Social Franchise Model Research Articles

Dialogue in the Dark Malaysia: reimagining an inclusive society through social innovation

Research methodology This case was developed via primary data collected from personal (one to one) interview with the CEO and founder of Dialogue in the Dark Malaysia (Dialogue Malaysia), Stevens Chan. With Stevens’ contact, the authors also conducted personal interviews with Kaye Chan (co-founder and wife of Stevens Chan), Lynn Foo (project manager since inception until early 2022) and Dr Foo Yin Fah (academic researcher in social entrepreneurship and advisor for Dialogue Malaysia). Secondary data included reports on visually impaired context in Malaysia, Dialogue Malaysia’s annual reports and online articles. Prior to the primary data collection, the authors obtained ethics approval from the University Human Ethics Committee (Project ID: 35461). Case overview/synopsis This case narrative focuses on Stevens Chan, a blind social entrepreneur who champions the empowerment of the disabled and marginalised community. Through a social franchising model, Stevens founded Dialogue in the Dark Malaysia in 2012. As a social start-up, Stevens showcases the strengths of blind and visually impaired individuals through transformative experiential encounters and reimagining future possibilities. Although there are constant challenges in securing financial and human capital, Stevens never lacks psychological capital, characterised by hope, self-efficacy, optimism and resilience. His vision is to educate society on the power of empathy (and not sympathy) and to create a holistic experience of celebrating diversity and inclusion through an innovative discovery centre, where the elderly and the disabled community (including the deaf, mute and those with mobility issues) share their lives with the public through fun activities. However, the future of this social enterprise is uncertain, and this case invites participants to embark on this journey with Stevens to uncover future pathways for growth and social impact. Complexity academic level The case is tailored for higher level undergraduates and entry-level and mid-level managers of executive education programs.

Promoting mental well-being in Western Australia: Act Belong Commit® mental health promotion campaign partners' perspectives.

The Act Belong Commit® mental health promotion campaign aims to improve population mental well-being. Based on a social-franchising model, partnerships are sought with organizations offering 'mentally healthy activities' that foster social connectedness and mental well-being. There are four categories of partner organizations sought: Site (government agencies and health services), Associate (organizations with state-wide or national services), Community (local, grass-roots community groups) and Schools. This research explored organizational perceptions of the Act Belong Commit® Partnership Program. A purposive sample of 14 organizational representatives across all four partner categories participated in semi-structured interviews online or face-to-face between July and September 2021. Reflexive thematic analysis was used to identify three main themes: (a) A passion for promoting mental health; (b) Implementation, innovation, adaption and creation (e.g. the ability to adapt, create and deliver activities aligned with the campaign message; and (c) Future sustainability (e.g. recommendations for the sustainability of the programme). The use of reflexive thematic analysis enabled deeper insights into the complexity of the partnerships. Findings describe how the Act Belong Commit® Partnership Program supports mutually desirable objectives and extends the campaign reach. Embedded in a shared belief system that incorporates a passion for good mental health, the model supports the flexibility to adapt, create and deliver fit-for-purpose activities that promote mental well-being in the places where people live, work and play.

Analysing the Factors Influencing the Internationalisation of Social Entrepreneurship: A Study of Internationalised Social Businesses from Bangladesh

Social businesses (SB) have significant relevance as they create social impact through revenue-generating business models. The current study is intended to contribute to social entrepreneurship literature by identifying the factors that can influence social business in the internationalisation process from a developing country context, Bangladesh. The research utilised the qualitative approach to extract the required information from the selected ten (10) business cases. MAXQDA software was used to generate the required codes and categories. From the findings, three broad categories of factors have been identified that influence internationalisation: firm-centric, entrepreneur-specific, and context-specific factors related to home and host country environments. The study determined that the firm’s capabilities, such as designing technological apps and platforms to provide essential health, education, and medical services, contribute to internationalisation. In addition, the research identified the adaptation of the business model as one of the determinants of SB internationalisation. Some adaptation practices include maintaining hybrid logic, adopting social franchising model, value delivery, and value capture processes through partnership with for-profit organisations in host countries. The findings of this study are expected to be useful for academicians and also for the social entrepreneurs willing to take their enterprises to the international market level.

Lessons for the Design of Comprehensive Primary Healthcare in India: A Qualitative Study

Health systems with strong comprehensive primary health care (CPHC) are known to result in better health outcomes for people. In India, there is a recent push to strengthen CPHC through Ayushman Bharat. This study aimed to document lessons from successful CPHC initiatives in rural and urban India using a qualitative case study approach. A total of 72 CPHC initiatives were identified through desk review and 12 of these were studied as cases. The following two main models of CPHC delivery were seen in India: (a) a hospital or health centre with outreach and (b) social franchising model, prevalent in rural and urban contexts, respectively. Themes identified were related to organisation of services, workforce, financing and challenges in practice. Services being comprehensive, dialoguing with the community, addressing social determinants were themes under organisation of services. There is need for more generalists and training health professionals towards CPHC. Financing of CPHC especially in the rural context remains a major challenge and cannot be sustained with user fees. Leadership, values, team-based care and organisational culture play a vital role in the delivery of good quality CPHC. These findings contribute to the literature on what works and why, which could be used to design CPHC in India.

Commentary for Unjani clinics: meeting the need for scale through social franchising

This commentary reflects on the social franchising model of Unjani. It discusses the intricate interwoven elements of the model which allows it to flourish. Here, I take a stewardship and social capital view to elaborate on these mechanisms. In the second part of the commentary, I highlight the limitations of the model specifically as it pertains to its potential growth.

Scaling social franchises: lessons learned from Farm Shop

BackgroundThe challenge of enhancing food security and livelihoods for smallholder farmers has been a significant concern in the agricultural development field. To increase farm productivity and enable smallholder farmers to rise out of poverty, several organizations have initiated social franchising business models to create sustainable social enterprises. Social franchising has recently gathered increased interest in lower-income countries for its potential to address social and ecological issues, support local entrepreneurs, and reach financial sustainability to allow for scaling through market forces. Social franchising combines the principles of business franchising (standardized systems and other supports that reduce risk for the entrepreneur) with a social mission. To gain deeper insights into the opportunities and challenges for scaling social franchises, we gathered quantitative and qualitative longitudinal data on Farm Shop, a social franchise with a network of 74 agricultural input shops seeking to reduce food security through improving productivity, incomes and food security of smallholder Kenyan farmers.ResultsWe derived five critical lessons from our findings. First, social franchising can create jobs and profitability for farmers and strengthens the rural entrepreneurial ecosystem. Second, economics of scale is critical for profitability and sustainability of the social franchisor. Third, building trust with farmers is crucial for a successful social franchising model. Fourth, social franchisors should be aware of the variety of options to ensure the sustainability of the social franchising program. Fifth, to develop a scalable business model, cost-effectively gathering the right data to validate key assumptions is essential.ConclusionsFarm Shop is one of a cohort of pioneering social franchises that have applied the principles of franchising to address particular social needs. In this case, the needs were food security, livelihoods, and prosperity for smallholder farmers. Farm Shop uncovered important lessons relevant for all social franchises at similar stages in the business model development process. With these lessons in mind, Farm Shop and other social franchises can be better equipped to live up to social franchising’s promise of achieving social objectives in a more resource-efficient and sustainable way.

Scaling considerations for the social franchising model

Scaling considerations for the social franchising model

Enhancing Foster Care Home NGO Sustainability via Social Franchising

Research Question: This paper investigates how the social franchising approach may enhance the sustainability and capability of Foster Home NGOs in the Global South. Motivation: While many programmes exist to address issues such as poverty and lack of education for children in nations of the Global South, many operate in isolation, and are grassroots and/or stand-alone operations. Little research has been undertaken to understand how various approaches to organizational sustainability may be enacted for non-governmental organizations (NGOs) seeking to provide care for children in foster care homes. Our goal was to apply franchising and social franchising concepts as a framework for NGOs and non-profit organizations to use as a way of enhancing both the capability of achieving their mission as well as a method of organizational sustainability. Idea: Much of the literature on social franchising has been in the area of providing health care and services – however, this model may be useful to enhance the sustainability for NGOs and non-profit organizations that provide other critical services as well, such as foster care homes in the Global South. Findings: The social franchising model offers a concrete and actionable business model to foster home organizations with multiple homes to standardize care delivery as well as develop a strong core organization. Contribution: This paper explores how applying the social franchising model could enhance sustainability of NGOs with foster care home programmes, as well as some of the opportunities and challenges in applying this model to such NGOs and non-profit organizations.

