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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.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

The case is particularly well suited to entrepreneurship, marketing, technology, innovation, or strategy courses.

This teaching case is aimed at postgraduate students in management or business programmes.

This case follows the Kenyan healthcare tech company Savannah Informatics as they contemplate how the company will continue to grow in a post-pandemic world. Savannah is the market leader in electronic claims validation solutions for the Kenyan healthcare system. Their flagship product, the digital platform Slade 360, allows health insurers, healthcare providers, and patients to share claims information for health services in real time, drastically reducing payment transfer times, incidents of fraud, and account errors. The Covid-19 pandemic and the subsequent lockdown mandates from the Kenyan government have reduced short-term revenues by driving down hospital visits for citizens overall, but they have also created a demand for telemedicine and more online healthcare solutions. CEO John Muthee and his co-founders are left to consider their options for growing Savannah Informatics: expanding into new markets, creating more solutions for their insurance and provider customers in Kenya, or diversifying.

Identify the key challenges facing Savannah

Analyse the organisation using the 5Cs model (company, customers, competitors, collaborators and context) and VRIO (value, rarity, imitability, and organisation) analysis

Assess the growth opportunities available to Savannah and make recommendations

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.

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.

Diagnostics services in India were growing at 20% annually with billing of USD 3.4 billion. With WTO's GATS, foreign competition was arising. Dr. Lal PathLabs had formidable brand recognition and Dr. Arvind Lal was wondering whether to accept private equity and induct management professionals to keep pace with competitors through acquisitions or greenfield or sell out. He worried over loss of proprietary control. The industry practice of incentivizing doctors for referrals meant that acquisitions brought perverse incentive systems. The choice of compromising ethics or inventing another business model had to be made alongside whether to expand in India or abroad.

Impact investing, Social entrepreneurship.

MBA, EMBA, Executive Education.

CareCross Health describes the impact due diligence leading up to an investment into CareCross Health by impact investor Palm Capital. The case follows the protagonist, Caitlin Stevens, CEO of Palm Capital, as she identifies CareCross Health as a potential investment target, performs an initial screening of the company and visits the company and its sites as part of an in-depth impact due diligence.

By the end of this case, the student should be able to consider the critical steps associated with conducting an impact due diligence; understand the challenges associated with conducting an impact due diligence, with a particular focus on due diligence in an emerging market scenario; analyse a potential impact investment, in this case CareCross Health, and make a preliminary recommendation on whether the investment is viable from an impact perspective; identify the trade-offs between private sector and public sector provision of services to low-income groups, and consider unintended consequences in analysing the impact of a social enterprise; and prepare possible scenarios and weigh the potential outcomes of various arrangements to ensure alignment of investor objectives.

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 1: Accounting and Finance.

Public Health; Leadership; Organisational Development; Organisational Behaviour; Public Administration Management.

Postgraduate level for honours or masters programmes in courses on public health; executive leadership and management programmes; MBA level.

The case unpacks decentralisation as a means to promote and improve local decision-making and accountability through community participation and engagements. Ayanda Nkele was a programme manager in a health district in South Africa. He was faced with many challenges when trying to implement his programme, most of which were related to local authority, responsibilities and decision-making abilities at his level. This case describes briefly the South African health system. and how it functions. It describes the proposed changes to the health system and its transformation towards Universal Health Coverage. The decision space analysis as discussed in the case illustrates the types of decentralisation in the country and how this also applies to Nkele’s level.

Understanding the concepts and principles of decentralisation within the context of strengthening district health services, the re-engineering of primary health care (PHC) and rolling out a National Health Insurance in South Africa. Applying the “decision space” approach to analyse the extent of decentralisation. Grasping the requirement of leaders to be “contextually intelligent” and identify the important contextual variables to take into account when analysing public health care.

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 7: Management Science.

Health Management and Leadership, Marketing Social Causes, Strategy, International Business.

Post-graduates, Practitioners.

