Yen Le Kim, MSI Vietnam - Social Franchising for Health

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Efficiency of the BlueStar Social Franchise
network and prospect of investment in
reproductive health private clinics in Viet Nam
Marie Stopes International in Viet Nam
Cebu, Oct 22-24, 2014, Cebu, Philippines
SLIDE 1
Content
1
Viet Nam – Health Context
2
MSIVN overview
3
BlueStar Social Franchise
Model – Highlights and Lowlights
4
Challenges
5
The way forward
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 2
Viet Nam – Health context

90 million people, 24.3 million women of RH age (27%); 40.9% under
25

Health Insurance coverage: 65% (2013). FP is not covered.

CPR modern method 76.2% amongst married women. High unmet
need for modern contraceptives amongst youth under 24

High abortion rate (average 2.5-2.8 per woman/lifetime). Around 30%
amongst young women under 20.

Rapid growth of private health sector: >35,000 private
clinics/hospitals serving about 48 million client visits per year
(JAHR-2012) accounting for 32% of the health service market.

Private sector contributes only 14% of FP services (USAID 2010)
Sources: Population Changes and Family Planning Survey 2012; Joint Annual Health Review 2013; *Goodkind D, Abortion
rate in Vietnam: Measurements, puzzles and concerns
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 3
BlueStar Social Franchise Model

Organization: Marie Stopes International
in Vietnam

Year of beginning: 2008

Network of 300 SFs. First tier: 150
Ob/Gyn, 70 GPs; Second tier: 80 Midwives

Franchised services: FP and safe
abortion, Essential RH services as add-on

Locations: Urban/peri-urban areas

Target clients: low income women

Key support: standardization,
training/certifying & accreditation; quality
control; brand promotion/demand
generation; SRH commodities supply;
linkage with public health sector for
support.
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 4
BlueStar Social Franchise Model
1. Increase access
2. Improve service quality
1. Served more than 4.1 million
client visits between 2008 –
2014
2. Provided FP services to
more than 1.3 million clients
3. Offered CAC to 660,000
clients
3. Increase equitable access
1.
950 mobile trips targeting at low
income women
2.
Offered free essential RH/FP
services to about 160,000 factory
workers
3.
Introduced 5 Voucher schemes,
serving 63,000 MA and IUD clients
Objectives
& key
achieveme
nts
1.
More than 2500 service providers
trained and certified on various RH/FP
services; 1,500 participants attended
advanced clinical seminar via BlueStar
club
2.
External QTA scores increased from
76% in 2011 to 85% in 2013. Infection
prevention increased from 45% to 88%
3.
Client satisfaction: 75% to 93%
4. Increase cost effectiveness
1.
2.
Develop financial sustainable
social franchise model

Cost sharing

Cost reduction

Government contributions
Central purchase of high
quality products at discounted
price
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 5
BlueStar Vietnam
Strengths:
 Low cost per CYP: less than
USD2/CYP compared to MSI average
of USD7/CYP
 Good productivity: over 120
CYPs/franchisee/month compared to
MSI global average of 110
 Quality improvement:
 From under QTA 50 baseline to
over QTA 90
 CS score: from 86% to 95%
 Reaching under 25 year old youth
(30% of client visits in 2013)
 Strong professional network –
BlueStar club
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 6
BlueStar Vietnam
Why is the BlueStar Vietnam
model efficient?

Strong focus on sustainability
at the core of our strategy

Government contributions

Quality control: joint
monitoring and evaluation
with the government

Social marketing sales

Increasing cost-sharing
approach with franchisees
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 7
Challenges

Sustaining private sector social
franchising model beyond donor
funding is a big challenge.

Provider behavior change: from
willingness to participate in
BlueStar – willingness to invest
in BlueStar. Takes time.

Post abortion family planning:
Providers’ behaviour change (it
may influence incomes?)

Government policies
Baseline
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 8
Lesson learnt and the way
forward

Our response will no longer be general; but targeted

Sustain the quality control intervention

Diversify the services/products provided at BlueStar
network

Financial sustainability of BlueStar model through:
 Cost reduction and cost sharing
 Diversify/generate income sources: membership
fees, SMPs

Advocate for policy change to extend the scope of
services for 2nd tier providers - midwives
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 9
Thank You

Marie Stopes International in Viet Nam
http://www.mariestopes.org.vn/

BlueStar Viet Nam
http://bluestar.org.vn/
EFFICIENCY OF THE BLUESTAR SOCIAL FRANCHISE NETWORK AND PROSPECT OF INVESTMENT IN REPRODUCTIVE
HEALTH PRIVATE CLINICS IN VIETNAM
SLIDE 10
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