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After discussing this case, students will be able to understand the challenges faced by social entrepreneurs in starting a health-tech start-up in Africa; create and evaluate lean business models of health-tech companies as a social enterprise; evaluate how health-tech start-ups were developing innovative business models and supply chain networks to make prescription drugs accessible and available in Africa; understand how inorganic growth strategies can help health-tech start-ups scale up; and evaluate what promises investors were seeing while investing in social enterprises in the health-care sector in Africa and what social wealth they were creating.

In August 2022, Gregory Rockson (Rockson), social entrepreneur and founder of for-profit health technology (health-tech) social enterprise in Ghana, mPharma, stated that he had plans to replicate the company’s business model, which provided people access to drugs and at affordable prices, to other African nations, beyond the company’s existing footprint. However, analysts pointed out that the fragmented drug supply chain and poor regulation in the health-care market across Africa could act as a challenge for mPharma to replicate its business model successfully across the African continent. People in Africa were forced to pay higher prices to buy life-saving drugs due to the continent’s fragmented drug supply chain. To add to their woes, pharmacies struggled to keep life-saving and life-sustaining medicines in stock. Often, patients traveled miles to a pharmacy only to find out that the drugs they needed were not in stock. In addition to this, the markets were flooded with counterfeit drugs. And the Covid-19 pandemic only exacerbated the situation. mPharma managed the prescription drug inventory for pharmacies and drug suppliers using its proprietary vendor management information system. By using the technology infrastructure it had built, the company connected patients, pharmacies and hospitals through a cloud-based software. The system enabled doctors to track in real-time which drugs were available and at which location, thus giving patients reliable access to medicines. Patients registering with mPharma with their prescriptions and medical history received an alert on their mobile phones notifying them where the drugs they needed were available. mPharma bought drugs from major drug manufacturers such as Novartis International AG, Pfizer Inc. (Pfizer) and Bayer AG, on behalf of the pharmacies. This enabled the pharmacies to save on the up-front costs of stocking the drugs, reduced supply constraints and ensured availability of drugs to consumers in these underserved markets. The company had a consignment model wherein member pharmacies had to pay only for what they sold. Most pharmacies forecast the number of drugs they needed and purchased them from mPharma at pre-agreed rates. The company took the inventory liability to prevent pharmacies from going out of stock. As mPharma used its purchasing power to buy drugs in large quantities from drug manufacturers and suppliers, it was able to help patients realize cost savings of 30% to 60% in the purchase of medicines. mPharma was focusing on achieving its ambitious goal of dominating the health-care market in Africa in future. However, analysts felt that the company would face challenges related to poor regulation in the health-care market, high prices of drugs and the fragmented pharmacy retail market in the continent.

This case is intended for use in MBA/MS level programs as part of a course on Social Entrepreneurship, Sustainability, Business Model Innovation, Disruptive Business Models, and Supply Chain Management in the Drug Industry.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

Need for preventive health care: To comprehend the contribution of preventive health care in improving the health quotient. Sri Sathya Sai Sanjeevani Hospital (SSSSH) and its initiative is an apt example of the wonder which preventive care can bring in the context of rural health. Community participation: The case can be instrumental in showing the pathway to encourage community involvement in mainstream health by promoting the holistic model of SSSSH that understands mothers and children's health profile and needs, especially in the unreached rural segments of an emerging economy like India. Importance of healthy childhood: World Health Organization (WHO) promotes the school health programme to prevent health risks among children by inculcating healthy behaviours during childhood. The successful SSSSH model proves that it is implementable by integrating comprehensive health education modules in the existing institutions for medical care.

The challenge of a healthy childhood is inadequate availability and accessibility of quality care. Non-awareness of the parents is also a significant reason for the children who miss the benefit of a happy childhood. While much is planned by the Government and some part of it being executed, this case highlights the effectiveness of the maternal and child health programme executed by the Sri Sathya Sai Sanjeevani Hospital (SSSSH). This initiative fulfills the dire need of ensuring the preventive healthcare component leading to safe motherhood and safe birth of healthy children. Further, the case is also the culmination of pin-pointed innovative awareness activities such as school health screening and the Divine Mother and Child Health Program (DMCHP). It opens up the discussion on the current model of health care followed by SSSSH, Raipur, and its impact in the local areas to decide on its expansion across the country for nationwide implementation.

