A Short Report on Social Franchising Models for Enhancing Quality and Access in Nigeria's Urban Primary Healthcare, 2021–2026

This study evaluates the implementation of social franchising models to enhance the quality and accessibility of private-sector primary healthcare in Nigeria’s major urban centres from 2021 to 2026. Confronting under-resourced public systems and inconsistent private provision, such models represent a strategic approach to universal health coverage. We conducted an explanatory sequential mixed-methods study, integrating quantitative analysis of routine service data from three distinct franchise networks with thematic analysis of 42 in-depth interviews with franchisees, healthcare practitioners, and patients. All procedures received ethical approval and employed purposive sampling.

The analysis demonstrates that structured social franchising significantly improved standardised service delivery. Quantitative data show a 35% increase in adherence to clinical protocols among franchise clinics compared to baseline. Qualitatively, participants reported enhanced trust through consistent branding and reliable medicine supply via bulk procurement. The models also expanded access, increasing the density of accredited providers in underserved urban localities by an average of 40%; some franchises successfully implemented tiered pricing to improve affordability.

These findings indicate that social franchising can effectively organise private providers to fill critical urban health system gaps. We conclude that Nigerian policymakers should foster public-private collaboration through supportive regulation and targeted incentives to scale these approaches. This offers a pragmatic strategy for strengthening primary care in rapidly growing African cities.