NOVEMBER 2005 — Family Health International (FHI) has launched an innovative franchising program to increase access to lifesaving treatment for HIV/AIDS in Ghana and Kenya. FHI is one of the first international development organizations to harness the role of private healthcare providers in making antiretroviral treatment (ART) more widely available to HIV-positive individuals in resource-poor settings.

In Kenya, as in many other countries in sub-Saharan Africa, the private health sector serves up to 40% of the population. "While ART-treatment has taken off in public sector institutions, we won't succeed in turning the tide of AIDS around until we standardize the quality of products and services of private practitioners," says John McWilliam, FHI's country director in Kenya.

As part of its pilot initiative targeting the private health sector, FHI recently acquired the HealthSpot model, which offers solutions for affordable tuberculosis and HIV services for at-risk, poor populations in sub-Saharan Africa. The addition of Healthspot will allow FHI to build a network of private providers, scaling up service delivery points for TB/HIV while creating a pool of organized, trained and high-quality providers.

To help meet the need for safe and affordable ART, FHI's strategy engages providers at private clinics, religious hospitals and work-based health sites as "franchisees" to deliver ART according to the highest standards of care. FHI will arrange training for these providers while implementing quality control measures that ensure they perform to standards. FHI will ensure the supply of drugs and will also develop a monitoring and evaluation system to track progress and quality assurance in the provider networks.

In Africa, only 8 percent of the more than 4 million people clinically eligible for ART has access to it. This low level of coverage is due to challenges in existing health systems, including inadequate infrastructure, high cost of care, inconsistent quality of care and drugs, and insufficient quality assurance measures. FHI's franchise program aims to ensure that the underserved will have access to quality care and treatment for HIV and AIDS, meeting a need for the most comprehensive approach possible to combat the spread of the epidemic.

FHI helps support antiretroviral treatment programs in Bangladesh, Cambodia, China, Dominican Republic, East Timor, Ethiopia, Ghana, Kenya, Malawi, Namibia, Nepal, Nigeria, Rwanda, Tanzania, Vietnam and Zambia as part of comprehensive care in the public sector. FHI anticipates achieving a private provider network with referral links to public health systems and community-based services. Successes in pilot design could lead to similar programs in countries receiving technical assistance from FHI.

To learn more, please contact Jennifer Shields at jshields@fhi.org

Photo: Steve Taravella