Bachelors in Business Administration, MBA, Executive MBA, Post Graduate Diploma in Healthcare Management

Teaching notes are available for educators only.

CSS 2: Built Environment.

This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

After a successful transition from a projects-based IT business services company to a platform-driven analytics company, Saama's core leadership team gathered in 2017 to brainstorm the next phase of its growth. The year before, the team had decided to narrow its target market to the life sciences vertical. Saama now had to decide how to execute on this focused strategy by choosing a growth pathway within the life sciences vertical. Saama's leadership team was considering three alternatives: acquiring new customer accounts, developing existing customer accounts, or developing new products by harnessing artificial intelligence (AI) and blockchain technologies. The team had to evaluate these growth pathways in terms of both short- and long-term revenue potential, as well as their potential for sustaining Saama's competitive advantage.

The learning objectives have been prepared following Bloom’s taxonomy (Bloom et al., 1956). After completing the case study, the students will be able to identify and recall the prerequisites necessary for establishing a pathology laboratory. (knowledge); analyze the micro- and macroenvironmental factors considered by Mr Sabihul Haque in the development of the strategic plan for Healthcare Laboratories (HCL) (knowledge and application); explain the key components of the Porter’s value chain and their significance in the operation of HCL (comprehension and evaluation); use the TOWS analysis to map the internal strengths, weaknesses, opportunities and threats of HCL (application and synthesis); and analyze the challenges faced by protagonist in managing HCL and generate suggestions for addressing the challenges (analysis and synthesis).

HCL, an enterprise established in 2018 in Sahdeo Khap, Gaya, Bihar, India, aims to provide high-quality pathological diagnostic services in semi-urban and rural areas. This health-care initiative is pioneering, offering pathology services to make high-quality, low-cost diagnostic services accessible in rural India. In rural settings, numerous health-care hurdles make it challenging for individuals to access the care they need. Since its inception, HCL has expanded its reach to connect more areas, facilitating diagnostic services for people in remote regions. The establishment of laboratories in semi-urban areas aims to reduce patient travel time, costs and health risks by bringing services directly to their doorstep. Haque, the chief executive officer of the lab, grappled with multiple challenges, including selecting an appropriate location for the lab, recruiting and retaining skilled workforce, managing logistics supply, collaborating with local health-care providers, dispelling the stigma among the population that superior services are only available in cities and enhancing health literacy in rural communities. Following numerous meetings with Ms Ummati Naiyyer, head of operations, they worked collaboratively to address these challenges, developing a blueprint and future plan to operate services in rural areas. This case study provides insights into the obstacles faced by HCL striving for success in rural areas. It elucidates the beneficial application of the Porter’s value chain, along with an analysis of macro- and microenvironmental factors. Unique challenges such as societal stigma and mistrust are specifically emphasized. Students engaging with this case study will enhance their problem-solving skills through brainstorming and providing recommendations, contributing to potential solutions for HCL’s difficulties.

The teaching notes for the HCL case is designed to enhance the learning experience of undergraduate and graduate students within the context of the course. This case study serves as a valuable teaching tool, allowing students to apply theoretical knowledge to real-world scenarios in the health-care industry. The notes provide a framework for instructors to facilitate discussions, encourage critical thinking and promote a deeper understanding of key concepts related to establishing diagnostic laboratories in rural areas.

Teaching notes are available for educators only.

CSS3: Entrepreneurship.

Entrepreneurship, Strategic Management, Social Sector.

The case can be used in undergraduate, graduate and executive education courses in entrepreneurship and strategic management. It is a perfect fit for executive sessions at incubation centers for not-for-profit (NPO) start-up social enterprises. The case is aimed at early-phase social entrepreneurs and those interested in the field.

