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The subject areas are family-owned business, entrepreneurship and strategic management.

The target audiences for the case study are BBA and MBA students and management trainees who are interested in learning about family-owned business and the problems faced by them when generations change. This case can be used to teach concepts in family-owned business and strategic management courses in the context of emerging markets. The case also introduces the problems faced by a traditionally operating organization which has to change to survive in the market. The case can be used to teach senior management teams participating in executive education programs on how problems arise in family-owned business. To successfully work with this case study, students need to have the basic theoretical understanding of family-owned business.

Sree Subramania Ayurvedic Nursing home (SSANH), one of the most reputed Ayurvedic treatment centers in Kozhikode, Kerala in India, was converted into its present form in 1974 from Thekkayil Vaidyasala by Thekkayil Rajaratnam Vydiar. The latest addition to this family run nursing home is Dr Sananad Ratnam, who in continuity of his family tradition studied Ayurveda. Dr Sanand wanted to rethink the positioning of the 400-year-old family business system with an objective to increase the number of people served by SSANH. He is armed with ambitious plans to expand SSANH and increase the volume of patients served. Dr Sanand’s father, the second partner of SSANH, was not quite supportive of this idea. His father felt that the increase in scale without compromise in quality was impossible in Ayurveda. Dr Sanand felt handicapped with problems such as lack of marketing strategies, lack of standard managerial procedures, lack of innovation in processes and, more importantly, conflicting ideologies between father and son in the family-owned business. To address these problems, Dr Sanand has recently hired the services of a consulting firm. This case highlights how SSANH, in spite of being in an advantageous position, is unable to exploit its full potential. Further explaining the different ways in which different generations perceive business, this case invites the attention to the dilemma: Should the business proceed with its expansion plan? If it decides to expand, how it should convince the previous generation of the family that the expansion plan accommodates their concerns.

After completion of this case, students would be able to: gain a perspective on the problems faced by a family-owned business which has successfully survived for decades; understand how a family-owned business functions differently from other business models; evaluate different ways in which the organization can look to solve the dilemma by considering the different stakeholders in question; and apply the result of the literature on family-owned businesses to understand the dynamics of business of this specific setting, i.e. one that has a rich heritage, is in an emerging economy and is a family-owned business.

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CSS 3: Entrepreneurship.

This case focuses on ethics issues arising from the tobacco trade. Government as regulator of that trade and guardian of public health faced complex political, financial and ethical issues in discharge of its responsibilities. The harms resulting from tobacco use were well-known and had generally attracted adverse decisions from governments everywhere. The company offering tobacco products for sale, Carreras Ltd., had generally continued to do well financially despite those adverse decisions. Government, in the present case, had introduced legislation to penalize tobacco use in public places, and in so doing, raised several ethical issues such as punishing smokers for using a legal, widely distributed product; classifying cigarettes as harmful to health yet allowing its wide distribution and sale; continuing to derive substantial tax revenue from sale of a harmful product; enabling Carreras to profit from sale of said harmful product; offering little help to smokers to break their nicotine addiction. Students should be asked to identify and recommend solutions to the ethical issues faced by: the government and its “point man”, the Minister of Health as they sought to reduce the public’s use of a harmful product. The smoker who may be even addicted to a product is known to cause or contribute to a host of serious diseases. Students were to identify and recommend solutions to ethical issues faced by the players in the case. One of these players was Carreras whose operations were facing severe regulatory and public relations headwinds. Another was the nonsmoking public whose health was put at risk even though they did not use the product. The sentences could be reworded to read; Carreras, in its continued efforts to justify selling a harmful product. Nonsmokers who, despite not using the product, suffered adverse health consequences because of its use by others.

Cigarette smoking has been linked to a long list of serious diseases including several cancers, cardio-vascular disease, pulmonary ailments and stroke. Despite several government actions over the years to reduce cigarette smoking, it remained widespread and continued to take a heavy toll on public health. The government’s latest gambit, the Public Health (Tobacco Control) Regulations introduced in 2013, represented the first legislation specifically designed to restrain smoking in “public places”. Carreras Ltd., a subsidiary of British American Tobacco (BAT), had been the only significant provider of cigarettes in Jamaica for several decades and in the period allocated for public feedback, mounted a fierce assault on the Regulations, and galvanized other private sector interests to join in that effort. The case addresses the interaction between government’s roles as guardian and financier of public health, the public’s right of choice, and a company’s right to sell a legal product, albeit one deemed harmful to public health. That government derived substantial tax receipts from trade in that product added another layer of complexity to the matter. The Minister of Health, Dr Fenton Ferguson, was the government’s point man and our protagonist.

