Incorporating elements of social franchising in government health services improves the quality of infant and young child feeding counselling services at commune health centres in Vietnam

Datos Bibliográficos

ID11490286
AutoresPhuong H Nguyen (0000-0003-3418-1674, International Food Policy Research Institute, autor de correspondencia), Sunny S Kim (0000-0003-3960-3354, International Food Policy Research Institute), Sarah C Keithly (International Food Policy Research Institute), Nemat Hajeebhoy (International Food Policy Research Institute), Lan Mai Tran (0000-0001-5129-5716, International Food Policy Research Institute), Marie T Ruel (0000-0002-9506-348X, International Food Policy Research Institute), Rahul Rawat (0000-0002-6555-7809, International Food Policy Research Institute), Pratiksha Menon (0000-0001-5988-2894, International Food Policy Research Institute), Purnima Menon
Año2014
Volumen29
Número8
Páginas1008-1020
Fecha de publicación2014-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czt083
PMID24234074
OpenAlexW2153212292
IdiomaEN
Citas recibidas8
Referencias citadas26

BACKGROUND: Although social franchising has been shown to enhance the quality of reproductive health services in developing countries, its effect on nutrition services remains unexamined. This study assessed the effects of incorporating elements of social franchising on shaping the quality of infant and young child feeding (IYCF) counselling facilities and services in Vietnam. METHODS: Process-related data collected 12 months after the launch of the first franchises were used to compare randomly assigned Alive & Thrive-supported health facilities (AT-F, n = 20) with standard facilities (SF, n = 12) across three dimensions of service quality: 'structure', 'process' and 'outcome' that capture the quality of facilities, service delivery, and client perceptions and use, respectively. Data collection included facility assessments (n = 32), staff surveys (n = 96), counselling observations (n = 137), client exit interviews (n = 137) and in-depth interviews with mothers (n = 48). RESULTS: Structure: AT-F were more likely to have an unshared, well-equipped room for nutrition counselling than SF (65.0% vs 10.0%). PROCESS: Compared with SF providers, AT-F staff had better IYCF knowledge (mean score 9.9 vs 8.8, range 0-11 for breastfeeding; mean score 3.6 vs 3.2, range 0-4 for complementary feeding). AT-F providers also demonstrated significantly better interpersonal communication skills (score 9.6 vs 5.1, range 0-13) and offered more comprehensive counselling sessions. OUTCOME: Overall utilization of franchises was low (10%). A higher proportion of pregnant women utilized franchise services (48.9%), compared with mothers with children 6-23.9 months (1.4%). There was no quantitative difference in client satisfaction with counselling services between AT-F and SF, but franchise users praised the AT-F for problem solving related to child feeding. CONCLUSIONS: Incorporating elements of social franchising significantly enhances the quality of IYCF counselling services within government primary healthcare facilities, particularly their structural and process attributes. Provided that service utilization is improved through demand generation, this model has the potential to impact IYCF practices and child nutrition.

Breastfeeding · Business · Environmental health · Family medicine · Government (linguistics) · Health facility · Health services · Interpersonal communication · Population · Quality (philosophy) · Reproductive health · Service (business) · Service provider · Child Nutrition and Water Access · Global Maternal and Child Health · Marketing · Medicine · Nursing · Poverty, Education, and Child Welfare · Psychology · Social Psychology · Pediatrics