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APHA Scientific Session and Event Listing

Recorded presentation

Sohail Agha, PhD, International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, (504) 988 - 3655, sagha@tulane.edu

Background Legislation to improve the quality of care provided by the commercial sector has had only limited success in developing countries. Franchising is a voluntary mechanism available to improve the quality of care provided by private providers in developing countries. A social franchise was launched in urban Pakistan with the purpose of improving the provision of high quality family planning services through the commercial sector.

Methods A representative survey of providers in franchised commercial clinics, non-franchised commercial clinics and public sector clinics was conducted in 11 cities in urban Pakistan. About 1200 doctors and lady health visitors were interviewed at commercial and public sector clinics. The study uses bivariate and multivariate analysis to compare differences in quality of care between franchised, non-franchised and public sector clinics. The study investigates the effects of training and supervisory visits on the quality of care provided and provider reasons for remaining or dropping out of the franchise.

Results The quality of care provided was highest in government clinics, followed by franchised commercial clinics. Provider experience in the provision of family planning services, their having received in-service training and supervisory visits from the franchisor were associated with the quality of care provided. Overall, the performance of the franchise was determined by the degree to which the franchisor was successful in motivating providers.

Policy Implications Clinic franchising has the potential to improve the quality of care provided by the commercial sector.

Learning Objectives: By the end of the session, the participants will be able to

• Assess the degree to which a social franchise was able to improve the performance of private providers
• Understand provider motivations for remaining part of or dropping out of the franchise

Keywords: Providers, Quality Improvement

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation