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Transforming Social Marketing and
Franchising for FP in India
Friday | May 31, 2019 | New Delhi
Context Setting
Ministry of
Health &
Family
Welfare
Global Health
Conference at
Kochi
Conference
Steering
Committee
Social marketing and social franchising to strengthen the RMNCH+A
• Ministry of Health & Family Welfare was exploring social marketing and social
franchising as strategies to strengthen the RMNCH+A (reproductive, maternal,
new born, child and adolescent health) program in India.
The Conference's Steering Committee initiated a project to achieve four objectives
• Synthesize learnings and best practices from SM/SF models in India and globally
• Create an approach to deliver a prioritized basket of goods through SM
• Create an approach to deliver RMNCH+A services through SF
• Draft a costed framework for operationalizing the strategy over a three-year timeframe
Global Health Conference on Social Marketing and Franchising
• Hindustan Latex Family Planning Promotion Trust (HLFPPT) conducted the Global
Health Conference on Social Marketing and Franchising at Kochi in December 2013
with support from MoHFW, HLL Lifecare and Indian Institute of Corporate Affairs
(IICA)
McKinsey’s Recommendations for SM
Expand the product basket
Go beyond condoms and OCPs,
include more profitable products
Set our own prices
Subject to certain conditions, 30-
35% below market rates
Shift the contract duration
Advocate for 8-10 year contract for
greater stability and efficiency
Explore bridge funding
INR. 450-500 crores over 10 years, as
soft loans to become viable.
Create last-mile connectors
A cadre of last-mile community health
entrepreneurs (or use ASHAs)
Performance metrics
Create explicit performance
metrics to ensure availability of
products in rural geographies
Focus on BCC and DG
Undertake category promotion
Smaller SKUs & PP
2 pcs pack size for condoms
SOCIAL MARKETING IN CURRENT CONTEXT
Changes in the Social Marketing Ecosystem
Condoms price revision
SM brands corrected in 2016-17
(from INR. 2per1 pc to INR
3.33/ 1pc MRP )
OCP MRP unchanged
INR. 10 per cycle in 2013 to
2016-2019 still INR. 10 per
cycle )
Subsidies Withdrawn
Government withdrawn
marketing and packaging
subsidies
Erratic supplies
Some SMOs pull out of SM
program and go direct to
market
External funding dries up
SMOs reduce their spending
on ATL/BTL and activation
NACO withdrawn Support
Condom social marketing
program ends
New products for SM
Government added new
products to free supply
(Chhaya & Antara)
Social marketing can promote the use of essential commodities
Condoms
Emergency
contraceptive
pills
Pregnancy
test kits
Sanitary
napkins
Iron & Folic Acid
(IFA) tablets
Zinc Sulphate
dispersible tablets
Oral Rehydration
Salt (ORS)
Oral
contraceptive
pills
8Direct-to-consumer
products that SM can
address
WAY FORWARD FOR SOCIAL MARKETING
Some Challenges Still Remain
Sustaining the supply chain after phasing out of NACO CSM
Lack of funds for ATL/BTL & visibility through POP material and
packaging
Wholesale route is becoming unviable due to poor visibility and
focus on retail route
Funds requirement for launch new products
• Additional funds for channel partners
• Counsellor for injectables
• ATL/ BTL promotion
No support for category promotion
Actions Needed for Overcoming the Challenges
Viability gap funding – grants/ soft loans
Expansion of SM basket – injectables, EC and weekly pills
Category promotion to support SM Division
Special vehicles for rural markets
Longer duration SM contracts
SOCIAL FRANCHISING IN CURRENT CONTEXT
Desired Objectives of Social Franchising
Penetration
Scaled up network across all
districts along with
coverage of RMNCH+A
services
Adoption
Increased awareness and
adoption of added services
through influencing of mind-
sets and behaviours
Quality
Improved quality of
services by enforcing
standards of care
Social Franchising for Delivering RMNCH+A Services in Rural Areas
Interval IUCDs
Quality
sterilization
services
Full ANC
services
Essential
newborn care
Management of high
risk pregnancies
Diarrhoea
management
Adolescent
reproductive
health
Comprehensive
abortion care services
10Services that SF can
address
Delivery and
access to EmOC
Management of
pneumonia
MGHN: a Social Franchising Model for Scaling Up
Highly Fragmented &
Unregulated Private Sector
Public Health Sector Under-
Resourced with High Burden
45,000 Preventable Maternal
Mortality Cases Annually
1.3 Millions Under Five
Mortality Cases Annually
KAP Related to Service Uptake
Service Cost for Beneficiary
OOPE
Challenges
MGHN Support brings together
Private Sector Facilities to Support
Public Sector Services
Fraction Franchise Model to
Increase Access to Quality Ensured
MCH and NBC services
Community Health Volunteers
Promote Counseling, Referrals and
Service Uptake Trends
Set Prices and Stringent Medical
Protocols for Case Management
and Service Price
Merry Gold Health Network
MGHN Programme Model
Merry Gold
Hospitals
(Urban)
Merry Gold
Hospitals
(Rural)
Merry Tarang
members
Selection criteria for
Franchisees
Returns committed to the
Franchisee
• Increase in patient foot fall
• Training
• Communication & branding
• Outreach activity
• L3 network support
• Accreditation support etc.
