Protocol for the evaluation of a social franchising model to improve maternal health in Uttar Pradesh, India
Authors
Shreya Pereira
Department of Global Health and Development, London School Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
Paresh Kumar
Sambodhi Research and Communications Limited, C-126, Sector-2, Noida, Uttar Pradesh India
Varun Dutt
Sambodhi Research and Communications Limited, C-126, Sector-2, Noida, Uttar Pradesh India
Kaveri Haldar
Sambodhi Research and Communications Limited, C-126, Sector-2, Noida, Uttar Pradesh India
Loveday Penn-Kekana
Department of Infectious Disease Epidemiology, London School Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
Andreia Santos
Department of Global Health and Development, London School Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
Timothy Powell-Jackson
Department of Global Health and Development, London School Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
Keywords:
Social franchising, Impact evaluation, India, Study protocol
Abstract
Social franchising is the fastest growing market-based approach to organising and improving the quality of care in the private sector of low- and middle-income countries, but there is limited evidence on its impact and cost-effectiveness. The “Sky” social franchise model was introduced in the Indian state of Uttar Pradesh in late 2013.
Methods/design
Difference-in-difference methods will be used to estimate the impact of the social franchise programme on the quality and coverage of health services along the continuum of care for reproductive, maternal and newborn health. Comparison clusters will be selected to be as similar as possible to intervention clusters using nearest neighbour matching methods. Two rounds of data will be collected from a household survey of 3600 women with a birth in the last 2 years and a survey of 450 health providers in the same localities. To capture the full range of effects, 59 study outcomes have been specified and then grouped into conceptually similar domains. Methods to account for multiple inferences will be used based on the pre-specified grouping of outcomes. A process evaluation will seek to understand the scale of the social franchise network, the extent to which various components of the programme are implemented and how impacts are achieved. An economic evaluation will measure the costs of setting up, maintaining and running the social franchise as well as the cost-effectiveness and financial sustainability of the programme.
Discussion
There is a dearth of evidence demonstrating whether market-based approaches such as social franchising can improve care in the private sector. This evaluation will provide rigorous evidence on whether an innovative model of social franchising can contribute to better population health in a low-income setting.
Electronic supplementary material
The online version of this article (doi:10.1186/s13012-015-0269-2) contains supplementary material, which is available to authorized users.
Keywords: Social franchising, Impact evaluation, India, Study protocol
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