In designing the MSD for Mothers programme, MSD has put an emphasis on the role that the private sector can play in low- and middle-income countries by increasing the overall availability of care, improving the quality of care, as well as reducing the burden on the public sector. As part of the initiative, MSD for Mothers is supporting three social franchising models—the Matrika project in Uttar Pradesh, the Merrygold model in Rajasthan and the ProFam model in Uganda. The programmes share some common elements, but differ in details and key features.
We are using a mixed-methods approach to examine the similarities and differences in the design and implementation of these models. At the end of the project, we will be able to describe the three programmes and how they have changed since their inception. We will also have a better understanding of the experiences and perceptions of various stakeholders, including franchise operators and employees, community health workers, women and their families. We will document patient pathways to see where women go for antenatal care and delivery services, and why, and capture the care they receive. We will look at the costs of setting up and running a social franchise and examine the financial sustainability of the three models. Finally, we will assess the quality of care provided.
Photo: PACE-Uganda (KK Big Sky)
Equity and sustainability are cross-cutting themes of the case studies. Equity will be explored through analysis of socio-economic differences in pathways of care, assessing whether differences in women’s socio-economic status affects care seeking behaviour and care received. In terms of sustainability, we will explore financial sustainability and also provide insights on social sustainability from the point of view of franchisees, community health workers and women attending the facilities. We aim to not only describe the models in detail, but also to understand the challenges they face and how these challenges may affect the quality of care and long-term sustainability of the programmes.
In Uganda, we have partnered with the Policy Analysis and Development Research Institute (PADRI) to collect data on the ProFam social franchise. We have also partnered with TRIOs in India to work with us on the case studies in Uttar Pradesh and Rajasthan.