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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.

Managing non-profit organizations, social enterprises, strategic management for small entities and tourism.

Useful for graduate students enrolled in courses with development aspects. Undergraduate students learning about non-profit organizations can also benefit.

This is a case of a small non-profit organization that is struggling to formalize its operating systems to generate sufficient surplus to plough funds back to the community that it envisioned to serve. The protagonist has to make a decision of whether to invest large sums in a health center for permanent visibility or to implement health services on a smaller scale given its current level of operations. Whether the protagonists’ operations are scaleable or not is also in question, as its main activity – slum tours – is not a widely accepted concept.

1. Students will understand the challenges of starting and growing non-profit organizations. 2. Students will recognize the need to make operations efficient and to establish control systems to manage enterprise resources. 3. Students will realize that decision-making requires the balancing of interests of multiple stakeholders. 4. Students will learn to analyze the options of financing social projects considering marketing, operations and financial data. 5. Students will gain better appreciation of the merits and demerits of slum tourism.

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CSS 11: Strategy.

Leadership and Health Care management and Organisational Development and Talent Management.

Postgraduate level for honours or master’s programs in courses on public health, executive leadership and management, organisational development and public administration leadership.

The case study offers an account of Ms Xolani Ngumi’s Chief Director, Enola District Health Services, South Africa, who was driving from her newly constructed modern district hospital to one of the municipal clinics that she was overseeing. It highlights the dilemma of the general practitioners (GP’s) that refused to be relocated, leading to many clinics being without clinical support.

Expected learning outcomes are as follows: Identification of stakeholders in a particular dilemma to aid leaders’ decision-making; developing the competence of balancing conflicting needs of stakeholders by juggling complex systems; and analysing staffing issues and offer recommendations to enhance talent management.

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CSS 7: Management Science.

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.

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CSS 3: Entrepreneurship.

Non-governmental organization (NGO) intervention in poor communities using information and communication technology (ICT).

BBA, MBA courses on marketing management, social entrepreneurship, rural marketing, marketing to bottom of pyramid.

In 2009, Digital Empowerment Foundation (DEF) along with Media Labs Asia and the Ministry of Information and Communication Technology (MICT) established the Chanderi Weavers ICT Resource Centre (CWIRC) as a self-sufficient community information resource center involved in skills’ enhancement of weavers at Chanderi in Madhya Pradesh. The next three years of CWIRC resulted in an overall growth of the project with progress in the various domains of handloom industry through ICT-enabled development of weavers and weaving. The project not only aimed at the handloom industry revival and development, but also advanced in other sectors such as education, health and tourism. Osama Manzar, the DEF founder, is in a dilemma as to whether the local community of weavers in Chanderi would be able to continue with the sustainable ecosystem created in Chanderi. Is it the right time to exit Chanderi?

Issues related to the market development at the bottom of the pyramid; managing local communities and building their capabilities for marketing; marketing strategies of community marketing efforts; and key success factors for ensuring successful completion of any developmental project.

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CSS 8: Marketing.

In January 2005 Dr. Mean Chhi Vun, director of the Cambodian National Center for HIV/AIDS, Dermatology and STDs (NCHADS), needed to decide how to control the spread of HIV/AIDS and save the lives of thousands of Cambodians who were dying from it each year. In the seven years since Dr. Vun had been appointed director, NCHADS had built an organization that was transparent and efficient, had implemented a nationwide 100 percent Condom Use Program, had established a system that allowed individuals to voluntarily seek confidential counseling and testing, and had instituted a set of guidelines and procedures for staff at health facilities to refer HIV-positive patients to treatment clinics and link them with NGOs providing financial and psychosocial support. Now, however, Dr. Vun faced decisions about three initiatives that were critical to expanding care and treatment programs in his country. First, he needed to decide how to quickly and cost-effectively improve the national HIV/AIDS laboratory support infrastructure. Second, Dr. Vun needed to improve logistics and supply management in order to get the best prices and ensure patients had access to life-saving medicines. Finally, he needed to figure out how to provide sustainable care and treatment to the thousands of Cambodian children living with HIV/AIDS.

Create innovative solutions for large-scale, socially relevant challenges. Understand how to start, scale, and lead cross-sector public health initiatives, or any initiative requiring behavior change by a range of players on a large scale over the long term. Discover and implement operating models that balance the needs of for-profit, non-profit, and government organizations. More effectively manage situations where required resources are not under one's direct control.

The purpose of this case study is to illustrate how Dianne Savastano, founder and CEO of Healthassist, Inc., a US-based health-care advocacy firm, successfully led her clients and team through the COVID-19 pandemic of 2020. To gather the data for this case study, the authors interviewed the protagonists, the members of her team and two clients. The authors read Healthassist Newsletters and the firm’s documents; and in fact, they included one Newsletter and several documents in the Exhibits of the case study. The authors conducted a literature review for articles in newspapers and journals about the newly developing field of “health-care advocacy,” a field which Savastano helped to create.

