Using and Joining a Franchised Private Sector Provider Network in Myanmar

BACKGROUND: Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. METHODS AND FINDINGS: Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor

LIBERIA (2011): UNDERSTANDING THE DRIVERS AND BARRIERS FOR HAND WASHIND AND SANITATION PRACTICES AMONG CAREGIVERS OF CHILDREN UNDER FIVE IN THREE COUNTIES OF LIBERIA

Since February 2010 CHF International (CHF) in collaboration with PSI/Liberia has been implementing the five-year Improved Water, Sanitation and Hygiene (IWASH) program funded by the United States Agency for International Development (USAID). The purpose of this study is to collect information to improve the design of existing BCC messages to improve WASH practices in the 3 counties and selected communities in Greater Monrovia. Between October and November of 2011 PSI Liberia will conduct a qualitative gap study to gather information in the above mentioned areas. Rapid qualitative research (PRA) and ethnographic methods will be used to collect data. This method was chosen because: (i) time-lines for the study are compressed and extensive qualitative methods which require long periods of data-processing and analysis are not possible; (ii) rapid participatory methods are particularly relevant within the arena of WASH given that the divergence between knowledge, belief and self-reported practice are often profound. Rapid and ethnographic techniques aim to put the respondent or Key Informant in a position of ease in which data-collection is more natural and hence more likely to generate rich data. PRA and ethnographic techniques also provide opportunities for direct observation.The qualitative gap study will complement and en rich insights emerging from the TRaC study and a customer market survey conducted by CHF. The qualitative study will respond to and be informed by insights emerging from CHF's rapid assessment of the ongoing program. The qualitative method will utilize an assortment of exercises, tools and techniques. Not all exercises/tools will be used with all respondents and in all communities

QuIP report on effect of the Aga Khan University BSc Midwifery degree on the lives of graduate midwives in Uganda

Bath Social & Development Research Unit (BSDR) was commissioned to undertake an independent evaluation of the BScM degree programme at the Aga Khan University School of Nursing and Midwifery (AKU-SONAM) in Uganda. The evaluation focused on the impact of the programme on the quality of life (QoL) of the first unit of students to graduate in 2017. The aim of the study was to help AKU-SONAM understand more about drivers of change, both positive and negative, for use in the development of midwifery programmes in the future

Thailand (2014): Rapid Assessment Findings. MSM in Bangkok: Drug Use and Sexual Risk Practices

This exploratory study aimed to generate a more detailed understanding of the “scene” and context within which recreational drug use and risky sex occur among MSM in Bangkok, considering their behaviors and preferences, as well as socio-economic status and decision-making thought processes. The study analyzed the motivating factors that influence the uptake of desired health behaviors, such as HIV testing and counseling (HTC) and correct and consistent condom and lubricant usage. Findings from the study will inform the design and implementation of social marketing and behavior change communication (BCC) activities for MSM who combine recreational drug activity with risky sex in Bangkok

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar

Abstract Introduction This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar’s social franchise operations from 2007 to 2009. Methods The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. Results In 2009 PSI Myanmar’s social franchise devoted $2.02 million towards a 94$2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. Conclusion In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every$1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO’s, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers’ cost structures as well as strategic objectives in maintaining the network and its portfolio of services

Recently graduated midwives in Uganda: Self-perceived achievement, wellbeing and work prospects

Objective: To investigate how recent graduates from a combined work/study midwifery degree programme in Uganda viewed its effects on their wellbeing and work prospects. Design: Using an adapted version of the Qualitative Impact Protocol (QuIP), a phenomenological approach was applied to thematic analysis to examine semi-structured interviews and WhatsApp group discussion. Setting: Introduction of enhanced midwifery training (from Diploma to Degree level) combining study with professional practice within a low income country health system facing extreme capacity constraints. Participants: 14 members of the first cohort of graduates from the degree programme. Findings: The graduates were overwhelmingly positive about improved professional knowledge, clinical skills, confidence, career commitment and prospects. They also had to contend with resentment from colleagues, increased workload and debt. Counselling training, peer support, and experience of managing stress during the training helped them to cope with these challenges. Conclusions: Qualitative feedback from those receiving advanced midwifery training highlights the importance of addressing social as well as technical skills, including leadership capacity and resilience in handling working relationships