Governments are looking for ways to increase the access to and quality of health care services in low- and middle-income countries. One system not connected to the public sector, has been to provide health services through a franchise, called social franchising. The concept of franchising for health services is similar to franchises in business. A franchiser develops a successful way to provide the health services, and then other franchisees copy the model in other franchises. Each franchisee, though, has to follow the original model. There is also usually specific training, protocols and standards to follow, monitoring, and a brand name or logo which identifies that the provider is part of a franchise.
There is hope and early work reports that social franchising may quickly spread health services in low- and middle income countries to improve health. But this Cochrane review did not find any rigorous evidence to demonstrate the effect of social franchising on access to and quality of care in low- and middle-income countries. Well designed studies are needed.