Final year University students of Management would have been exposed to ethics theories. Many management courses do not devote enough effort to the study of the interplay between the ethical, financial, and legal and the issues that can arise therefrom to complicate decision-making. The case was structured to invite exploration of this interplay.

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CSS 11: Strategy

This case study outlined the strategic and organizational issues faced by an entrepreneurial firm operating in an emerging economy. While the traditional view is “more for more” and “less for less” with respect to quality and price, the medical devices sector demands “more for less” in an emerging economy such as India, i.e. the market demands quality products at affordable prices. This case was written to equip students with the knowledge of how entrepreneurs can overcome certain barriers and use technology to recognize and exploit an opportunity, using the Indian health-care industry as an example. The key learning outcomes for the case include the following:

• Entrepreneurs define their own market, come up with innovations and create a completely new market with suitable customer value proposition.

• Entrepreneurial opportunity recognition comes from being prepared, having prior knowledge of customers and the market and having a strong network.

• An entrepreneurial preference for error of omission or commission is the determining factor when deciding whether to exploit a recognized opportunity or not.

• Entrepreneurs exploit an opportunity by giving special emphasis on their entry and risk reduction strategy.

• A technology-based product with a combination of services that will create its own product ecosystem with data is the primary goal.

The Indian health-care sector is one of the largest sectors in India and incorporates the medical devices sector, and the heart monitor segment especially represents a huge untapped opportunity. India has the highest number of deaths because of heart disease in the world, yet there is no mechanism for affordable heart monitoring, which results in large number of deaths. As existing products are either B2B or unaffordable, there is an opportunity to leverage technology to come up with cgiq products similar to blood pressure and sugar monitors. However, there are certain challenges unique to the market and product. The case described how two young entrepreneurs founded a company called Agatsa and overcame certain challenges to create a credit card-sized ECG device and the importance of building an ecosystem in a new market. Some specific issues that the case posed included the following: will it be possible for Agatsa to come up with an ecosystem to monitor heart functioning and will that be accepted by the stakeholders in an emerging market such as India? Should Agatsa have a product-driven strategy or a data-driven strategy? Will Agatsa be able to find the right business model to create and capture value?

MBA in courses such as entrepreneurship development, new venture creation and entrepreneurship in emerging markets.

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CSS 3: Entrepreneurship.

Subject area – Marketing and strategic decision making. Study level/applicability – Undergraduate business and management programmes, particularly with advanced marketing modules; and MBA programmes incorporating strategic management. Case overview – Claudio Bedoya, founder of BioScience (BS) and CEO has decided to launch a new product line, BioMobile (BM), to enter the new telemedicine market. BS is an Argentine company, which develops and commercializes innovative diagnosis equipments since 1995. The BM is a device which sends vital signals (from a patient with a chronic disease) through the mobile phone to a recipient's cell phone (doctor and/or relative).Three market segments, the alternative value propositions and the suggested go-to-markets for each of them are suggested. A debate between Antonio, Claudio's partner and Ydavelis, the marketing manager, highlights the underlying disagreement on which segment to serve and on the choice of value proposition. Expected learning outcomes – The case has been written having a senior classroom in mind. The case works best when used towards the end of the course, as it allows integrating all the concepts discussed in the course as such it assumes that participants have acquired basic concepts of strategic management and marketing management. Thus, it is not in the scope of the case to introduce any new theoretical concepts and no specific reading material is assigned to it:

To apply prior knowledge to an emerging economy setting:

For example: the SWOT analysis, the identification of critical success factors (CSF) for each alternative, segmentation, pricing, or the new product adoption curves.

To calculate the projected revenues with limited data.

To foster critical thinking about a company's strategic planning. Specifically, to be able to identify the underlying business decision: BS needs to decide whether to focus on the B2B/B2C market.

Critically think on the differences between B2B and B2C business models.

Prayas is a unique healthcare initiative, launched in India by Sanofi-Aventis, a French multinational pharmaceutical company, with the objectives of updating the medical knowledge of doctors in semi-urban and rural areas, bridging the gap between diagnosis and treatment, and making available quality medicines at affordable prices. This case discusses the evolution of the Prayas model from its inception to its current state, and the company's business strategies around it. Cognizant of the success of Prayas, many competitors of Sanofi-Aventis are actively developing and implementing similar models. The company's top management team has to respond to the competitive threat.

This case was developed from secondary sources. The secondary sources included company websites, social media and news reports. This case has been classroom tested in multiple executive master of business administration (MBA) courses on business model innovation and entrepreneurship.

