Phuong H Nguyen1, Sunny S Kim2, Sarah C Keithly2, Nemat Hajeebhoy2, Lan M Tran2, Marie T Ruel2, Rahul Rawat2, Purnima Menon2. 1. International Food Policy Research Institute, Hanoi, Vietnam, International Food Policy Research Institute, Washington, DC 20006, USA, Institute of Social and Medical Studies, Hanoi, Vietnam, FHI360, Hanoi, Vietnam and International Food Policy Research Institute, New Delhi 110012, India P.H.Nguyen@cgiar.org. 2. International Food Policy Research Institute, Hanoi, Vietnam, International Food Policy Research Institute, Washington, DC 20006, USA, Institute of Social and Medical Studies, Hanoi, Vietnam, FHI360, Hanoi, Vietnam and International Food Policy Research Institute, New Delhi 110012, India.
Abstract
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. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine
RCT Entities:
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. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine
Authors: Sunny S Kim; Disha Ali; Andrew Kennedy; Roman Tesfaye; Amare W Tadesse; Teweldebrhan H Abrha; Rahul Rawat; Purnima Menon Journal: BMC Public Health Date: 2015-04-01 Impact factor: 3.295
Authors: Phuong H Nguyen; Sunny S Kim; Tuan T Nguyen; Lan M Tran; Nemat Hajeebhoy; Edward A Frongillo; Marie T Ruel; Rahul Rawat; Purnima Menon Journal: PLoS One Date: 2016-03-10 Impact factor: 3.240
Authors: Dylan Walters; Susan Horton; Adiatma Yudistira Manogar Siregar; Pipit Pitriyan; Nemat Hajeebhoy; Roger Mathisen; Linh Thi Hong Phan; Christiane Rudert Journal: Health Policy Plan Date: 2016-04-23 Impact factor: 3.344
Authors: Purnima Menon; Phuong Hong Nguyen; Kuntal Kumar Saha; Adiba Khaled; Andrew Kennedy; Lan Mai Tran; Tina Sanghvi; Nemat Hajeebhoy; Jean Baker; Silvia Alayon; Kaosar Afsana; Raisul Haque; Edward A Frongillo; Marie T Ruel; Rahul Rawat Journal: PLoS Med Date: 2016-10-25 Impact factor: 11.069
Authors: Sk Masum Billah; Kuntal Kumar Saha; Abdullah Nurus Salam Khan; Ashfaqul Haq Chowdhury; Sarah P Garnett; Shams El Arifeen; Purnima Menon Journal: PLoS One Date: 2017-05-18 Impact factor: 3.240
Authors: Phuong H Nguyen; Minh V Hoang; Nemat Hajeebhoy; Lan M Tran; Chung H Le; Purnima Menon; Rahul Rawat Journal: Glob Health Action Date: 2015-08-31 Impact factor: 2.640
Authors: Phuong H Nguyen; Sunny S Kim; Tuan T Nguyen; Nemat Hajeebhoy; Lan M Tran; Silvia Alayon; Marie T Ruel; Rahul Rawat; Edward A Frongillo; Purnima Menon Journal: Matern Child Nutr Date: 2016-06-23 Impact factor: 3.092