Mohanan, M; Babiarz, KS; Goldhaber-Fiebert, JD; Miller, G; Vera-Hernandez, M; (2016) Effect Of A Large-Scale Social Franchising And Telemedicine Program On Childhood Diarrhea And Pneumonia Outcomes In India. Health Affairs , 35 (10) pp. 1800-1809. 10.1377/hlthaff.2016.0481.

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Abstract

Despite its rapid growth, there is little evidence on the population impact of social franchising in the health sector. This paper evaluates a large-scale social franchising and telemedicine program in Bihar, India: the World Health Partners (WHP) Sky Program. Studying appropriate treatment for childhood diarrhea and pneumonia – and associated health outcomes, we analyze data collected from 67,950 children (ages 5 and under) in 2011 and 2014 using multivariate difference-in-difference models. We find that the WHP-Sky program did not improve rates of appropriate treatment or disease prevalence. Both provider participation and service use among target populations were low. Our results do not imply that social franchising cannot succeed, but rather underscore the importance of understanding factors that explain variation in performance of social franchises. Our findings also highlight, for donors and governments in particular, the importance of conducting rigorous impact evaluations of new, potentially innovative healthcare delivery programs before investing in their scale-up.

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