SynthesisBMJ global health2025
Social franchising in healthcare: a systematic review and narrative synthesis of implementation and outcomes.
Synthesis in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe growing prominence of social franchising in healthcare underscores the need to analyse its implementation and impacts; however, substantial research gaps remain. Therefore, we aimed to conduct a systematic review and narrative synthesis of evidence to analyse the social franchise models, implementation and outcomes.
methodsWe conducted a systematic literature search in February 2024 on Medline, Embase, PubMed, Web of Science, CINAHL and Scopus using terms related to 'social franchising' in healthcare. We conducted a qualitative narrative synthesis of study findings into five thematic areas: client impact and utilisation, healthcare outcomes, financial sustainability, innovative technologies and awareness activities.
resultsFrom 4184 search results, 47 studies were included in the analysis. We identified 29 social franchises across 25 countries. Social franchises were mostly present in Africa, Asia and Central America. Most franchises focused on sexual, reproductive and maternal health (n=18) and family planning (FP) (n=25), and most included training (n=21), service provision (n=17) and financial support (n=12). Franchising improved client volumes, satisfaction and contraceptive continuation rates and increased access to healthcare. Vouchers and subsidised services reduced the financial burden among clients. Telemedicine and call centres enhanced healthcare delivery, and community outreach and marketing increased awareness and modern contraceptive use. However, franchises struggled to reach poorer populations due to high fees and competition from public services. It often did not improve FP, reproductive healthcare and child nutrition and had limited branding and promotional activities. Additionally, heavy reliance on donor funding threatened long-term sustainability.
conclusionSocial franchising presents a potential strategy for expanding healthcare access and improving service delivery, though outcomes regarding the effectiveness of social franchising vary across regions. More research is needed to evaluate digital technology use and the long-term impact, equity and sustainability of social franchising. PROSPERO REGISTRATION NUMBER: CRD42022328104.
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