The Secrets of Starbucks

PSI and MSI Launch Social Franchising eLearning Course

By Christine Bixiones, Technical Advisor, Sexual Reproductive Health & TB Department

Twenty years ago in Nepal, the first modern example of social franchising for health – the application of commercial franchising strategies to achieve public health goals – began expanding access to quality health services.

This year, PSI and Marie Stopes International, two organizations that have long-employed social franchising to improve health outcomes, came together to create an online course on social franchising, with support from the U.S. Agency for International Development (USAID).

Social franchising creates networks of healthcare providers or clinics, typically with a focus on small-scale private practices rather than facilities in large, government-run health systems. Borrowing practices from commercial franchises like Starbucks, PSI franchise members, or “franchisees,” work under a common brand, adhere to strict quality standards, and offer specified services.

In order to reach the underserved, franchisees are obligated to offer services at affordable prices. As “franchisors,” PSI and its national partner organizations train, equip, and support franchisees to expand the range of health services they offer, improve service quality, help underserved populations overcome barriers to access, and collect data on performance and impact.

The course presents the basics of social franchising for health using interactive content and real country examples from a wide variety of organizations. Participants learn how the success of social franchising is measured, how the approach strengthens health systems, and what best practices are emerging.

One example is Population Services Kenya’s Tunza Family Health Network, a social franchise network launched in 2008, which now includes more than 261 private practitioners countrywide.

In order to reach underserved populations, Tunza uses its team of 164 community-based workers called Tunza mobilizers. Tunza mobilizers collaborate with organized women’s groups and go door-to-door to dispel myths and create demand for Tunza products and services.

Franchisees like Tunza typically offer an integrated package of services that include family planning services,reproductive health and maternal child health interventions, treatment for tuberculosis and pneumonia, HIV counseling and testing, malaria prevention and treatment, and diarrheal disease treatment. When Kenyan clients go to Tunza clinics, they can trust that their healthcare will be affordable, high quality, and delivered with respect. Population Services Kenya supports Tunza franchise providers with:

    • training in family planning and other services,
    • subsidized health products,
    • Tunza branding and marketing,
    • awards for high-quality service provision, and
    • access to microcredit for facility renovation and the purchase of medical equipment.

PSI uses the popular Tunza brand for its franchises in Malawi and Burundi as well.

Tunza is just one of 31 PSI-operated franchises in 30 countries across Asia, Africa, and Latin America, which add up to 10,000 franchisees who in turn reach more than 10 million clients per year.

The Social Franchising for Health eLearning course is available free of charge through the USAID Global Health eLearning center at