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ORIGINAL ARTICLE
Open Access

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International

Erik Munroe, Brendan Hayes and Julia Taft
Global Health: Science and Practice June 2015, 3(2):195-208; https://doi.org/10.9745/GHSP-D-15-00056
Erik Munroe
aMarie Stopes International, London, UK.
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Brendan Hayes
aMarie Stopes International, London, UK.
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Julia Taft
aMarie Stopes International, London, UK.
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  • FIGURE 1.
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    FIGURE 1.

    Annual Number of Family Planning Clientsa by Type of Contraception and Annual Couple‐Years of Protection Provided by MSI Social Franchising Programs in Selected African and Asian Countries,b 2008–2014

    Abbreviations: CYPs, couple‐years of protection; LARCs, long‐acting reversible contraceptives; MSI, Marie Stopes International.

    a The number of family planning clients was estimated as follows: for short‐acting methods, the number of commodities provided each year divided by the number of commodities needed for a full year of contraceptive protection (i.e., 13 for oral contraceptive pills; 98 for condoms; 4 for DMPA contraceptive injections, given every 3 months; these factors differ slightly from CYP conversion factors because CYP conversion factors take into account method effectiveness and wastage); for LARCs, the number of IUD and implant insertion services provided each year; and for permanent methods, the number of tubal ligation and vasectomy services provided each year.

    b Data are from routine program monitoring, from 7 countries in 2008 and growing to 17 countries in 2014.

  • FIGURE 2.
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    FIGURE 2.

    Annual Couple‐Years of Protection Provided per MSI Franchisee,a 2008–2014

    Abbreviations: CYPs, couple‐years of protection; MSI, Marie Stopes International.

    a Data are from routine program monitoring, based on 695 social franchisee outlets in 7 countries at the end of 2008 and growing to 4,070 outlets in 17 countries by the end of 2014.

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    TABLE 1. Marie Stopes International Social Franchising Results Framework: Measures of Intended Outputs
    Intended OutputDefinitionData SourceNo. of Countries and YearsIndicators
    AccessThe extent to which a program ensures potential clients can reach or obtain services regardless of financial, geographic, or cultural barriers to accessRoutine program monitoring dataStarting in 7 countries in 2008 and growing to 17 countries by the end of 2014Estimated number of family planning clients
    Number of couple-years of protection (CYP)
    EfficiencyHow inputs (financial, human, technical) are used to produce the maximum outputRoutine program monitoring dataStarting in 7 countries in 2008 and growing to 17 countries by the end of 2014Average number of CYPs generated per social franchisee per year
    QualityThe degree to which a provider or facility meets certain objectives and perceived levels or expectations of health care delivery standardsClinical quality audit10 countries in 2011,10 countries in 2012,15 countries in 2013,14 countries in 2014Mean quality score of audited social franchisees
    Proportion of audited social franchisees scoring over minimum standard (score ≥80%)
    Client exit interviews14 countries in 2013Self-rating of overall experience
    EquityThe extent to which a program ensures all potential clients have an equal or fair opportunity to obtain services.Client exit interviews14 countries in 2013Family planning adopters: Proportion of family planning clients who newly adopt a modern contraceptive method (defined as not using a modern method during the 3 months prior to their visit)
    Client exit interviews14 countries in 2013Age: Proportion of clients under 25 years old and proportion under 20 years old
    Client exit interviews12 countries in 2013Poverty: Proportion of clients living below US$1.25/day and proportion living below $2.50/day
    • View popup
    TABLE 2. Quality Audit and Client Satisfaction Scores of Selected Marie Stopes International Social Franchisee Outlets, 2011–2014
    2011 (N=61)2012a (N=164)2013 (N=211)2014 (N=200)
    Overall quality score, mean (95% CI)78.5 (73.5, 83.5)80.8 (79.4, 82.3)86.6 (85.3, 88.0)87.9 (86.5, 89.3)
    Proportion of audited outlets scoring higher than minimum standard score of 80%, % (95% CI)39.8 (20.9, 58.8)58.7 (49.5, 67.9)77.4 (71.7, 83.1)84.1 (78.5, 89.6)
    Client satisfaction score,b mean (95% CI)4.51 (4.46, 4.56)
    • Quality scores are from clinical quality audits while client satisfaction scores are from client exit interviews.

    • ↵a The program in Pakistan used a slightly amended scoring methodology for clinical audits in 2012.

    • ↵b Total possible client satisfaction score was 5.

    • View popup
    TABLE 3. Equity in Access to Family Planning Through Marie Stopes International Social Franchising Programs in Selected Countries, 2013
    Equity Domain%, (95% CI)
    Age of clients
     15–19 years5.0 (3.9, 6.1)
     15–24 years26.1 (23.8, 28.4)
    Poverty level of clientsa
     Living on under US$1.25/day15.1 (13.8, 16.4)
     Living on under US$2.50/day57.4 (54.9, 60.0)
    Family planning adoptersb
     Newly adopted a modern contraceptive method40.7 (37.4, 44.0)
    • Data are based on client exit interviews in 14 countries (Ethiopia, Ghana, India, Kenya, Madagascar, Malawi, Mali, Nigeria, Pakistan, Philippines, Senegal, Sierra Leone, Uganda, and Vietnam), except for the “poverty” indicator, which excludes results from Madagascar and Nigeria because they used non-comparable measures of poverty than the other 12 countries.

    • ↵a Measured using the Progress out of Poverty Index (PPI).13

    • ↵b Defined as modern contraceptive method clients who had not been using a modern method during the 3 months prior to their visit.

Additional Files

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  • GHSP-D-15-00056 Supplementary Material

    Munroe et al. doi: 10.9745/GHSP-D-15-00056

    • Supplementary Material - Munroe et al. doi: 10.9745/GHSP-D-15-00056
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Global Health: Science and Practice: 3 (2)
Global Health: Science and Practice
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June 01, 2015
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Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International
Erik Munroe, Brendan Hayes, Julia Taft
Global Health: Science and Practice Jun 2015, 3 (2) 195-208; DOI: 10.9745/GHSP-D-15-00056

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Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International
Erik Munroe, Brendan Hayes, Julia Taft
Global Health: Science and Practice Jun 2015, 3 (2) 195-208; DOI: 10.9745/GHSP-D-15-00056
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