Scaling Affordable Quality Care Through a Financially Sustainable Social Franchise in India

Session: What is the Local Private Health Sector and Can it Offer Quality Maternal Health Care?

Presenter: Abha Jha, Hindustan Latex Family Planning Promotion Trust

Background: With funding from Merck Sharpe and Dohme Corp., Hindustan Latex Family Promotion Trust (HLFPPT) established the Merrygold social franchise network in Rajasthan to expand access to affordable, quality maternal health and family planning services.  The network includes large hospitals, small nursing homes and clinics with services offered by a wide range of providers, including general physicians, specialists and indigenous system of medicine (ISM) doctors.

Methodology: As the franchisor, HLFPPT supports providers to improve care through various quality assurance and quality improvement activities. HLFPPT first assesses facilities to ensure they meet basic threshold criteria in order to join the network.  HLFPPT trains franchisee staff on a range of topics including MNH and FP, infection prevention, quality assurance, and reporting and documentation via a core health management information system (HMIS).Doctors conduct periodic quality assurance visits using a quality checklist, and develop quality improvement action plans with providers to address any needs identified.

Results: As of May 2015, in 15 districts, 33 providers and their team received training and 27 facilities received quality assurance (QA) visits. During initial QA visits, 17 clinics followed 75% of the critical steps/criteria and 60% of desired steps/criteria. In the second visit, scores for critical steps/criteria rose from 75% to 90% for all providers. It was further observed that gaps existed mainly in the area of infection prevention rather than in service delivery.

Conclusion: The MGHN Network now expands in various states in India namely Uttar Pradesh, Bihar, Odisha, Rajasthan and Andhra Pradesh, making it one of the largest social franchises not only in India but in the world. The model has proven to be a financially self-sustainable way to offer quality services at affordable prices for underserved women. It also offers governments a timely opportunity to organize private providers and ensure they offer quality care.