franchising change concept

Do we need a change?

Social Franchising development profile

2001 2003 2004 2005

Program RH

MalariaSTIs TB VCT

SQHC

Staff

73 331 467 559

9 15 22 29

Social Franchising development profile

2008 2010 2011

Program PneuIUD

PITCART, Ca CxPPH, PAC, MD

SQHC

Staff

879 1169 1300

66 143 143!

Non-SQH

SPH

100 235

137 1100 1500

In 2011, can we do all the activities without increasing head count?

Current HR strength1 Dy Country Director

1 Dy Director 4 Sr managers

7 Managers

11 Sr FO

50 FO 3 Opt officers

Admin staff43 Field leaders

1 Tech advisor

What we have done in 2010?

• Conducted 189 sessions of training related to 5

health areas

• Conducted over 22,000 monitoring and supervisory

visits to reach 1169 SQH clinics and 858 SPH

providers

Informal assessment on (TB+ others )FO’s time allocation (n=7 August, 2010)

• Travel -16%

• Supply & revenue -4%

• Technical support -4%

• Check & work on forms -7%

• Others – 3%

Field (34%)8.4 working days

• Pre-training – 5%

• Training – 14%

Training (19%)

4.7 working days

• Pre-trip – 8%

• Financial transaction – 5%

• Meeting – 1%

• MIS – 10%

• Assignment - 11%

• Others – 11%

Office (43%)

9.9 working day

Informal assessment on IUD SFO/FO’s time allocation (n=12 August, 2010)

• Travel -16%

• Supply & revenue -1%

• Technical support -7%

• Check & work on forms -5%

• Others – 3%

Field (32%)7.9 working days

• Pre-training – 5%

• Training – 18%

Training (23%)

5.7 working days

• Pre-trip – 5%

• Financial transaction – 5%

• Meeting – 6%

• MIS – 7%

• Assignment - 10%

• Others – 11%

Office (44%)

11.2 working day

Total working days: 24.8

Field staff’s time spent on channel and health area during monitoring and supervision

SPH SQH

M & S RH IUD STI Mala Pneu TB Travel Supply Others

SQH-FO - 5% - 5% 5% 5% 30% 20% 20% 10%

IUD-FO - 2.5% 95% 2.5% - - - 50% 3% 10%

SQH/SPH-FO 30% 2% - 2% 2% 2% 12% 30% 10% 10%

Field leader 100% - - - - - - - - -

SPH

RH DTK Mala Pneu TB Others

Field leader 17% 13% 13% 13% 21% 25%

Implementing activities in 2011

• Continuing health program of previous year

• Expanding SQH and SPH channels

• Taking over new non-SQH channel

• Scaling up ART at cost and PITC

• Launching Medical detailing, Cervical cancer prevention and

treatment, PPH and PAC

Franchising Health Services to be implemented by FD in 2011

RH

STM

LTM

Ca Cx

PPH

PAC

MD

SQH Non-SQH SPHCA

100

100 235 200

500- -

-

45 15 - -

- - - 560

1300 - - 1500

120- - 250

≈50% of trained providers

GPINGOs

TOP

Franchising Health Services to be implemented by FD in 2011

HIV/STIs

STIs

(100)

VCT

PITC

(60)

ART

(80)

Malaria

SQH – (100)

SPH – (500)

Pneumonia

SQH – (100)

SPH – (500)

TB

SQH – (100)

SPH – (500)

Anticipated activities in 2011

• 266 training sessions (140% increase)

• 33,600 monitoring and supervision visits to 1300

SQH, 235 non-SQH, and 1500 SPH providers (153%

increase)

• 1,440 medical detailing visits to 120 non-SQH IUD

providers

Question 1: In 2011, is Franchising fit for us in accordance with the departmental change?

Question 2: In 2011, can we do all the activities without increasing head count?

If it is not possible to increase in head count especially FO, how do we solve it out?

• Allocation of more time to monitoring and supervision

• 80% of working days in fieldField (↑)

• Move training assignment to other senior staff

Training (shift assignment)

• Reduction of office work

• Limitation to meeting/financial transaction and pre & post trip preparation

Office (↓)

( )

Paradigm shift of FO’s monitoring & supervision

Other issues following the paradigm shift

• To improve field staff’s quality at monitoring and

supervision aspect

• To coordinate effectively among units of a new set-up

• To effectively operate implementing activities

• To continue entrepreneurship of the department

Issues still need to be tackled

• Creating more transparent environment

• Eliminating unfairness within department

• Minimizing staff turn-over