Health Franchise Networks: How to Maintain the Clinical Quality?

Donors in Bangladesh have been supporting NGO health service delivery for approximately 25 years. As a result, many NGOs have developed extensive clinical networks that rely on a strong central and in many cases an external element to monitor the quality of the services they provide. With the advent of the Smiling Sun Franchise Program, the goal of which is to transform 30 local NGOs that have a network of 319 clinics to a franchise business model that will provide sustainable, high quality reproductive health and primary care services, NGOs must assume greater responsibility for the monitoring their own quality. For many this represents a challenge for some NGOs in the network have 50 clinics throughout the country. For others who have a small number of clinics, they now need to develop the internal competence that previously was done by an external body. This presentation discusses the steps taken to implement a quality assurance model (QAM) that strengthens NGO capacity in a way that is cost-effective yet assures high quality services. This represents a change in systems as well as a change in attitudes of taking greater responsibility for health services. The presenters will discuss the development and role of the clinical quality council. How local clinic staff are more engaged in quality monitoring and local-level problem solving, and the steps taken to ensure that this quality monitoring system is institutionalized in the NGO management structure.