Improving reproductive health service in primary healthcare settings through "Tinh chi em" ( Sister hood ) social franchise model, experiences from Vietnam

Background: The Vietnamese Government sets clear goals to increase universal access to sexual reproductive healthcare (SRH), particularly at the primary health level-commune health stations (CHSs). However, CHSs are under-utilized due to perceived poor service quality. To strengthen CHSs’ ability to deliver SRH services, Marie Stopes International Viet Nam and local partners implemented a partial social franchise model called “tinh chi em” (Sisterhood).

Objective: Social franchising is aimed at increasing service utilization, especially SRH services; enhancing clinical quality and improving users’ perceptions of services.

Results: “Tinh chi em” successfully franchised 220 CHSs in five provinces between 2007 and 2011. In the first year, service utilization at franchised CHSs increased by four-fold, and SRH consultations increased by five-fold. There was a positive correlation between franchised CHS membership with the improvement in community’s perception of service quality . Client satisfaction level increased significantly at franchised CHSs at first and second follow-up survey .

Conclusion: A partial franchise enables the utilization of existing public health system to increase SRH service delivery at the local level which can potentially reduce the burden on provincial/ central hospitals.