Types of Franchise – Hub spoke, what franshise gain


The MGHN manages a three- tiered network of healthcare delivery institutions which works in coordinated fashion to optimize efficiency at every level. The whole MGHN is broadly divided into three levels such as Level-1, Level-2 and Level-3 of which first two are the health facilities and the last one is individual health worker known as “Merrytarang Workers” who link community with the facilities i.e. L-1 and L-2 depending upon health needs of the community. A diagrammatic representation of MGHN network is summarized below:

Types of Franchise

HLFPPT is the franchisor responsible for selecting, engaging and managing the potential franchisee hospitals. HLFPPT identifies a potential Health Facility after a thorough screening which includes both field and institutional (technical and managerial aspect) assessment.

HLFPPT support the franchisee and its providers through various value propositions such as capacity building on clinical, managerial and quality assurance protocols for delivering MCH & FP Services, augment institutional image through enhanced branding, actively engaging community through various activities , establishing referral linkage to complete the continuum of care. Franchisee is also supported through manpower for effective handholding by deploying Merrytarag Workers (MTW) and Outreach Workers (ORW).


The graphical representation of the SF model is representative of L1 and L2 as franchise hospitals whereas L3 are community based health workers who act as a referral linkage between the community and the franchise facility.

L1 Hospitals: District/City level, hospital owned by the franchisee having more than 15 beds & an Operation Theatre facility. These would typically have a qualified Obstetrician (M.S or DGO) with an associated, Paediatrician and Anaesthetist available on call. L1 hospitals adheres to specific infrastructure norms with designated wards / labour rooms, ultrasound facility, ambulance facility, pharmacy, blood transfusion facility, autoclave area, pre-labour and post-labour rooms. L1 would receive referrals from the rural L2, L3 and also from other nearby facilities. L-1 is housed to provide all the facilities for provision of comprehensive emergency obstetric care and also provides Family Planning Services thereby playing an important role in increasing “Couple Protection Years”.

L-2 Hospitals:  Are 5-10 bedded clinics, based at sub-divisional level, with capacity of providing standard Antenatal Check-ups (ANC), normal deliveries and Postnatal Care, these facilities are equipped with necessary medical devices required to perform routine service. These Merrygold clinics refer obstetric emergencies to L-1 facilities or pre- identified specialists.

L-3: Merrytarang Workers: These are community based health workers called Merrytarang members or Merrytarang workers or L-3 workers. In some areas they are the local ASHA workers who are well trained and accepted by the community. They are ground level workforce for the MGHN with an objective to improve community’s engagement with the program so that community will be aware and utilize the services that are being rendered by the MGHN facilities. In order to enhance the utilization of the health facilities, the L-3 workers conduct monthly group meetings, facilitate outreach activities and undertake household visits to women of reproductive age, specifically pregnant women and women within the reproductive age group. They would counsel these women and their family members about care during pregnancy, birth preparedness and complication readiness, safe delivery, newborn care and various FP methods available. In case of high risk pregnancy, L-3 workers refer pregnant women to nearest appropriate franchisee facility and do necessary follow-ups. L-3 also undertakes Social Marketing of MCH and FP products like pregnancy test cards, condoms, oral contraceptive pills, emergency contraceptive pills and sanitary napkins. L-3 also collects critical project related information such as data base of all pregnant women and their MCH & FP Service status and maintains records for HLFPPT.

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