The authors illustrate how Savastano, using the five practices of exemplary leadership by Kouzes and Posner, in The Leadership Challenge, led her team through the pandemic of 2020. This is a story of a woman leader, using traits such as warmth, empathy, analysis and decisiveness, keeps her small business afloat when so many other firms collapsed in 2020.

The authors conducted seven interviews and literature searches on the topics of health-care advocacy; women leaders; leading through a crisis; and COVID-19.

The case study illustrates how a woman founder and CEO can lead her firm through a crisis.

This is an example of how a woman leader managed through the 2020 pandemic.

CSS 3: Entrepreneurship

This case requires students to evaluate alternative dual-share-class corporate structures that allow companies and entrepreneurs to pursue profit with purpose. The case explores Impact Makers, an IT consulting company based in Richmond, Virginia. While original founders of the firm hold all voting rights, the cash flow rights belong to two nonprofits setting the stage for a Newman's Own model of management consulting. The case discusses whether and how the alternative corporate structure aids the firm's overall strategy to attract top-quality employees, pay them competitive salaries, and provide superior service to its clients while donating 100% of its lifetime value to charitable causes, largely through partnerships with various nonprofit organizations. More importantly, the case asks students to evaluate how such a dual-share-class and dual-purpose company can raise capital to fund continued growth.

The case opens with CEO Michael Pirron reminding himself of all the questions he had run through to execute a strategy to further grow Impact Makers' consulting business both through expanding a menu of services and through conquering new geographical markets. To do either, or both, the company needed a cash infusion. Internal cash was limited, as up to 40% of it flowed to charitable partners, demonstrating Impact Makers' commitment to its mission. Raising debt for a company without fixed assets was challenging and time consuming. Complicating it all was that being structured as a nonstock corporation rendered equity raising difficult. Could Impact Makers raise money to grow and stay true to community values at the same time?

The Global Health Initiative (GHI) is a tripartite collaboration among Northwestern University, non-profit donors, and commercial diagnostics companies. GHI attempts to bridge the gap between the market for sophisticated medical diagnostics equipment in wealthy nations and the need for point-of-care diagnostics in resource limited settings. In 2006 GHI narrowed its focus to HIV diagnostics for underserved nations. The case examines the accuracy-access tradeoff related to the roll-out of infant HIV diagnostics in Tanzania. Tanzania has a prevalent HIV/AIDS problem, particularly in children. As of 2007, Tanzania had an estimated 140,000 children infected with HIV. Existing lab-based diagnostic equipment was either inaccurate for use in infants or required highly skilled health workers. Tanzania's limited infrastructure also forced healthcare providers to choose between providing advanced care to a minority of the population and offering minimal care to the majority with poor access. A Kellogg MBA student research team performed more than thirty in-country interviews to collect data on stakeholder perceptions of three infant test concepts: the strip test, the squeeze test, and the filter paper test. Across the three tests, access decreased as accuracy increased---rural labs could not find or afford health workers skilled enough to conduct the test. In general, interviewees closely affiliated with the government preferred accuracy over access. In contrast, private health facilities had to follow fewer regulations and preferred access over accuracy. The case focuses on the decisions facing Kara Palamountain, the executive director of GHI, in her roll-out recommendations for infant HIV tests in Tanzania. It examines key factors of working in a developing country, including the need to operate in the absence of sufficient market research, balance the competing agendas of different stakeholders, and mitigate external risks such as major international funding.

This case was written to be used as a teaching case for students unfamiliar with how to approach and analyze a typical business school case. Unlike many cases used in specific classroom settings, this case is intended to be broad enough that any single student will not have a significant advantage because of his or her background. Moreover, the case is designed to guide students' thinking in a certain direction, using open-ended and more focused discussion questions provided at the case's end.

Business administration, brand management, marketing management, international marketing, strategic marketing.

This case is suitable for MBA students with exposure to marketing strategy and basic marketing. It may also be useful for junior and middle level marketing professionals during their training programs. This case-study may find its application while teaching strategic marketing, marketing management, international marketing and pharmaceutical management.

Unicare Formulations was a reputable pharmaceutical company in India. It started small and with the growth of the industry it could capture significant market share in it chosen segments. It introduced brands in small and niche areas with low innovation and where bigger companies showed little interest. It also infused new blood through outside talent. It brought newer brands to its brand portfolio. A relatively new but promising brand – Tbgo – was struggling. Its marketing head was confused whether to continue with the brand. He needs advice based on management principles.

After covering this case study, a student should be able to: use SWOT and environmental analyses to solve complex business problems; explain segmentation, targeting and positioning (STP) and shall be able to use those for preparing marketing strategy; use 4Ps in different combinations in planning brand strategies; use Ansoff's model (product-market grid); use Porter's generic strategy to analyze brand performance and to take appropriate action for brand revival; and internalize the intricacies of brand-building and their impacts on the business performance of a firm.

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