• Bed size
• Services
• Manpower
• Equipment availability
• Agrees to abide on quality
parameters and price list
• Others
MGHN: Reach & Impact
64
RAJASTHAN
338
UTTAR PRADESH &
UTTARAKHAND
57
BIHAR
43
ODISHA
502 networked facilities
in 2017-18
Network Size
500+ hospitals
ANC
2,000,000+
Institutional deliveries
300,000+
PNC
1,000,000+
Ujjwal in Bihar and Odisha
• L1 facilities
EmOC, C-sections, normal
deliveries, FP services,
MCH services
• L2 (public and private)
Basic Obs care, normal
deliveries, FP counseling,
insertions and injectables
• Ujjwal Saathis (incl. ASHAs)
carry products to
supplement their income
L1 clinics
78
L2 clinic
214
Ujjwal Saathis
6,000
Two part model works better than a
model with one type of facility
Upfront accounting for sustainability
made franchisor more focused on
collection of fees
ASHAs doubling up as outreach for the
network led to a conflict for referral
THANKS!

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Transforming Social Marketing and Franchising For FP in India

  • 1. Transforming Social Marketing and Franchising for FP in India Friday | May 31, 2019 | New Delhi
  • 2. Context Setting Ministry of Health & Family Welfare Global Health Conference at Kochi Conference Steering Committee Social marketing and social franchising to strengthen the RMNCH+A • Ministry of Health & Family Welfare was exploring social marketing and social franchising as strategies to strengthen the RMNCH+A (reproductive, maternal, new born, child and adolescent health) program in India. The Conference's Steering Committee initiated a project to achieve four objectives • Synthesize learnings and best practices from SM/SF models in India and globally • Create an approach to deliver a prioritized basket of goods through SM • Create an approach to deliver RMNCH+A services through SF • Draft a costed framework for operationalizing the strategy over a three-year timeframe Global Health Conference on Social Marketing and Franchising • Hindustan Latex Family Planning Promotion Trust (HLFPPT) conducted the Global Health Conference on Social Marketing and Franchising at Kochi in December 2013 with support from MoHFW, HLL Lifecare and Indian Institute of Corporate Affairs (IICA)
  • 3. McKinsey’s Recommendations for SM Expand the product basket Go beyond condoms and OCPs, include more profitable products Set our own prices Subject to certain conditions, 30- 35% below market rates Shift the contract duration Advocate for 8-10 year contract for greater stability and efficiency Explore bridge funding INR. 450-500 crores over 10 years, as soft loans to become viable. Create last-mile connectors A cadre of last-mile community health entrepreneurs (or use ASHAs) Performance metrics Create explicit performance metrics to ensure availability of products in rural geographies Focus on BCC and DG Undertake category promotion Smaller SKUs & PP 2 pcs pack size for condoms
  • 4. SOCIAL MARKETING IN CURRENT CONTEXT
  • 5. Changes in the Social Marketing Ecosystem Condoms price revision SM brands corrected in 2016-17 (from INR. 2per1 pc to INR 3.33/ 1pc MRP ) OCP MRP unchanged INR. 10 per cycle in 2013 to 2016-2019 still INR. 10 per cycle ) Subsidies Withdrawn Government withdrawn marketing and packaging subsidies Erratic supplies Some SMOs pull out of SM program and go direct to market External funding dries up SMOs reduce their spending on ATL/BTL and activation NACO withdrawn Support Condom social marketing program ends New products for SM Government added new products to free supply (Chhaya & Antara)
