A new SHOPS Plus brief highlights how social franchising empowers women. It finds that the increased opportunities social franchising provides—such as training and access to finance—improves the ability of women franchisees to deliver high quality health services, mentor younger women, make household spending decisions, and expand their businesses.
MaryBeth Hastings, gender integration lead for SHOPS Plus and lead author of Empowering Women Health Providers through Social Franchising: Stories from Kenya and Uganda, explains that the brief was developed to address a gap in knowledge of the factors that contribute to women’s empowerment within the private health sector.
“In developing the gender strategy for SHOPS Plus, one of the things I noticed was a lack of literature around gender and the health workforce in terms of social franchises,” she explains. “We had seen evidence that many franchisees are primarily women, and we knew about the various barriers women face in starting their own businesses, so I wanted to dive deeper—with the hypothesis that women are able to overcome some of the barriers to success in their health businesses through partnership with social franchises.”
To illuminate whether and how women franchisees are empowered through social franchising, Hastings and her team captured the life stories of women franchisees from five social franchises in Kenya and Uganda. They analyzed the findings by looking at four dimensions of empowerment—Power Over, Power To, Power Within, and Power With—to identify how they might manifest in social franchising.
Across the two countries and the five franchises, women reported positive changes as a result of franchising—particularly in their ability to offer an increased variety of services demanded by their communities and in their self-confidence in knowing that they are able to perform these services well. One woman franchisee noted that she never offered family planning before because she wasn’t trained in it, but she now proudly considers herself “a guru” for voluntary IUD insertion and removal. Another noted that when her husband—a doctor in the clinic—passed away she felt that people weren’t sure she could meet their needs. She said that joining a social franchise and participating in their training gave her significant confidence in her skills.
To varying degrees, all of the women interviewed had used the knowledge and skills they gained from franchising to improve their businesses. All interviewees had added staff since joining the franchise, and all but one mentioned plans for physical and staff expansion of her business in the future.
“These are women who look at their clinics as they are now and see possibility,” Hastings observed. “How many other women providers are there out there who could be having similar impact given equivalent resources and opportunity?”
Many of the women also noted how they converted the benefits of franchising into gains for themselves and their communities. As a result of their increased income levels and self-confidence, the women said they had more influence in their household spending decisions and used their increased income to invest in themselves and their families in addition to their businesses. The women also indicated that their success as business owners and providers allowed them to share their knowledge and leadership with their communities. Some women used their increased knowledge to discuss the importance of family planning in their churches or to provide health care to marginalized communities as volunteers. Nearly all the women said they act as mentors to younger staff or their children who’ve entered the medical field.
Because social franchising interventions were not designed specifically to improve gender equality, the positive impacts of social franchising on women is largely unintentional. The brief concludes that a more intentional approach to women’s empowerment in the health workforce is needed among social franchises and the private sector overall. With targeted investments, the systemic weaknesses, isolation, and gender-related barriers to success that women providers encounter inside and outside of social franchising can be addressed.
“The economic and political power of female providers could expand greatly with just a few programmatic tweaks and better tracking.” explains Intissar Sarker, family planning specialist and co-author of the brief. “This isn't important just for social franchising groups, I hope that any organization that works with health providers in the private sector can better understand the challenges women face, and some of the solutions to improve women's odds of succeeding in private practice, which will have a huge impact on their home lives as well.”
Download the brief to read stories from the women and to learn how social franchises and the private sector overall could take a more deliberate approach to addressing gender issues in the health workforce.