Process evaluation of a social franchising model to improve maternal health: evidence from a multi-methods study in Uttar Pradesh, India

BackgroundA prominent strategy to engage private sector health providers in low- and middle-income countries is clinical social franchising, an organisational model that applies the principles of commercial franchising for socially beneficial goals. The Matrika programme, a multi-faceted social franchise model to improve maternal health, was implemented in three districts of Uttar Pradesh, India, between 2013 and 2016. Previous research indicates that the intervention was not effective in improving the quality and coverage of maternal health services at the population level. This paper reports findings from an independent external process evaluation, conducted alongside the impact evaluation, with the aim of explaining the impact findings. It focuses on the main component of the programme, the “Sky” social franchise.MethodsWe first developed a theory of change, mapping the key mechanisms through which the programme was hypothesised to have impact. We then undertook a multi-methods study, drawing on both quantitative and qualitative primary data from a wide range of sources to assess the extent of implementation and to understand mechanisms of impact and the role of contextual factors. We analysed the quantitative data descriptively to generate indicators of implementation. We undertook a thematic analysis of the qualitative data before holding reflective meetings to triangulate across data sources, synthesise evidence, and identify the main findings. Finally, we used the framework provided by the theory of change to organise and interpret our findings.ResultsWe report six key findings. First, despite the franchisor achieving its recruitment targets, the competitive nature of the market for antenatal care meant social franchise providers achieved very low market share. Second, all Sky health providers were branded but community awareness of the franchise remained low. Third, using lower-level providers and community health volunteers to encourage women to attend franchised antenatal care services was ineffective. Fourth, referral linkages were not sufficiently strong between antenatal care providers in the franchise network and delivery care providers. Fifth, Sky health providers had better knowledge and self-reported practice than comparable health providers, but overall, the evidence pointed to poor quality of care across the board. Finally, telemedicine was perceived by clients as an attractive feature, but problems in the implementation of the technology meant its effect on quality of antenatal care was likely limited.ConclusionsThese findings point towards the importance of designing programmes based on a strong theory of change, understanding market conditions and what patients value, and rigorously testing new technologies. The design of future social franchising programmes should take account of the challenges documented in this and other evaluations.

Social Franchising Model as a Scaling Strategy for ICT Reuse: A Case Study of an International Franchise

Reuse is a type of concept meant to solve environmental problems and can be implemented in different models. This study explores the social franchising model in the area of ICT reuse, relying on a case study of international social franchise and a comparative analysis of its three franchisees. The concept of the proposed social franchising model is based on a theoretical framework and a case study organization analysis, and has four developmental phases with nine identified key factors, which are essential to creating the necessary systematic approach for a successful outcome by creating both economic and social impact on a scale. This article contributes to the social entrepreneurship literature by analyzing success factors that have allowed our case study to operate as a highly successful franchise. The empirical part of the paper employs a case study of the organization to provide evidence of the existing model for social franchising in the reuse of ICT in Ireland, the U.S. and Slovenia. The paper concludes by revealing the social franchising model framework in the reuse of ICT.

Models of Franchising for Social Enterprise

Social franchising has been utilized by social enterprises in a variety of ways, yet franchising as a marketing channel structure in the social enterprise context is a relatively new area of research. There is a need for better understanding of the various forms of the phenomenon and clarification of its fundamental meaning. This article examines franchising in the nonprofit sector by modeling social franchising according to the first of the four indicators derived from the social enterprise literature—social purpose over profit. The article suggests that there are distinct models of social franchising applied in marketing channels and supply chains that can be identified according to the for-profit or nonprofit status of the contracting parties. Finally, the article presents a pilot Australian case study conducted through a qualitative in-depth interview that considers the effectiveness of applying a social franchising model in the context of one form of social franchising known as microfranchising. This study provides foundational findings for future research in the nascent area of social franchising.

Model for Service Delivery for Developmental Disorders in Low-Income Countries.

As in many low-income countries, the treatment gap for developmental disorders in rural Pakistan is near 100%. We integrated social, technological, and business innovations to develop and pilot a potentially sustainable service for children with developmental disorders in 1 rural area. Families with developmental disorders were identified through a mobile phone-based interactive voice response system, and organized into "Family Networks." "Champion" family volunteers were trained in evidence-based interventions. An Avatar-assisted Cascade Training and information system was developed to assist with training, implementation, monitoring, and supervision. In a population of ∼30,000, we successfully established 1 self-sustaining Family Network consisting of 10 trained champion family volunteers working under supervision of specialists, providing intervention to 70 families of children with developmental disorders. Each champion was responsible for training and providing ongoing support to 5 to 7 families from his or her village, and the families supported each other in management of their children. A pre-post evaluation of the program indicated that there was significant improvement in disability and socioemotional difficulties in the child, reduction in stigmatizing experiences, and greater family empowerment to seek services and community resources for the child. There was no change in caregivers' well-being. To replicate this service more widely, a social franchise model has been developed whereby the integrated intervention will be "boxed" up and passed on to others to replicate with appropriate support. Such integrated social, technological, and business innovations have the potential to be applied to other areas of health in low-income countries.

