PRIMARY HEALTH CARE CLINIC
SOCIAL FRANCHISE PROJECT
2014 Global Conference on Social Franchising for Health
Mactan Island, Philippines
22-24 October 2014
Dr Andrew K L Robinson,
Anita du Toit, Dr Uma Nagpal
PROBLEM STATEMENT
• While certain clinics run excellent services, there
is no uniformity of standards across all clinics,
nor are there effective mechanisms to do so.
• The well-run clinics are primarily a result of the
initiatives, inspiration, motivation and dedication
of the facility manager and not as a result of
business models, support structures or training.
Paradigm shift from status quo to social franchise business model
Current
Move towards
1
Poor image of PHC clinics, by-passing of PHC
services resulting in hospital congestion with
inappropriate levels of care patients
High acceptability by service users
2
Headed up by a facility manager, usually a good
nurse, with no training on facility management
Health professional with ‘equity stake’, performance driven
Run according to:
Clearly defined operations manual with training manual
with specific emphasis on:

Core Standards, Clinic supervision
manual, Various operational SOP’s and
stock management systems and Limited
HR plans

All vary between facility and district
3

Business management administration, processes
and procedures , Clearly defined support and
training, Efficient stock management and
procurement (Pharmaceuticals), HR management
systems, Time management and allocations, Asset
management
4
Variable PHC package of services, of variable
quality -only provided if resources exist
Standardised, quality full PHC package of care provided at
each PHC facility
5
Poor data collection and management
Data driven management with clear outcomes
6
Limited opportunities for job creation
Numerous opportunities for job creation at a local or rural
level
PROPOSED SOLUTION
• An innovative and dynamic approach will be necessary to
shift the “current” situation to the “future” required
standards expected from our clinics within the NHI.
• 28 March 2012 meeting with the South African Franchise
Association - a social franchise solution was deemed
possible and warmly supported.
• Franchising consultants were approached assist to develop
this innovative solution using business principles within the
social franchising concept and business models.
HOW TO DEVELOP A PHC CLINIC TO MEET NHI REQUIREMENTS…
HOW TO DEVELOP A PHC CLINIC TO MEET NHI REQUIREMENTS…
CONSISTENT HIGH QUALITY HEALTH SERVICES
THAT CAN BE REPLICATED
SOCIAL FRANCHISING
AS A MECHANISM?
1. Standardised
consistent service
2. Brand
3. Replicable
4. Sense of ownership
5. Systems and
Controls
6. Support
PROJECT PROCESS
Develop Model
Clinic
Pilot Clinic
Learnings
Replicate
Ongoing Monitoring
and Support
We are
here
Opportunities for job creation in rural areas
Within this model, a number of micro enterprises and
business opportunities could be created, particularly in rural
areas, which would have the potential to create jobs and
enhance the sense of ownership of facilities (not
privatisation).
These enterprises could comprise:







Cleaning services
Garden services, vegetable and traditional medicine production
Maintenance
Security
Water management, waste management and recycling
Laundry
Transport
PROGRESS / CONCLUSION
 The procurement process is the rate limiting factor.
 The business plan is developed, the operations and
training manuals are almost complete.
 Clinic decorating and renovations are commencing.
 Once implemented, this model will be replicated to one
clinic in the NHI pilot district to prove concept, before
being rolled-out province wide.
• Thank you!