Day 2 of the 1st Global Social Franchising Conference displayed the successes and failures, insights and concerns, opportunities and risks faced daily by the front-line social franchising program implementers.
PANEL SESSION 1: HISTORY, CONTEXT & OPPORTUNITIES
Social franchising is at a tipping point – a time when it could become a system that is widely adopted and expanded. So we’re well poised to talk about where we are and where we should be headed.
The first speaker, Khama Rogo, rated Africa’s health systems on leadership and governance; service delivery packages and models; human resources for health; health information; and financing, medical products, technologies. We’re currently performing low to moderately.
How can we get to where we have to be? Khama Rogo suggested 8 fundamental changes:
1. Entrench social health franchising into national policies, strategies and laws;
2. Public sector must adopt public-private partnerships;
3. Franchisors must collaborate with the public sector;
4. Look at social health insurance, starting with microfinance;
5. Donor flexibility;
6. Commitment to scaling up;
7. Local ownership; and
8. Inclusion of social health franchises in schools of medicine and health.
The second speaker, Dana Hovig of MSI, took us through the history of social franchising from when it first began in Pakistan with the Greenstar network. He then challenged us to enter social franchising 3.0 – looking beyond supply-side interventions and the dogma of public-private boundaries.
Karl Hofmann of PSI, the third speaker, presented six ideas to focus our social franchising efforts moving forward with social franchising:
1. Being driven by the needs and behaviors of our audience (clients and providers)
2. Integration – the needs of the people we serve are holistic; our solutions should address all of these needs.
3. Innovative business model that works within a total market approach.
4. Standard metrics to measure the four pillars of social franchising.
5. Demand and supply side performance-based financing.
6. Telling and selling the story and sharing our best practices
PANEL SESSION 2: MANAGING TO SCALE
The second panel addressed the challenge faced by all social franchises – taking a program to scale successfully.
Top 5 lessons learned from the 2nd panel:
1. When you scale up, match the infrastructure and complement it with more human resource and technical assistance.
2. Use technology to link rural providers to high-level skills available at metros.
3. Use innovative models to sustain a rural network of community health workers.
4. Focus on sustainable scale.
5. Understand your brand promise, deliver to it and measure it
The small groups sessions in the afternoon addressed a few of the divergent ideas relevant to social franchising:
FOCUS vs. INTEGRATION OF SERVICES:
Top 3 challenges of integration:
• Maintaining the quality of each service.
• Keeping the brand promise. Will integration affect the brand value?
• It’s important to maintaining and/or improving the business skills of providers as the number of services they offer improves – especially in relation to accounting, financial sustainability and financial credit.
Top 3 lessons learned about integration:
1. Don’t position franchising as focused on a particular health area.
2. Focus on smart integration.
3. Focus on the needs and behaviors of the audience (provider and client) when considering integration.
Top 3 guidelines on capturing data:
• Ensure that there’s less data that’s more useful.
• Align metrics with government requirements.
• Continue the conversation about developing quality metrics. The Social Franchising Metrics Working Group is developing standardized metrics for each of the four pillars of social franchising, including quality.
TIERED DELIVERY SYSTEMS AND PROVDIER REFERRALS:
Top 3 solutions to the challenges presented by tiered delivery systems and provider referrals:
1. Introduce referral fees.
2. Use mHealth and technology for data collection.
3. Encourage communication between the different networks and systems, through meetings and newsletters.
DEMAND-SIDE FINANCING: VOUCHERS vs INSURANCE SCHEMES
Vouchers could be the first step to build a new program – a long-term way to cover niche areas of your program. They are less bureaucratic than insurance schemes, but insurance schemes are more sustainable.
If you weren’t able to participate in the 1st Global Social Franchising Conference, keep checking out the Highlights series to get the inside scoop into the conversations at the conference. You can also view the PowerPoints at sf4health.org