Total Market Approach

Engaging the private sector for better health results

At its heart, Futures Groups Total Market Approach works with government, private sector, and civil society to make healthcare more accessible to those who need it most. We help the overall market expand and diversify, building on existing provider networks and varied public and private service delivery channels. Specific public-private partnerships also create new solutions by sharing risks, blending incentives, promoting demand, and building new pathways to care that did not exist before.

Program Areas
population and family planning sexual and reproductive health maternal and child health hiv and aids infectious diseases gender poverty and equity

futures group offerings:

F  utures Group conducts Total Market Analyses to segment the market, complement and buildon existing service providers, and inform supplyside and demand-side strategies that grow and diversify overall service access and health results.
W  e facilitate dialogue between the public and private sectors, helping to broker relationships and develop institutional structures that support long-lasting public-private partnerships and innovative solutions.

W  e plan workable subsidized-to-commercial transitions for health products and services, and support franchising to improve quality and value.

Technical Services
policy and advocacy research and strategic information  health markets and private sector engagement modeling and economic analysis health systems strengthening strategic consulting program management

W  e work directly with the government to We design and run social marketing campaigns develop pro-private policies and to help them to increase demand for quality health products create demand-side financing approaches, such and services, and incorporate new approaches as vouchers, so the poor can use healthcare such as SMS and mHealth tools. services in private hospitals and clinics. And we provide open-source informatics  We work directly with the private sector to solutions to interface with existing reporting identify market expansion opportunities, platforms, allowing private, faith-based, and develop sustainable business strategies, and community-based results to more easily inform connect to national public health goals. national planning and results.

Record of Results:
In Afghanistan, Futures Group established the Afghan Social Marketing Organization (ASMO) to work with the government to identify health priorities, with civil society to develop and deliver messages, and with the private sector to deliver quality commodities. This resulted in sales of more than 59 million health products through 5,300 outlets across the country, with more than 360,000 people trained on family planning methods, water purification, and the use of oral rehydration salts. In India, several of Futures Groups successful USAID-funded public-private partnership pilots were scaled up more than 10-fold through local government investments. For example, in Uttarakhand, population coverage for vouchers to provide access to reproductive health services increased from reaching 150,000 people under the pilot to reaching 2.58 million people following scale-up. Accredited Social Health Activist (ASHA) Plus community health workers under the ASHA Plus program reached out to 260,000 people across six blocks during the pilot and scaled up to cover 3.13 million people across six districts. The population coverage for mobile van health services also increased from 500,000 to 10 million. In Madagascar, with funding from the Reproductive Health Supplies Coalition through the Innovation Fund, Futures Group worked with partners to conduct a total market assessment. We found that, with the introduction of free contraceptives in the public sector in 2007, many wealthier clients began using public sector products, leading the private sector family planning market to contract. Also, there was still unmet need across all wealth quintilesincluding among people most likely to have the means to pay for contraceptives. These findings have driven exploration of new policy approaches to support a more robust private sector for contraceptive provision, for enhanced contraceptive security and sustainable family planning gains in Madagascar over the long term for contraceptive provision, and for enhanced contraceptive security and sustainable family planning gains in Madagascar over the long term.

Futures Group One Thomas Circle, NW Suite 200 Washington, DC 20005 U.S.A. tel 202.775.9680 fax 202.775.9694 Futures Group Europe, Ltd. 2nd Floor Turnberry House 100 Bunhill Row London, EC1Y 8ND U.K. tel +44(0) 20 7250 0556 fax +44(0) 20 7336 8742 Futures Group India, Pvt., Ltd. DLF Building No. 10-B, 5th Floor DLF Cyber City, Phase-II Gurgaon - 122002 (Haryana) India tel 91.124.4702000 fax 91.124.4702042

