TY - JOUR
T1 - The cost of service quality improvements
T2 - Tracking the flow of funds in social franchise networks in Myanmar
AU - Bishai, David
AU - LeFevre, Amnesty
AU - Theuss, Marc
AU - Boxshall, Matt
AU - Hetherington, John D.
AU - Zaw, Min
AU - Montagu, Dominic
N1 - Funding Information:
In 2009, PSI’s franchising department supported a team of over 1,700 private providers currently enrolled in PSI’s Network. There were 1006 and 741 in the Sun Quality and Sun Primary Health Networks, respectively in 2009. Social franchising activities were supported in part by four other departments within PSI’s organizational structure. (1) Social Marketing (423 staff); (2) Strategic Information (36 staff); (3) Finance (136 staff); and (4) Program Support (125 staff). These departments were supported by international technical advisors, senior advisors, an executive office team, the finance monitoring unit, and a special advocacy team, all of which fall under the leadership of PSI-Myanmar’s country director. Most critically, the social marketing department works to provide support to product branding as well communications, whilst strategic information facilitates the collection of routine data on products sales, distribution, and incentives.
PY - 2013/7/4
Y1 - 2013/7/4
N2 - 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% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $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.
AB - 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% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $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.
KW - Burma
KW - Costing
KW - Myanmar
KW - Social franchise
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U2 - 10.1186/1478-7547-11-14
DO - 10.1186/1478-7547-11-14
M3 - Article
C2 - 23826743
AN - SCOPUS:84879802463
SN - 1478-7547
VL - 11
JO - Cost Effectiveness and Resource Allocation
JF - Cost Effectiveness and Resource Allocation
IS - 1
M1 - 14
ER -