Service Delivery: The Smiling Sun franchise serves over 20 million customers every year and is the largest private healthcare network in the country. Smiling Sun targets the low income population, migrants/refugees, and women and youth in providing a variety of primary care, RH/FP and maternal and child care services, including contraceptives, STI treatment, cervical cancer screening, post-abortion care, antenatal care, labor and delivery, emergency obstetric care, post-natal care, vaccinations, pediatric consultations, malaria treatment, tuberculosis (TB) case management, diarrheal disease treatment, and pneumonia testing and treatment. In line with the National Tuberculosis Control Program (NTP), Smiling Sun clinics offer Directly Observed Treatment Short Course (DOTS) and microscopy services in four city corporations (Dhaka, Chittagong, Khulna and Rajshahi). Along with consultations, dispensing of essential drugs and diagnostic laboratory services are also offered from SS clinics. Additionally, many clinics operate pharmacies, offering quality packaged consumer goods within easy-reach of the customers. The "Vital" clinics have, on average, 12 staff members and the "Ultra" clinics have, on average, 30 staff members.
Pricing and Payment: The network now has a pricing structure that establishes a maximum and minimum price range that responds to market conditions such as clinic location (rural – urban) or competitive environment. The new pricing strategy is in full alignment with the project’s double bottom line approach, as it seeks to balance service expansion, access to the poor and program income objectives and financial sustainability. Currently, 55% of the payment source is out-of-pocket payment, 13% is third party payers, 1% is vouchers and 31% of the services are provided for free. Smiling Sun is currently partnering with the Government of Bangladesh on a voucher scheme pilot designed to provide safe delivery services to poor women in Chittagong division.
Quality Monitoring: NGOs monitor the clinical quality of the clinics by their Monitoring Officers (MOs) and report the findings from the variety of monitoring tools and progress on resolving the identified performance gaps to the SSFP. This monitoring is done by Quality Monitoring and Supervision visits popularly known as QMS visits. At the clinic level, all clinic staff members are responsible for assuring and maintaining quality of the services provided by them and that a clinic level quality circle is in place.
Measuring and improving quality in Smiling Sun clinics is implemented by a three-tier process: 1) setting up and facilitating Quality Circles at all clinics; 2) conducting Quality Monitoring and Supervision (QMS) by Monitoring Officers (MOs), and 3) by holding meeting of Clinical Quality Council (CQC) to review performance and output indicators and performance gaps identified at the clinic level.
Technology Use: The franchise network is piloting an SMS-based reporting mechanism for satellite clinics and is working with general practitioners (GPs) to develop a hotline/SMS dialog with youth.