How can Franchising Expand Access to Quality Health Services in Developing Countries?

Large scale improvements and expansion of health services are required to meet the Millennium Development Goals (MDGs) by 2015. More health facilities per capita are not enough to reach the MDGs. There is evidence that people do not use facilities if the perceived quality of care delivered is not what they consider good. Even very poor people are prepared to make large out of pocket expenditures for better quality services. Franchising a.k.a. social franchising offers a model of organizing and expanding quality and affordable health care services in developing countries. In business, a franchise requires a prototype service model, a franchiser, a number of franchisees with investment capital, reliable suppliers and a market that will pay for those services. The prototype is a proprietary system of doing business developed by the franchiser, who owns the system and the operations manual and licenses it to the franchisee. This manual is an essential component of the franchise because it describes every step for the franchisee to have similar success. To reach the MDGs, a manual needs to include every step of how to deliver a quality health care “menu” of services consistently and efficiently, from greeting the patient to treatment and follow up.

This paper compares and discusses business franchises and three social health franchise programs and summarizes the key operational aspects of putting franchising into practice to deliver and expand affordable quality care. The paper lists a number of recommendations for making a franchising prototypes and manuals available globally to accelerate reaching the MDGs.