It has instituted one of the most unique and largest social franchising health networks in India under the brand name of Merrygold Health Network. https://hlfppt.org/

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Subsidies Withdrawn
Government withdrawn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

17. THANKS!