Social franchising primary healthcare clinics--a model for South African National Health Insurance?

This article describes the first government social franchise initiative in the world to deliver a 'brand' of quality primary healthcare (PHC) clinic services. Quality and standards of care are not uniformly and reliably delivered across government PHC clinics in North West Province, South Africa, despite government support, numerous policies, guidelines and in-service training sessions provided to staff. Currently the strongest predictor of good-quality service is the skill and dedication of the facility manager. A project utilising the social franchising business model, harvesting best practices, has been implemented with the aim of developing a system to ensure reliably excellent healthcare service provision in every facility in North West. The services of social franchising consultants have been procured to develop the business model to drive this initiative. Best practices have been benchmarked, and policies, guidelines and clinic support systems have been reviewed, evaluated and assessed, and incorporated into the business plan. A pilot clinic has been selected to refine and develop a working social franchise model. This will then be replicated in one clinic to confirm proof of concept before further scale-up. The social franchise business model can provide solutions to a reliable and recognisable 'brand' of quality universal coverage of healthcare services.

Protocol for the evaluation of a social franchising model to improve maternal health in Uttar Pradesh, India

BackgroundSocial 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/designDifference-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.DiscussionThere 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 materialThe online version of this article (doi:10.1186/s13012-015-0269-2) contains supplementary material, which is available to authorized users.

Incorporating Social Franchising (SF) Principles in Government Health Services Improves Breastfeeding (BF) Practices in Vietnam

Alive &Thrive (A&T) applied principles of SF to improve quality of infant & young child feeding (IYCF) counseling in >800 government health centers in Vietnam. We assessed the impact of the SF model on IYCF practices for children < 24 mo and attained linear growth for children 24‐59 mo using a cluster‐randomized evaluation design. Forty communes were randomly assigned to either 1) A&T‐intensive (A&T‐I) (standard government health services (SGHS), mass media (MM), and SF IYCF counseling), or 2) A&T‐mass media only (A&T‐MM) (SGHS and MM). Cross‐sectional surveys [N~2000 children/group] at baseline (2010) and endline (2014) were used to derive cluster‐adjusted double‐difference estimates (DDE) (differences in changes over time between groups). Large, significant impacts were seen on exclusive BF (18.9→ 57.8 in A&T‐I, p<0.001 for DDE); and not using prelacteals (50.3→ 52.2 in A&T‐I vs. 44.8→ 29.0 in A&T‐MM, p<0.001 for DDE). Compared to 2010, early initiation of BF was stable over time in A&T‐I (58.8→ 54.4), but decreased in A&T‐MM areas (58.1→ 43.4; p<0.05 for DDE), suggesting that A&T‐I services were protective. Minimum diet diversity was high (>70%) at baseline and increased to >90% in 2014 in A&T‐I and A&T‐MM (DDE n.s.). Child stunting in 24‐59 mo, already low at baseline, reduced from ~23% to ~17% between 2010 and 2014 in both groups (DDE n.s.). A SF approach to strengthening and scaling up IYCF counseling improved BF, particularly EBF, and is an effective model for integration into the health system in Vietnam and similar contexts.Funding: Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI360.

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

By mapping the mechanisms through which interventions are expected to achieve impact, program impact pathway (PIP) analysis lays out the theoretical causal links between program activities, outcomes, and impacts. This study examines the pathways through which the Alive & Thrive (A&T) social franchise model is intended to improve infant and young child feeding (IYCF) practices in Vietnam. Mixed methods were used, including qualitative interviews with franchise management board members (n = 12), surveys with health providers (n = 120), counseling observations (n = 160), and household surveys (n = 2045). Six PIP components were assessed: 1) franchise management, 2) training and IYCF knowledge of health providers, 3) service delivery, 4) program exposure and utilization, 5) maternal behavioral determinants (knowledge, beliefs, and intentions) toward optimal IYCF practices, and 6) IYCF practices. Data were collected from A&T-intensive areas (A&T-I; mass media + social franchise) and A&T-nonintensive areas (A&T-NI; mass media only) by using a cluster-randomized controlled trial design. Data from 2013 were compared with baseline where similar measures were available. Results indicate that mechanisms are in place for effective management of the franchise system, despite challenges to routine monitoring. A&T training was associated with increased capacity of providers, resulting in higher-quality IYCF counseling (greater technical knowledge and communication skills during counseling) in A&T-I areas. Franchise utilization increased from 10% in 2012 to 45% in 2013 but fell below the expected frequency of 9–15 contacts per mother-child dyad. Improvements in breastfeeding knowledge, beliefs, intentions, and practices were greater among mothers in A&T-I areas than among those in A&T-NI areas. In conclusion, there are many positive changes along the impact pathway of the franchise services, but challenges in utilization and demand creation should be addressed to achieve the full intended impact.