The case traces the entrepreneurial journey of Dozee, a remote patient monitoring system in India. Dozee was manufactured by Turtle Shell Technologies Private Limited, cofounded by Mudit and Gaurav. The primary customers of Dozee’s offering were households with elderly citizens and health-conscious individuals who sought preventive health care. The cofounders identified the unmet need for a convenient and user-friendly contactless health tracker. Dozee team built a thin sensor-embedded sheet and module that can be placed beneath the mattress to track sleep patterns and health vitals. They also provided data analysis and data interpretation services. After four years of conceptualization, Dozee launched its product and service in 2019. Although the initial response was lukewarm, the onset of the COVID-19 crisis led to significant changes in the health-care industry. Demand for virtual assistance and contactless monitoring devices became increasingly important elements of COVID-19 treatment. Unlike other sensor-based fitness trackers, the sheet could be easily placed under the patient’s bed to capture health vitals. Choosing to pivot from a home-based individual customer segment to a medical-grade device provider for hospitals could significantly increase the scale and scope of the offering for Dozee, but it would also place Dozee in direct competition with other health monitoring devices from different business categories.

This case is appropriate for MBA and executive-level courses related to entrepreneurship and business model innovation. The case explores issues such as digital disruption and how start-ups can design a go-to-market strategy. The case works well in the classroom, even if people are unfamiliar with the health-care industry. Participants can certainly relate to the concept of adopting artificial intelligence–enabled devices for monitoring their health. The instructor should be able to quickly engage participants in a lively discussion about Dozee’s vision and the opportunities and challenges in adopting digital solutions in health care.

Fundraising, Marketing Strategy.

Undergraduate and Postgraduate.

Professional fundraising plays a key role in the operation and sustainability of various forms of organizations, particularly non-governmental organizations (NGOs). “Fundraising for Life” is the success story of a center that is totally dependent on fundraising to achieve its mission of lifesaving and treatment for children with chronic diseases regardless of their financial situation. This case sheds the light on the primary sources of contributions, the importance of an integrated development program, the mutual benefits of partnering with other entities and the challenges encountered in the fundraising endeavors in this developing and unstable part of the world.

The students will be able to explore the current practices used in fundraising as well as the marketing and communication strategies employed in nurturing and maintaining relations with potential donors and partners. They will also be able to explore the internal and external challenges and opportunities available for fundraisers.

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Organizational Development; Change Management; Leadership; Healthcare Management Operations; Supply Chain.

MBA; Masters in Healthcare Management; Post-graduate Diploma in Leadership; MPhil in Strategic Leadership.

On April 16, 2016, the CEO of Prince Mshiyeni Memorial hospital, Kwa-Zulu Natal, South Africa, Dr Sandile Tshabalala reflected as he drove through the winding hills of the Cato range. In recent years, the hospital had been a subject of negative publicity with horror stories about patients collapsing while waiting for their medication at one of Durban’s largest hospitals. The case features a number of stakeholders and their demands and even threats. Contextual leadership intelligence requires accurate identification of relevant stakeholders and then involvement in solutions. The case illustrates how these demands had been listened to and how the stakeholders had been involved in finding solutions. A remarkable solution was to realize that the bottleneck at the pharmacy was actually caused by a problem early on in the process, for example, the late start of administrative staff who had to submit patients. A further solution was to utilize the primary health care clinics and even churches for dispensing chronic medicine.

Gaining insight and foresight into the operations and supply chain dilemmas in public health care. Developing understanding of the impact of various stakeholders in the healthcare sector. Understanding buy-in when leading change. Acquiring contextual leadership intelligence in the public health environment.

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CSS 7: Management Science.

Pharmaceutical company Genzyme has created a new drug, Renvela, which is a phosphate binder designed to be used primarily by patients with kidney failure. Renvela is a slightly different version of Genzyme's highly successful Renagel. Company executives must now decide how best to launch Renvela. Should it replace Renagel? Should it be a premium version of Renagel? Is it worth launching the product at all? The case appears rather simple on the surface, but the questions are challenging to work through.

This case, launched with great success in the 2009 Kellogg Biotech and Healthcare Case Competition, can be used to teach growth strategy and new product strategy. It also provides an introduction to the pharmaceutical industry. Students will be given the opportunity to think critically about the role of innovation, risk, and ethics in healthcare-related firms.

The chairman and CEO of the Genzyme Corporation, one of the country's top five biotechnology firms, has received a phone call requesting a meeting with the cofounder and principal of a large activist investment fund that now has a 2.6% stake in his company. Before meeting with him, the CEO is aware that he needs a strategy for dealing with this “activist” investor with a track record of forcing out CEOs.