Impacts of a government social franchise model on perceptions of service quality and client satisfaction at commune health stations in Vietnam

Abstract

This study evaluates behavioural outcomes associated with a new approach - the government social franchise (GSF) model - developed to improve reproductive health and family planning (RHFP) service quality and capacity in Vietnam's commune health stations. A quasi-experimental design with a matched control group assessed GSF model effects on client perceptions of serviced quality and satisfaction. Survey data from 1181 users and potential users were collected at baseline, six months and 12 months after implementation of the franchise network. Regression analyses controlled for baseline differences between intervention and control groups. Commune health station franchise membership was significantly associated with improvement of community perceptions of service quality and client satisfaction as well as their likeliness to return and recommend low-cost, community-based RHFP services to others. This study provides preliminary evidence regarding the ability of the GSF model to increase client satisfaction with RHFP services in primary public healthcare clinics.social franchise, reproductive health services, satisfaction, commune health stations, Vietnam,

The Impact of Clinical Social Franchising on Health Services in Low- and Middle-Income Countries: A Systematic Review

“…A quasi-experimental study of a government franchise program in Vietnam found that after the introduction of the franchise clients did not report an overall increase in quality, but did perceive improvements in staff attitude. At the community level, residents perceived improvements in both overall service quality and provider expertise [27]. Qualitative focus groups reported similar findings; clients in Myanmar perceived franchise clinics to be of higher quality, in particular offering safer drugs and more privacy [28] and in Vietnam reported improvements in the quality of staff and facilities after introduction of franchised services [29].…”

“…Quasi-experimental pre- and post-studies show increased client satisfaction at a government franchise in Vietnam [27], and a non-profit franchise in Nepal [30]. Analysis of cross-sectional exit interview data found no variation in overall levels of client satisfaction between franchised and non-franchised clinics in India and Pakistan [20], [25]; however in Pakistan, franchise clients were more satisfied with the range of contraceptive methods and services offered [20].…”

“…The most rigorous study of client loyalty found significant increases both in client willingness to return and willingness to recommend the franchise clinic to others following the introduction of a government franchise [27]. Other studies showed divergent results.…”

Program Impact Pathway Analysis of a Social Franchise Model Shows Potential to Improve Infant and Young Child Feeding Practices in Vietnam

“…However, a growing body of research on social franchising interventions shows mixed results across a variety of outcomes (1,(6)(7)(8). Social franchising is associated with improvements in patient-reported quality-of-care indicators such as client satisfaction (9)(10)(11). However, there is a paucity of studies that comprehensively assess quality of care across multiple dimensions such as provider practice, provider knowledge and skills, and service availability (1,6).…”

Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy

“…Experiments with the government social franchise business model, 30 which increases service utilisation and patient perceptions of quality through branding and social marketing programmes, quality improvement, formalisation of user fees and staff incentive schemes have been successful in some CHS system trials in Viet Nam. 31,32 Revenues generated by user fees can be used to improve and sustain service quality. Both the poor who need subsidies and those who are better off will benefit from higher quality services offered at their local CHS as a result of such initiatives.…”