Understanding the implementation, utilization, and potential impact of a social franchise model to improve infant and young child feeding practices in Vietnam: a program impact pathway analysis (624.10)

Program impact pathway (PIP) analysis helps to lay out and study the causal links between program activities, outcomes and impacts. This PIP analysis‐based study examines the pathways by which the Alive & Thrive (A&T) social franchise model is expected to improve infant and young child feeding (IYCF) practices in Vietnam. Mixed methods (surveys, observations, facility assessments) were used to assess the following elements of the PIP: 1) training and knowledge of frontline health workers (FHWs) (n =447); 2) quality of service delivery and communication with clients (n =166); 3) mothers’ service utilization (n = 2,045); and 4) the program’s role in shaping maternal behavioral determinants of IYCF practices. A&T training was associated with improved FHWs’ IYCF knowledge and counseling skills, resulting in higher quality IYCF counseling. Franchise utilization increased from 10% in 2012 to 45% in 2013, but utilization fell far below the expected 9‐15 contacts specified in A&T guidelines. Improvements in breastfeeding knowledge, intentions, and beliefs were greater among mothers in intervention areas with social franchise and mass media, compared to media alone. In conclusion, many aspects of the franchise services are encouraging, but challenges in service delivery and utilization along the PIP should be addressed to achieve the full intended impact.Grant Funding Source: Funded by Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI360

Tuberculosis control needs a complete and patient-centric solution.

Tuberculosis control needs a complete and patient-centric solution.

Modelling a technology push by using hybrid franchising

Introducing a technology push to stimulate entrepreneurship in remote areas in developing countries can be examined in the context of a franchising model (social or commercial franchising). The results of this study (fieldwork in Kalimantan, Indonesia) point to a high feasibility of introducing a technology push by a franchising model. The results indicate that the smallholder rubber farmers (community level) and the head of villages, head of district and the government departments (low, middle and high institutional level) support a technology push and are willing to participate. Furthermore almost all stakeholders prefer a franchising model to introduce a technology push with social franchising elements. Additionally, empirical evidence confirmed the main theoretical argument of this research: a technology push carried out by a franchising model can stimulate (social) entrepreneurship in remote villages. This study thus concluded that in order to stimulate (social) entrepreneurship in local communities and with that local economic development, a hybrid franchising (a combination of both commercial and social franchising) model should be used to carry a technology push.

Pretreatment HIV-1 drug resistance testing in sub-Saharan Africa

www.thelancet.com/infection Vol 12 December 2012 911 of patients with tuberculosis in the Indian private sector get tested with antibody-based, serological tests that are now banned by the Government of India. Even after the ban, several private laboratories are continuing to off er tuberculosis serology, whereas others have switched to equally bad or worse alternatives such as in-house blood PCR and QuantiFERON-TB Gold for active tuberculosis. So, if patients are paying out-of-pocket for such inappropriate tests, can they instead get a quality-assured, WHO-endorsed test result for the same money? We are pleased that the UNITAID initiative has reduced the cost of Xpert MTB/RIF technology (Cepheid, Sunnyvale, CA, USA) to US$9·98 per cartridge, and that TB REACH will provide implementation grants. But it is a matter of concern that the buydown price of $9·98 is not available to private sector providers in countries such as Pakistan and India where aff ordable, quality tests are needed. For example, the present market price of Xpert MTB/RIF in the Indian private sector is about $50–75, substantially higher than the $10–20 price of tuberculosis serology that needs to be replaced. Generally, public–private mix projects including fi nancial incentives and salaries for a larger number of contractual outreach workers might pose challenges for sustainability. For example, despite its success and substantial contribution to increasing case detection, the performance of the Good Life social franchise model in Pakistan decreased unexpectedly at the completion of support from the Global Fund. The main challenge was the sustainability of outreach staff . Therefore, we are eager to see if the social enterprise model proposed by Creswell and colleagues will overcome such challenges. We hope it will.