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Monitoring the Performance of a Reproductive Health Franchise in Nepal

The Commercial Market Strategies project implemented a pilot network of private-sector nurses and paramedics in Nepal. Network activities began in April 2001, when franchisees were given basic reproductive health training for seven days. In addition, a two-day training was given on services marketing, which included the use of interpersonal techniques to develop trust and loyalty among clients. This paper assesses whether there were improvements in client perceptions of the quality of care received at clinics that were part of the Sewa (Nepali for "care") franchise network, and if there was an increase in reproductive health visits to the Sewa clinics. Two rounds of surveys were conducted with clients who exited franchise clinics. Clients' perceptions of the quality of services improved after the intervention. The proportion of women who visited for reproductive health reasons was also higher in the second round of surveys. The Sewa franchise has made progress in increasing the availability, perceived quality, and use of reproductive health services. These improvements appear to be related to provider training on building relationships with clients. Clients' limited awareness of the Sewa franchise brand name, however, suggests that providers have not received the full benefits of belonging to a franchise. A stronger marketing effort that increases client volume is likely to lead to the strengthening of the Sewa franchise.