Anthill Creations (hereafter referred to as Anthill) is a NPO organization engaged in building low-cost sustainable playscapes for underprivileged children. Their mission is to “Bring Back play” in the lives of millions of children of marginalized communities by building sustainable playscapes. It is an effort that contributes toward the objectives of clause 1.2 (Ministry of Human Resource Development, Government of India, 2020), on “Early Childhood Care and Education” (ECCE) in the new National Education Policy (NEP) 2020 of India as released on July 30, 2020. The ECCE clause emphasizes the importance of “learning through play”; and recognizes it to be central to quality early childhood pedagogy and education. Anthill has been working on the same philosophy since its inception in 2016. They have successfully built 300 playscapes across 18 states of the country and impacted the lives of more than 200,000 children. The playscapes are built using upcycled waste material, such as scrap tires, waste cable and oil drums; further, they use local resources and contextual designs and built them by mobilizing community participation. The playscape play elements provide for unstructured free play for children and encourage them to use their imagination to invent new games.

Pooja Rai – the founder and CEO of Anthill Creations, an architect by discipline started the NPO immediately after her graduation. It was her “calling” in life that pushed her to quit a corporate job in the early stages of her career and instead pursue a career in the social sector. The case details her methodical approach in pursuing her intuitive response to a social need, the way she adopts a lean start-up framework to set-up Anthill, her frustrations, personal resilience and ability to balance different stakeholder interests as she treads the difficult journey of building the awareness of inculcating play as a pedagogy in the early years of childhood development.

The case provides data on the large proportion of the marginalized population in India and the abysmal conditions of the Indian Government schools. The objectives of clause 1.2 on ECCE in NEP 2020 show the Indian Government’s good intent. And yet with the prevailing conditions, the policy’s ambitious target of universalization of ECCE by 2030 (Chanda, 2020), seems a mammoth task, even for the Indian Government.

On the other hand, Anthill as a small NPO of young dedicated individuals is invested and experimental in their approach; they have a tested model but financial dependency limits their activities. The ECCE clause is a sign of new hope for NPOs such as Anthill who want to reach out to millions of Indian children from marginalized communities. What could be a compatible, perhaps complementary or even skillful pathway to integrate Anthill’s tested model of building sustainable playscapes with the Indian Government’s good intentions of universalization of ECCE by 2030? How could Anthill “scale” for a systemic “impact”? Should not the NPOs, early childhood development researchers, funders and government authorities study collaboratively instead of the present siloed approach so as to bring about a systemic change in the thinking lenses about “play” to be an integral part of early childhood development? Rai ponders on the above questions.

To explain the importance of one’s purpose (calling) in life and how the authors can identify with it.

To explain how an intuitive response to social need can be complemented with a methodical approach to social entrepreneurship.

To discuss the importance of business model canvas from the social sector lens.

To explain the important elements in sustaining small start-up social organizations.

To discuss and evaluate the options an early-stage social enterprise can engage into “scale” for “impact.”

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

This case analysis will make the audience aware of the sudden nature of the crisis, specifically the transboundary crisis. They will be introduced to the concepts of participative leadership and situational leadership. Majorly the audience would learn to remain composed in times of crisis and comprehend how a circumstance can transform a participatory leadership style into a situational leadership style. The case will allow the audience to brainstorm how to take innovative decisions to manage a crisis situation. The primary objectives of the case are as follows: ■ to understand a transboundary crisis and its characteristics to deal with it; ■ to visualise the application of participative and situational leadership and evaluate and analyse the most suitable leadership style during an unknown crisis; ■ to make the students aware of how to remain composed in times of crisis and, for instance, implementing the change of leadership styles per the situation's requirement; and ■ to make students learn to design innovative decision-making strategies to develop a crisis management plan for managing future crises.

