Franchise clinics improve healthcare access for children in developing world

By Sarah Guy, MedWire Reporter

Franchise health clinics could substantially increase access to essential vaccinations and treatments among children living in low-income countries, regardless of their household income status, report researchers.

Their study results show that children in Kenya living within 30 km of a CFWShop (a child and family wellness clinic created by the HealthStore Foundation) received more vaccinations and were more likely to receive any medical treatment than their counterparts who lived further away.

Furthermore, these findings were not significantly different for lower-income versus higher-income households, report Justin Berk (Texas Tech University Health Science Center, Lubbock, USA) and Achyuta Adhvaryu (Yale School of Public Health, New Haven, Connecticut) in BMJ Open.

"Global health policymakers should continue to look towards innovative delivery models like the franchise health clinic model to improve cost-effectiveness and efficiency in treating the diseases that post the greatest burden on children," says the pair.

The model has the potential to "fill an important gap in health service delivery in low-income countries by exploiting returns to standardization and economies of scale," they add.

Proximity under 30 km from a CFWShop was associated with a significant increase in expected counts of DPT (diptheria, pertussis, tetanus) and polio vaccination among the 6079 children aged 5 years and under whose data was included in the 2008-2090 Kenya Demographic and Health Survey (DHS).

Indeed, children living in this proximity received 0.285 more vaccinations on average than those living further away, report the researchers.

Proximity to a CFWShop also improved children's chances of receiving any kind of medical treatment, with those who had acute illnesses (including malaria, fever, and diarrhea) a significant 14.2 percentage points more likely to receive some treatment than their far-away peers.

"This is a 39% increase above the dependent variable mean," note Berk and Adhvaryu.

After adjusting data for household wealth categories (as recorded by the DHS), the main effect of CFWShop proximity remained significantly positive - the same treatment receipt patterns remained apart from malaria.

"We find consistently positive significant associations between proximity to CFWShop and receipt of vaccinations and appropriate treatment for illnesses, suggesting that the franchise clinic model may be a useful innovation in healthcare delivery where there is a dearth of access to essential medicines and preventive technologies," conclude the authors.

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