ◽

Disposal Site ◽

Eastern Cape ◽

Home Base ◽

Work Site ◽

Social Franchising ◽

Partnership Model ◽

Specialized Equipment ◽

The Impact

Having viewed the successful social franchising partnerships pilot programme that serviced sanitation facilities at 400 schools in the Butterworth District of the Eastern Cape of South Africa, the Amathole District Municipality (ADM) expressed interest in exploring how well the partnership model could empty household pit latrines in its jurisdiction. The impact and effectiveness of the model was demonstrated by the emptying, by five franchisees over a period of only six weeks, of the contents of 400 household ventilated improved pit latrines in Govan Mbeki Village, and the safe disposal of their content. The paper describes the methods and results in removal and disposal of faecal sludge. Problems were encountered, and the solutions (technical, institutional and social) are described. Not unexpectedly, the amount of effort involved in this work – including time, training required, equipment required and ingenuity – varied enormously. The main variables included the type of top structure, the nature of the pit contents, whether or not there was broad consistency of type and contents in an area, distances (between pits, from home base to work site, from pits to disposal site, from location of specialized equipment to work site), logistical delays (e.g. non-arrival of equipment) and bureaucratic hold-ups (especially payment delays).

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