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Social Franchising Health Services: A Philippines Case Study and Review of Experience

For over 15 years, John Snow, Inc. (JSI) has managed a number of public-private partnerships intended to expand access to family planning and other reproductive health services. JSI has been instrumental in establishing one such partnership in the Philippines—a so-called "social franchise," the Well-Family Midwife Clinic (WFMC) franchise. With funding from USAID/Philippines, JSI has worked with Philippine non government organizations (NGOs), midwives and the Department of Health (DOH) to adapt commercial franchising approaches for the provision of reproductive health services. This monograph describes that experience in an effort to contribute to a better understanding of the promise and pitfalls of social franchising as an approach for sustainable health service delivery. By relating the WFMC experience to that of social franchising schemes implemented elsewhere, policy conclusions and outstanding issues can be drawn for this nascent and complex approach for providing public health services. The intended target audience for this publication includes policymakers and program managersin donor agencies, governments in developing countries, multilateral agencies (such as WHO), and technical assistance agencies working in public health. A secondary audience includes technical agencies working in other areas of social development interested in the applicability of social franchising to their work. While this document is focused on the Well-Family Midwife Clinic franchise, and the USAIDfunded TANGO Project under whose auspices the franchise was established, it is important to understand the theoretical framework of social franchising and to consider the experience of social franchises in other countries. The WFMC franchise, as well as other commercially oriented networks and franchises, offer valuable lessons and insights into the policy and programmatic implications for meeting public health goals, allocating public funds to achieve those goals, and capitalizing on the strengths of the private sector to offer basic health services on a sustainable basis.