Bangladesh: Social Franchise Consultant, Bangladesh

1. Background and context for assignment

The five-year, $86 million, USAID/DFID-funded NGO Health Service Delivery Project (NHSDP) provides technical assistance and capacity building to the “Smiling Sun” (“Surjer Hashi” in Bangla) network of 25 local NGOs that manage nearly 400 static clinics, around 10,000 satellite clinics and nearly 8,000 community health workers throughout Bangladesh. Through grant-funded subsidies (currently at around 60% across the entire network), to the partner NGOs, this network provides an essential service package (ESP) of primary health care services, with the objective to particularly ensure access for poor and underserved populations. The ESP includes services for family planning and reproductive health; maternal, newborn and child health; primary communicable disease control and curative care; and behavior change communications and community mobilization.

USAID/Bangladesh is committed to further strengthening the Surjer Hashi health care network, moving it towards greater financial and managerial sustainability in the context of Bangladesh’s progress towards Universal Health Coverage. With NHSDP scheduled to end by the end of 2017, USAID recently initiated a process to co-design a follow-on project called “Advancing Universal Health Coverage”. The stated intent of the next project(s) is to implement “interventions that demonstrate the highest potential to dramatically improve health impacts by tackling key constraints within the existing NGO health delivery sector and health financing sector.”

The current implementing partners of NHSDP, with Pathfinder International in the lead, are not part of the co-design process and therefore will not be implementing partners for the follow-on. However, NHSDP has a critical role to play in preparing the Surjer Hashi network for the coming transformation, as per guidance of USAID. This includes the following steps to be taken during the current, and final, project year:

a. Register an independent not-for-profit company to own and manage the Smiling Sun/Surjer Hashi brand. This new company, with technical support from USAID-funded projects and some start-up financing from USAID, will be the platform for more effectively and sustainably responding to a changing health sector environment including factors such as reduced grant funding from donors to support NGOs; the need for government to outsource at least some aspects of health service delivery; and the growth of alternative health financing mechanisms such as social health insurance or other third party payor mechanisms.

b. Develop a franchise strategy, process and tools that will then be used by the follow-on project to establish the new Smiling Sun/Surjer Hashi as the franchisor[1] for the service delivery network.

Company registration is currently underway by NHSDP with assistance from a local consulting company in Bangladesh.

This scope of work is designed for NHSDP to procure technical assistance to design a franchise mechanism and tools, helping to set the stage for the next project(s) to implement a different approach to the Smiling Sun/Surjer Hashi network of health services.

Note that any financing strategies or mechanisms for the new company, or for paying for services in the Smiling Sun/Surjer Hashi network in future, have not yet been established by USAID. Although NHSDP, at USAID’s request, recently prepared a report on “Strategies and Interventions to Strengthen the Financial Efficiency and Sustainability of Bangladesh Smiling Sun Clinics”, the analysis and recommendations in that report are not final. Further decisions and actions on financing for the Surjer Hashi network will be for USAID and the next project implementers to carry forward.

This Scope of Work related to franchising strategies, mechanisms and tools must be carried out irrespective of either the scope or the pace of change with regard to financing for the Smiling Sun/Surjer Hashi network.

1. Purpose

The purpose of this STTA is to design a simple and feasible franchising approach and tools that will allow for the new SH Company to quickly and efficiently franchise SH clinics with ongoing technical and financial support from the follow-on project(s).

This includes clarifying roles and responsibilities for the franchisor (the new company), illustrative of which will be: financial management and reporting; managing packages of services (which may vary from facility to facility and change over time); setting quality standards and managing quality assurance; supporting HR processes including effective recruitment and continuing education; and marketing.

Note that this is not necessarily an exhaustive description of the franchisor’s roles.

It also includes clarifying roles and responsibilities for the 25 local NGOs which, for the past 20 or more years, have owned and/or managed the network of static clinics, satellite clinics and community service providers (CSPs) that make up the Smiling Sun/Surjer Hashi network.

1. Tasks and Deliverables (including preparation)

2. Develop a franchise strategy, or multiple strategies, relevant and feasible for the Smiling Sun/ Surjer Hashi network based on the context outlined above.

DELIVERABLE 1: A report outlining franchise strategy options, with recommendations for which strategy is most applicable for each particular set of circumstances in the Smiling Sun/Surjer Hashi network. If one strategy is applicable across the board, this should be made clear. If more than one strategy is needed, the details and determinants should be fully outlined.

1. Design the processes and tools for implementing the franchise strategy/strategies, and conduct initital field testing to demonstrate the validity and practicality of the tools for the Smiling Sun/Surjer Hashi context.

DELIVERABLE 2: A detailed outline of processes, along with the set(s) of tools to support those processes; and a report on field testing of the tools.

1. Design and test a clinic readiness assessment that sets the stage for individual Smiling Sun/Surjer Hashi clinics to be assessed for franchise licensing. The assessment design and criteria should serve as a basis for clinics to immediately begin preparing for being franchised. The actual clinic-by-clinic assessment and franchising is NOT within the scope of this consultancy.

DELIVERABLE 3: Clinic readiness assessment tool with a report on its testing, demonstrating that it is feasible and practical for assessing Smiling Sun/Surjer Hashi clinics for franchise licensing purposes.

1. In-country counterpart(s)

Bruce Rasmussen, DCOP-SD

1. Other (e.g., unit requirements)

· Mohamed Abu Nar, Sr. Program Director

· Sarah Lance, Senior Program Officer

· Minal Rahimtoola, Technical Advisor Health Systems Strengthening

1. Supporting documents

· The Essential Service Package for the Surjer Hashi network

· Outline of types of Surjer Hashi clinics based on the range of services provided

· List of static clinics by type, with information about associated satellite clinics, CSPs and staffing

· Report on financing for the Surjer Hashi network (by Dennis Chao)

· Report on costing of services in the Surjer Hashi network (by Wu Zeng, et al)

· Other relevant project documentation

· USAID BAA outlining USAID’s vision for the future project: Advancing Universal Health Coverage

1. Comments

[1] *Working definition of franchising for purposes of this scope of work: A long-term cooperative relationship between two entities—a franchisor and one or more franchisees—that is based on an agreement in which the franchisor provides a licensed privilege to the franchisee to do business.*

Applicants must demonstrate expertise and proven experience in the field of social franchising for health services. Interested applicants should send CV and statement of interest to Sarah Lance, slance@pathfinder.org