South Africa is undertaking major reforms in its health sector to prepare for the introduction of financing reforms under National Health Insurance (NHI). Central to this effort is improving the quality of primary healthcare services. With the work of the Office of Health Standards and Compliance (OHSC) having commenced, standards are being used to assess services, stimulate improvements and overcome the current inequities in access to high-quality care. The National Department of Health is establishing excellence in the health sector through a number of initiatives, and one of these - the "Ideal Clinic" initiative - has been designed to respond directly to the problems around quality of services, ascertained through OHSC inspections. At this time of change, opportunities arise for innovation and experimentation in strengthening services and there is considerable experience in other countries that is of interest to South Africa. Concepts and approaches being used in the private sector may also be of use in speeding up the process by which quality of care is improved. Of particular interest is experience with social franchising, which applies a set of standards to a network of healthcare providers, to provide socially beneficial health services under a common franchise brand. This chapter concludes that the financing reforms under NHI, and the initial work of the OHSC, provide the context for more experimentation with regard to different approaches to expanding quality primary care services. The lessons from other countries, such as the application of social franchising concepts, are experiences from which South Africa can learn.