General Electric has been operating in the Middle East, North Africa (MENA) region for over a century. GE is committed to corporate citizenship having launched ecomagination in 2005 and healthymagination in 2009. For sustainability, GE believes that both innovation and localization are critical. This case deals with contextualization of breast cancer campaign for the Kingdom of Saudi Arabia through healthymagination. Rania Rostom, Communications Director, Middle East, North Africa and Turkey region, GE, reviews the campaign implemented and looks at roll-out across the MENA region. The situation is unique, as breast cancer strikes women in the region ten years earlier than the West, and the cultural context does not allow the discussion of the topic in public. One of the peculiarities of this region was the high penetration of social media and its large adoption rate by the young. GE used a unique Facebook campaign to drive awareness on the topic, encourage screening appointments, seek treatment and reduce the discomfort associated with the process.

On completion of utilizing the case study as an exercise, students should be able to gain case-specific skills – critically examine the importance of the consumer behavior, health marketing, marketing strategy and aspects of international business in the Middle East, KSA, in particular, and demonstrate this by analyzing real regional/world examples using complex theoretical frameworks; identify examples of best practice and explain the dynamics toward consumer behavior, health marketing, marketing strategy, international business with reference to a range of theoretical models and apply these in a meaningful way to the MENA region – discipline-specific skills – synthesize and critically evaluate a corpus of academic literature and government reports on consumer behavior, health marketing, marketing strategy, international business – and personal and key skills – reflect on the process of learning and undertake independent/self-directed learning (including time management) to achieve consistent, proficient and sustained attainment; work as a participant or leader of a group and contribute effectively to the achievement of objectives in the field of consumer behavior, health marketing, marketing strategy, international business.

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

The learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework.

September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context.

Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership.

Teaching notes are available for educators only.

CSS 7: Management Science.

Learning outcomes are as follows: Students will be able to demonstrate the need to understand the uncertainty faced in a crisis; demonstrate how dynamic capabilities allow an organisation to respond effectively in a time of crisis and deep uncertainty; explore how strong dynamic capabilities are required to maintain continuity of operations by enabling a shift in the current business model; and evaluate methods of mobilising resources to address needs and possible opportunities presented in a crisis.

Gordon Institute of Business Science (GIBS), a South African-based business school and the one of the top ranked business schools in Africa, faced a crisis in the midst of the COVID-19 pandemic. With the announcement of a national lock down, under strict conditions, and the immediate closure of the GIBS campus, the Academic Programmes had to radically shift their mode of delivery to enable students to continue with their respective programmes. When the situation was further exacerbated by the breaking of the undersea cable, the Executive Director of Academic Programmes, Professor Louise Whittaker faced the difficult decision on what to do next. The case illustrates the need for strong dynamic capabilities to foster organisational agility and to respond effectively in times of deep uncertainty or crises.

The case is positioned at a postgraduate level and would be ideal as a teaching case for business students on a Master of Business Administration programme, a specialised Master in Philosophy programme or selected executive education programmes for general managers or senior executives.

Teaching Notes are available for educators only.

CSS: 11 Strategy.

The learning outcomes focus on enabling higher-order learning for students to critically assess Agile project management in philanthropic settings, specifically compare and contrast Agile project management versus traditional project management in the context of a non-profit organisation (The Solidarity Fund) during a crisis; discuss and evaluate the role and contribution of philanthropy during times of crisis; rate the value additions and contributions of Agile approaches in philanthropy; evaluate the phases of Agile (unconventional) project management executed by The Solidarity Fund; and develop a review of the impact of the work done by The Solidarity Fund in terms of the approach that the Fund used. How effective/not effective was it?

Chaos, crisis and confusion: the three “C”s that succinctly condense the status quo during the COVID-19 pandemic. The roles and contributions of non-profit organisations gained recognition as countries worldwide responded to the crisis to save lives and livelihoods.

In South Africa, there was a sense of urgency and considerable pressure for a multi-stakeholder approach led by the government to save as many South African lives as possible. The conditions, however, were the opposite of traditional project management methodologies that advocate for the management of the triple constraints, namely, cost, time and scope.

How could cost be managed in a project without a set budget and which was reliant on philanthropy? How could time be managed without a set deadline and while tackling an invisible enemy – a virus that changed dynamics on a daily basis and – how could scope be managed in a context where the future was increasingly uncertain?

This case study can be useful for students undertaking postgraduate diploma in business, master of business administration (MBA), master of management courses.

Teaching notes are available for educators only.

CSS 11: Strategy.