Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India

Manoj Mohanan*, Soledad Giardili, Veena Das, Tracy L. Rabin, Sunil S. Raj, Jeremy I. Schwartz, Aparna Seth, Jeremy D. Goldhaber-Fiebert, Grant Miller, Marcos Vera-Hernández

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners’ Sky Program. Methods We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers’ performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. Findings The programme did not significantly improve health-care providers’ knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Conclusion Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up.

Translated title of the contributionEvaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India
Original languageSpanish
Pages (from-to)343-352E
JournalBulletin of the World Health Organization
Volume95
Issue number5
DOIs
Publication statusPublished - 1 May 2017

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