This report presents the findings of a systematic review of the research evidence relating to health worker dual practice. It recognizes dual practice in the health sector can be a threat to quality of services and examines the evidence on what measures have been attempted or proposed globally to manage this practice. The review identifies some of the outcomes of the approaches implemented to manage dual practice while assessing the contextual issues that might affect these interventions. It concludes that dual practice may have both positive and negative consequences and its negative consequence mostly arise from its being allowed to proceed unacknowledged and unregulated. Recognizing the existence of dual practice, defining it and measuring its extent is a major step in paving the way for efforts to be put in place to manage it. In any given setting, multiple approaches are required to manage dual practice.
This report presents the findings of a systematic review of the research evidence related to social franchising. It recognizes that social franchising developed as a possible means of improving the provision of non-state-sector health services in low- and middle-income countries and examines the evidence as to scope and nature of existing research literature on social franchising interventions, including reach, implementation, sustainability and goals, in health service delivery. It concludes that although there are a number of studies on social franchising, which mostly address client satisfaction, the quality of the evidence is weak and more work is needed on implementation and the effects social franchising.