The power of informatics: including private providers in national results

In Kenya, Futures Group is providing the open-source IQSolutions electronic health record system to help AccessAfya create a chain of ultra-mini clinics for the extremely poor. From inception, AccesAfyas vision was to create a branded, franchised model of affordable private health services, increasing health options for low income Kenyans. When Bobby Jefferson, Futures Groups Chief Informatics Officer, heard this vision, he knew IQSolutions matched the qualities AccessAfya was seeking. To create low-cost efficiencies, the IQCare health record could be paperless from the start and IQReferral could provide an electronic linkage and referral connection to the governments Kenyatta National Hospital without additional burdens on the clinicians. In addition, IQSMS provided a way for health workers to directly follow-up with clients. The system was already approved and used by the Government of Kenya, had passed an review by the U.S. Centers for Disease Control and Prevention, and was set up to provide a direct interface to the national District Health Information System-2 reporting system. As such, the system provided the added benefit of local acceptability and a way for AccessAfyas private results to contribute to national health results and planning. Two years later, IQSolutions supports a network of AccessAfya clinics in the Kibera slums, and the clinics are known for providing high tech health care at an affordable price. IQCare and IQReferral are active, IQSMS is coming online, and the clinics are slated to report into District Health Information Systems for coming cycles.

It is fantastic to provide innovative informatics solutions to social entrepreneurs supporting health service delivery especially those that are making an impact in public systems and priorities. Bobby Jefferson Director Informatics Futures Group

Building a platform for public-private partnerships during country transition

In Afghanistan, Futures Group, with funding from the U.S. Agency for International Development, worked within the Ministry of Public Health to help establish the Office of Private Sector Coordination (OPSC) and the Public Private Partnership Unit, to act as a catalyst for the Total Market Approach to healthcare. In the past, there was a lack of trust between the government and private sector. The purpose of the OPSC was to first build confidence on both sides and then initiate programs based on public-private collaboration to ultimately provide Afghans with better access to healthcare. While working with the Ministry of Public Health to establish the OPSC, Futures Group assisted the private sector in forming and strengthening professional organizations, such as the Afghanistan National Medicines Services Organization (ANMSO) and Afghanistan Private Hospital Association (APHA). Through the OPSC, the Ministry of Public Health was able to better-engage private sector organizations (especially the APHA and ANMSO) in relevant forums and involve them in decision-making and regulatory processes. Strengthening the public and private sectors simultaneously has resulted in increased collaboration in achieving Afghanistans health goals. By improving relationships and collaboration between the public and private sector and facilitating communication about mutual interests, Futures Group will allow more Afghans to access health care services in their own country, ensure some of the estimated $90 million spent for health services abroad each year remains in-country to strengthen the Afghan health system, and provide another way for the government to subsidize specific services for poor clients.

The power of vouchers: Creating demand, expanding safe birthing options

In India, one of Futures Groups goals was to make births more affordable at privately run clinics. In a USAID-funded project called the Innovations in Family Planning Services Technical Assistance Project, we approached the government and a number of private birthing clinics with an idea: The government would provide low-income women with a voucher that would cover all costs surrounding the birth of a baby. The vouchers covered a range of services, including antenatal care, institutional delivery, postnatal care, neonatal care, and family planning. The private clinics agreed to cut their costs and set a defined price schedule for all services. In return, the government promised to increase demand for the services by embarking on a social marketing campaign that promoted the voucher system, and provided the vouchers that allowed women to choose a private clinic. It worked: the marketing brought many more women to the clinics, and the clinics made profits despite the reduced cost because of the increased demand for services. In total, four Sambhav voucher pilot programs have been successful across three states: Uttarakhand, Uttar Pradesh, and Jharkhand. The vouchers have supported 44,000 antenatal care visits, 10,300 postnatal care visits, and 12,500 institutional deliveries. In addition, 9,500 vouchers were used for family planning services. The approach has been embraced by the state governments, especially in Uttarakhand where coverage has been scaled up from its initial two block radius to include the entire state.

Futures Group, the global health consulting firm, helps to protect and promote peoples well-being around the world. For 40 years, Futures Group has created lasting solutions to some of the most pressing public health challenges facing nations. For more information, please visit www.futuresgroup.com, www.facebook.com/FuturesGroup, and www.twitter.com/FuturesGroupGbl.

Access Afya micro-clinic