Most poor people in developing countries get healthcare from private rather than public service providers. For SRH, the strongest evidence for market interventions showed that franchising can expand private sector access to family planning services for the poor; social marketing of FP messages and products can improve access for everyone and raise awareness and knowledge; private sector community-based workers can be trained to administer injectable contraceptives with a high quality of care. Social marketing is as or more cost-effective than other channels for getting contraceptives to those who want them, for increasing demand, and especially in reaching out to adolescents. Social franchising aims at ensuring access (increase the number of providers and services offered); and cost effective and provision of services in line with quality standards equitable. It thus seems imperative to harness the potential of private sector health providers who are willing to upgrade their knowledge and skills in order to add family planning to the services they offer and in this way, contribute to increased contraceptive use by making high-quality family planning services and commodities available and accessable throughout urban and peri-urban Pakistan.
It calls for partnerships between the franchisers and selected providers (franchisees) with the Agreement that these providers would integrate a defined package of services, and deliver them according to the high-quality standards established by the former. In return, the franchisee receives specialized support, training, and rights to the franchise brand for as long as the franchisee maintains minimum quality standards. The franchisee also benefits from brand equity, indicating quality and reliability, created by the franchiser.
Delivering good quality care to all clients, wherever they are, is a fundamental principle of IPPF’s work. Good quality of care enhances clients’ satisfaction and their use of services. It increases job satisfaction and motivation among service providers, and it leads to greater sustainability of service provision.
IPPF promotes good quality of care by ensuring that clients have the right to information, access to services, choice, safety, privacy and confidentiality, dignity and comfort, and continuity of services and opinion.
To fulfill clients’ rights, the needs of service providers must be met as well. These needs include training, information, infrastructure and supplies, guidance, respect and encouragement, feedback and opportunities for self-expression.
IPPF’s ongoing efforts to improve quality assurance among its Member Associations aim to ensure:
- High quality integrated services that, depending on the context, may include: counseling, provision of contraceptives and family planning, safe abortion care, care for sexually transmitted infections and reproductive tract infections, HIV, gynecology, gender-based violence services, adolescent sexual and reproductive health services, and maternal and child health care services.
- Increased coverage for poor, marginal, vulnerable and under-served groups by strengthening their broader service delivery system.
- A client-centric approach that is sensitive, confidential and respects sexual rights and diverse needs.
- Health services are implemented according to best practices and in adherence to quality assurance measures.
- Lessons learnt are shared with the broader community and integrated in advocacy work to inform broader policy objectives.
- Rahnuma-FPAP has worked to increase access to SRH services through static service delivery points (SDPs), mobile and outreach clinics, associated clinics and community-based distributors (CBDs).
- Concerted efforts have been made to reach remote and under-served areas by deputing a mobile team of doctors, nurses and paramedics. Mobile service delivery has been provided through sexual reproductive health service awareness sessions, special family planning sessions and services through mobile vehicles on specific days.
- Strengthened service delivery, building capacity of service providers on newer services, advanced techniques, integrated counseling, and investment in frontline workers to provide higher level of services. These strategies are combined with initiatives for education, awareness, leveraging the government system, building community ownership, developing key partnerships, upgrading infrastructure and commodities management.
Under Catalytic Fund, There are 30 franchisees in 3 districts of Punjab. They include Lady Health Visitors and doctors, who are referred to as private service providers. The objective of the Catalytic Project was to increase access to the SRH services, through Social Franchising, with Private Practitioners (PPs), residing in peri-urban and rural areas of Pakistan. The strategy adopted was to build capacity of the selected number of PPs (30), so that they can provide additional SRH services, which they were not providing earlier (apart from the Family Planning Services). Capacity building was complemented by community mobilization, development of infrastructure, expansion of service packages and quality assurance, which was maintained and monitored by Rahnuma-FPAP.
b) Uninterrupted supply of Commodities:
Private Practitioners were supplied with commodities through Family planning representatives. The latter were responsible for the Continuous Medical Education of the providers.
c) Target population:
The target population for franchises is rural and poor, mostly married women. The market rate for Intra-Uterine Contraceptive Device (IUCDs) in the areas where these franchisees operate is Rs. 400-500, which is at least five times the cost of short term methods such as pills, injectables and condoms. Therefore, those who wish to use IUCDs and because of subsidized rates they are able to have access to long term family planning methods.