Taken together, the papers in this book provide a comprehensive summary of measurement issues for clinic-based FP quality. PSI was featured in two chapters:
Chapter 4: The private sector delivers approximately 60 percent of healthcare services annually, including 35 percent of family planning services. Yet it is often unregulated and subject to abuse due to lack of resources by regulatory authorities to cover many of these small enterprises. The consequences of low-quality family planning and other key healthcare services can include poor service provision, which may lead to poor health outcomes. One approach to improving the quality of private sector healthcare is social franchising, a model that harnesses the power of the private sector while supporting governments to maintain standards and hence quality. Quality is theoretically embedded within social franchises, yet efforts to define and measure quality as a means to improving it continue to be a challenge. The aim of this paper is to describe how three social franchises support, monitor and measure quality, and to provide recommendations for other franchises based on these social franchises’ experiences.
Chapter 10: Private provision of health care is an important avenue for increasing access to health services. In low and middle income countries (LMIC), over 50% of health care is provided by private providers. Patients seek services in the private sector due to shorter wait times, fewer drug shortages, and friendlier treatment than in the public sector, as well as from a belief that technical quality is better in the private sector. Yet, unlike public sector facilities, private facilities in LMIC are rarely submitted to oversight or supervision, and private providers have limited access to new skills and clinical information. In response, a number of interventions to improve the quality of care in the private sector have arisen. One of these is social franchising, which leverages economies of scale to create networks of healthcare facilities through which providers are trained and their quality assured, clinics are branded to increase client recognition, and routine support is provided.