The Bangladesh Smiling Sun Franchise Program

Sustainability as Program Objective

Definition of Sustainability

Sustainability is understood as the systemic capacity of an organization to consistently respond to societal demands while generating resources that cover structural needs and planned development.

Sustainability is understood as the managerial capacity of an entity to consistently deliver needed and demanded quality healthcare services while directly or indirectly generating sufficient revenues to cover overall operating and management expenses.

The Sustainability Cycle

Understandingevolving needs

DistinctiveCompetencies

Competitive advantage

Entrepreneurialinvention

Resources

Results

BUSINESS MODEL

Adapted from Van Der Heijden, Kees; Scenarios: The Art of Strategic Conversations, John Wiley and Sons , 2005, West Sussex, England

Smiling Sun - the challenge: Double bottom line

– Expand access to quality affordable health services

– Increase the number and proportion of poor people served

– Attain high levels of cost recovery

Enabling Exogenous Factors

• Large populations. High numbers, high density. • Custom of paying for health services. Majority of

health services in Bangladesh are paid OOP• Sophisticated market

– GOB contracting out– Third party payers (Companies, Insurance Schemes)

• Societal changes– Growing middle class – Urbanization– IT use on the rise

• Donor’s interest

Enabling Endogenous Factors

• Sunk investment. USAID had invested for years in establishing a clinic network

• Diversified service structure. SSFP provides FP, child and maternal health services, diagnostic and LCC.

• Installed capacity available • Brand equity

Sustainability: Areas of Attention

– Invest in relevant market differentiation

– Develop ecosystem

– Redefine relationships with clients• More service options for existing clients• Expand client base (regular, corporate, government)• Develop new products

– Address financials• Cost management• Pricing

Client Centered Quality of

Care Methodologies & Tools

Management Systems

Improvement &

Development

Brand Equity

Enhancement & Services Promotion

Continuous Capacity Building

Clinic Physical Enhancement Higher value perception

Client loyalty developed

Increased client traffic

Increased clinic income

Conversion Elements

Sustainability

Determinants

Conversion Process:Preparing for Sustainability

Lessons Learned

Challenges

– Culture matters – Business as usual, – “Donor dependence”– Clients in the center

– Mind the timeframe

– Align agendas of different stakeholders

– Effort to promote new models

Lessons Learned

What works

– It is important to have a common (well understood) objective

– Clients and providers like good quality

– People pay… really

– If you offer, they will come (integration works, new services and more)

– Partnership with government