Funding for this research was provided by:
Bill and Melinda Gates Foundation (OPP1032848, OPP1044138)
Received: 8 March 2019
Accepted: 20 April 2020
First Online: 4 May 2020
Change Date: 15 June 2020
Change Type: Correction
Change Details: An amendment to this paper has been published and can be accessed via the original article.
Ethics approval and consent to participate
: Ethical approval for the AHME qualitative evaluation was provided for each round of data collection by the Ghana Health Service Ethics Review Committee (Protocol #GHS-ERC: 11/05/2013), the Kenya Medical Research Institute (Protocol #Non SSC no. 411), and with “exempt” status from the Institutional Review Board of the University of California San Francisco (Protocol #13–11045). According to the requirements of the local ethical review boards, informed voluntary written consent was obtained from clients in Ghana and informed verbal consent was obtained from clients in Kenya before interviews were conducted. Clients were given the option to withdraw their participation at any time with no consequences for their healthcare. To thank them for their time, participating clients were given a small gift worth approximately one U.S. dollar, such as a bar of soap.Ethical approval for the client exit interviews each year was provided by Marie Stopes International’s Ethics Review Board (Protocol #014–14-E-Am15-Am16–1-17Am), and also the Ghana Health Service Ethics Review Committee (2018 Protocol #GHS-ERC-02/11/17; 2019 Protocol #GHS-ERC004/10/18). Prior to the interview, data collectors explained the survey to the client, and gave them an opportunity to ask questions before consenting. Clients who refused were not penalised, and franchisees were not made aware of client responses nor whether they took part in the survey. Clients received no incentive for participating in the survey.
: Not applicable. This manuscript only draws on data from qualitative interviews and quantitative surveys in which unique identifiers were assigned to each participant and no personal information was collected.
: The sponsors of this study were not involved in the study design, collection of data, analysis, interpretation, nor in the writing of the manuscript. Sponsors also were not involved in the decision to submit this manuscript for publication. The authors declare they have no competing interests.