Abstract
Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family planning services, even in settings with low contraceptive prevalence.
Highlights
Global Health: Science and Practice 2017 | Volume 5 | Number 2Survey (DHS) in 2012/13, below the West and Central Africa average of 17%.1,2 Use of contraceptives in Mali is much higher in urban than rural areas, with 23% of married women in the capital region of Bamako using a modern method compared with 3%–11% in other areas
The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family planning services, even in settings with low contraceptive prevalence
Clinical quality audits are based on family planning observations using a standardized Marie Stopes International (MSI) global tool commodities and are conducted annually; internal audits are through the public conducted by Marie Stopes International Mali (MSIM) staff on all franchisees that health system at a have trained providers in place and have been subsidized cost operational for at least 6 months, while external and provides clinical audits are conducted by international MSI them for free to staff on a smaller random sample of franchises. franchisees
Summary
Global Health: Science and Practice 2017 | Volume 5 | Number 2Survey (DHS) in 2012/13, below the West and Central Africa average of 17%.1,2 Use of contraceptives in Mali is much higher in urban than rural areas, with 23% of married women in the capital region of Bamako using a modern method compared with 3%–11% in other areas. Use of contraceptives in Mali is much higher in urban than rural areas, with 23% of married women in the capital region of Bamako using a modern method compared with 3%–11% in other areas. Along with low CPR, the contraceptive method mix in Mali remains heavily skewed toward short-acting. Mali Public-Sector Social Franchising to Increase Family Planning Access www.ghspjournal.org. Mali has one of the world’s lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices
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