The case highlights the successful management of the crises faced by a multi-specialty hospital named “Shukan-Caring Lives”, established in 2017 in Vadodara city of Gujarat, India. The case revolves around the Chief Operating Officer, his executive management body and the paramedical and medical staff of the hospital, who dealt with the grave Corona crisis. This case shows how the change in leadership style from participative to situational leadership style could manage the situation by taking brilliant initiatives and providing insightful solutions with a lot of dedication, showing how situational leadership can deal with the transboundary crisis.

The case is an excellent example of a transboundary crisis for any organisation and demonstrates a novel idea of transforming the participative leadership style into a situational leadership style as and when the need arises. The topics of transboundary crisis and management crisis can be taught in strategic management. At the same time, leadership styles and transformation of leadership style can be covered in organisation behaviour. Management development programmes can also include such kinds of cases to give exposure to crisis and its management. The target audience would be PG management students, management executives and senior-level managers in various courses.

Teaching notes are available for educators only.

CSS 11: Strategy.

Upon completion of the case, students will be able to reflect the forces, which may disrupt the art industry through Artientifique initiatives and the ability to apply Phoenix encounter method with proactive scanning to remain competitive; create various multi-functional roles as a youth entrepreneur in the micro, small and medium enterprises (MSMEs) capacity and be able to understand the level and review the competition and business trends from an art industry perspective; analyze how innovation clubbed with sustainability will create a competitive advantage in a circular economy; determine the leadership style most appropriate for MSMEs to indulge in innovation and sustainability in the fine arts business; and design and discover opportunities to promote women’s entrepreneurship in the art industry, especially in emerging markets.

On a cold Friday morning in November 2020, Aisha Mir was in utter confusion written all over her face. She had to decide on a prosperous pathway. Should it be customization or standardization of artwork? Also, whether she should continue investing in the existing in-house supply chain or outsource this to a third party. Being practicing sustainability in her personal and professional life, she had designed her art studio herself by using upcycled materials. While enjoying the pigeons and sparrows chirping and eating grains on her wide windowpane, she looked at the world map with keen interest and imagined herself flying to each country along with her gray and white pigeons. While sitting in Madina city, Saudi Arabia, she was concerned about the expired makeup collection hub being set up in Abu Dhabi, UAE. The collection and the painting processes had to be monitored; the artworks needed auditing, framing and packing before they were shipped to a customer. Centralizing would add unnecessary hassle, and outsourcing needed distribution of authority. Keeping the challenges in mind, she was struggling to find a solution for efficient community engagement.

This case has been particularly focused on undergraduate and postgraduate early-stage level students pursuing business or commerce programs, particularly those studying entrepreneurial and management courses in innovation and sustainability.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

Describes Myriad Genetics and its struggle to develop a genetic testing service while facing challenges from competitors and activist organizations. After Myriad's discovery of the BRCA gene, capable of genetic testing for breast cancer in women, Myriad needed to choose a strategy to provide this service to the public. With several major competitors offering similar services, intense media scrutiny, and a charged activist and political climate, a poor Myriad decision could have major repercussions.

Social entrepreneurship/innovation.

Basic to advanced level.

This case introduces students to the context of social innovation and social entrepreneurship. Societies are facing new challenges that will require innovative solutions. In our society, social needs are addressed in a variety of different ways. Some of these needs are addressed mainly through public organizations, some in private spheres through associations or businesses, and others in informal organizations or maybe not at all. As changes occur in our society, the current practices we use to meet our needs will not necessarily be the same practices we use to meet our needs in the future. In response, a number of initiatives are emerging. This case describes the process of such a new initiative.

Students need to understand what social innovation is; in how many ways it manifests; and why it is a multi-disciplinary field. Students need to understand the difference between for-profit and not-for-profit organizations and which challenges they are effective in addressing (context dependency). Students need to understand, describe and discuss the process and methods of developing social entrepreneurship and social innovations using the House of Plenty Social Innovation Model as a case. Students need to understand and discuss the main challenges that not-for-profit social innovations face in securing financial sustainability and in scaling up using the House of Plenty Social Innovation Model as a case.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 3: Entrepreneurship.