  • 6. Social marketing can promote the use of essential commodities Condoms Emergency contraceptive pills Pregnancy test kits Sanitary napkins Iron & Folic Acid (IFA) tablets Zinc Sulphate dispersible tablets Oral Rehydration Salt (ORS) Oral contraceptive pills 8Direct-to-consumer products that SM can address
  • 7. WAY FORWARD FOR SOCIAL MARKETING
  • 8. Some Challenges Still Remain Sustaining the supply chain after phasing out of NACO CSM Lack of funds for ATL/BTL & visibility through POP material and packaging Wholesale route is becoming unviable due to poor visibility and focus on retail route Funds requirement for launch new products • Additional funds for channel partners • Counsellor for injectables • ATL/ BTL promotion No support for category promotion
  • 9. Actions Needed for Overcoming the Challenges Viability gap funding – grants/ soft loans Expansion of SM basket – injectables, EC and weekly pills Category promotion to support SM Division Special vehicles for rural markets Longer duration SM contracts
  • 10. SOCIAL FRANCHISING IN CURRENT CONTEXT
  • 11. Desired Objectives of Social Franchising Penetration Scaled up network across all districts along with coverage of RMNCH+A services Adoption Increased awareness and adoption of added services through influencing of mind- sets and behaviours Quality Improved quality of services by enforcing standards of care
  • 12. Social Franchising for Delivering RMNCH+A Services in Rural Areas Interval IUCDs Quality sterilization services Full ANC services Essential newborn care Management of high risk pregnancies Diarrhoea management Adolescent reproductive health Comprehensive abortion care services 10Services that SF can address Delivery and access to EmOC Management of pneumonia
  • 13. MGHN: a Social Franchising Model for Scaling Up Highly Fragmented & Unregulated Private Sector Public Health Sector Under- Resourced with High Burden 45,000 Preventable Maternal Mortality Cases Annually 1.3 Millions Under Five Mortality Cases Annually KAP Related to Service Uptake Service Cost for Beneficiary OOPE Challenges MGHN Support brings together Private Sector Facilities to Support Public Sector Services Fraction Franchise Model to Increase Access to Quality Ensured MCH and NBC services Community Health Volunteers Promote Counseling, Referrals and Service Uptake Trends Set Prices and Stringent Medical Protocols for Case Management and Service Price Merry Gold Health Network
  • 14. MGHN Programme Model Merry Gold Hospitals (Urban) Merry Gold Hospitals (Rural) Merry Tarang members Selection criteria for Franchisees Returns committed to the Franchisee • Increase in patient foot fall • Training • Communication & branding • Outreach activity • L3 network support • Accreditation support etc. • Bed size • Services • Manpower • Equipment availability • Agrees to abide on quality parameters and price list • Others
  • 15. MGHN: Reach & Impact 64 RAJASTHAN 338 UTTAR PRADESH & UTTARAKHAND 57 BIHAR 43 ODISHA 502 networked facilities in 2017-18 Network Size 500+ hospitals ANC 2,000,000+ Institutional deliveries 300,000+ PNC 1,000,000+
  • 16. Ujjwal in Bihar and Odisha • L1 facilities EmOC, C-sections, normal deliveries, FP services, MCH services • L2 (public and private) Basic Obs care, normal deliveries, FP counseling, insertions and injectables • Ujjwal Saathis (incl. ASHAs) carry products to supplement their income L1 clinics 78 L2 clinic 214 Ujjwal Saathis 6,000 Two part model works better than a model with one type of facility Upfront accounting for sustainability made franchisor more focused on collection of fees ASHAs doubling up as outreach for the network led to a conflict for referral