SOCIAL FRANCHISING IN CONTEXT OF MARKETING LONG-TERM AND REVERSIBLE CONTRACEPTIVES (LARCS) IN UGANDA: ANALYSIS OF PACE SOCIAL FRANCHISE MODEL

Abstract

Background: Uganda is TFR is among the world’s highest at six children per woman, and contributes to the rising rate of poverty and maternal and infant mortality across the country. A social franchise model was adopted in Uganda to market and scale up contraceptive prevalence through the private sector. In 2008 PACE launched the Women’s Health Project, a core component of their reproductive health strategy to increase access to and demand for affordable, quality long‐term Family Planning (FP) services, through the setup of a network of private healthcare providers, branded as “ProFam” social franchise health facilities. The program expanded and included services aimed to offer and improve reproductive health services, limiting births through increased use of IUDs and implants as well change negative perceptions to FP. Until 2014, this network consisted of 189 private facilities spread out in 56 districts, following a business model of social franchising. Methods: The multifaceted effect of the social franchise intervention under PACE was then measured through a longitudinal cross sectional survey on perceptions towards Long-Term and Reversible Contraceptives (LARCs) use among the target population through a cross-sectional studies over two periods. The studies covered 53 districts hosting 194 privately owned health facilities branded Profam. Multi-stage cluster sampling approaches was used to draw a representative sample of women of reproductive age group. However, for Kampala (capital city), given its population size, the catchment area was restricted to a parish/Ward. Findings: There is an evident rise in current use of FP methods among WRA. Availability of LARCs particularly IUCDs significantly increased over the two time periods. Use of FP services among WRA is a socially sanctioned behavior/practice. There was reported increase in social support for FP services. There were high levels of correct knowledge about FP services and methods, particularly LARCs and outcome expectations from FP increased Conclusion: There is an opportunity for increasing uptake of LARCs especially IUDS and Implants through the private sector via a social franchising model. Further, positive changes have been registered in the campaign to mutate negative perceptions against LARCs suggesting positive effect of increasing service accessibility within the community of the target group in easily accessible outlets within the network