Unjani Clinics: meeting the need for scale through social franchising

In this contribution to the Organization Zoo series, we discuss an organization with a unique organization design that allows for a scalable and financially sustainable approach to social impact. Unjani Clinics is a network of nurse-led clinics in South Africa, where the nonprofit (head office) organization oversees the operations of more than ninety for-profit independent primary healthcare clinics. Combining for-profit and nonprofit entities in a social franchise structure represents a unique bundle of organization design choices that together enable the organization to effectively pursue its mission. By combining entrepreneurial incentives for nurses, such as ownership rights over their clinics, with social impact-driven controls, Unjani cultivates an otherwise untapped resource—i.e., professional nurses’ entrepreneurial ambitions—to deliver on its social mission. This novel combination of entrepreneurial autonomy with formal hierarchical as well as informal controls to safeguard the social mission allows Unjani to address the tension between social and financial value creation, which often prevents social enterprises from scaling successfully.