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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.

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.

Organisational behaviour; Leadership; Organisational development; Public–Private partnership; Health care management; Public health.

Masters students in Business Administration, Post Graduate Diploma, Clinical Training of Medical Professionals, Health Leadership Programme.

Prof Jannie Hugo, the protagonist in the case, was considering his dilemma of aligning the multiple partners involved in public health care. A high level of collaboration was required of a multitude of stakeholders in developing the Daspoort clinic into a pilot site for the Tshwane district’s implementation of the National Health Insurance system. In addition, the re-engineering of primary health care with the focus on the patient and community orientated approach were launched on this site.

Gaining insight into international and national landscapes and principles of health care systems. Critically analyse the role of technology in delivering innovative health and social services. Present judgment of Prof Jannie Hugo’s contextual leadership effectiveness in enhancing collaboration between the multiple stakeholders and recommend next steps.

2 × DVDs on Vimeo, Slides and teaching plan with discussion or exam questions with model answers.

CSS 7: Management Science.

This case was based on both primary and secondary data. In-depth semidirected interviews were conducted in 2021–2022 after receiving the institutional research board approval. The interviews took an approximate time ranging from 90 to 120 min. They were recorded and transcribed. A thematic analysis was undertaken to identify the most relevant themes for the case. The secondary sources used included various websites, scholarly and trade journals, as well as specific databases, such as Statista.

The case exposes students in multiple disciplines to the challenges created by the COVID-19 crisis at Yale School of Medicine (YSM). It describes its remarkable effects on organizational and community members as they struggled to reimagine more inclusive and supportive spaces. As one of the most severe crises humanity has ever witnessed, COVID-19 exacerbated the existing struggles of the underrepresented communities, creating a double pandemic. It has also amplified inequities among marginalized groups including black, indigenous and people of color; women; immigrants; lesbian, gay, bisexual, transgender, queer/questioning; people with different abilities; working parents; single parents; religious minorities; and people with low income. When COVID-19 hit in 2020, Yale University School of Medicine (YSM), like other pioneering schools in the field of health care, doubled their efforts to face both the public health crisis and the substantial social turmoil (racial tensions after the death of George Floyd, food insecurity, vaccine resistance, social inequalities, etc.). Professor Marietta Vazquez, MD, who was the first Latina to be named Associate Dean for Medical Students Diversity at YSM, launched with Dr Latimore (Chief Diversity Officer) and her other colleagues many strategic initiatives aiming at improving the diversity, equity and inclusion of organizational and community members.

The case is an invitation to graduate students and students in executive education programs to reflect on the grand challenges leaders faced at YSM as well as in other institutions across the nation and the globe. It is also a call to reimagine ways leaders can accelerate the pace of change in their organizational ecosystems.

This case was written for use in graduate-level courses, including executive education dealing with Diversity, Equity, Inclusion and Belonging, Leadership and Change, Health-Care Equity/Policy, Health Sciences, Human Resource Management, Organizational Behavior, Crisis Management, Sustainability, Business and Society, Social Issues in Management, Strategy, etc. Faculty members can easily adapt the case to fit the content of the course they teach, the students’ context as well as the specific learning outcomes to be achieved.

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

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.

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.

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 8: Marketing.

The learning outcomes are to understand the definition of public value and the strategic drivers behind public value creation, understand the nature of social innovation in the public sector, identify the critical opportunities and challenges involved in sustaining innovation in the public sector and identify the role that non-profit organizations can play in supporting and sustaining social innovation.

This case puts participants in the shoes of a global health innovator’s leadership team as the organization approaches a funding crisis. The organization, VillageReach, is on a quest to expand across the public health system of Mozambique and experiences a funding dilemma. The case reveals the challenges of working with governments to achieve large-scale, systemic change. It explores the conundrum of using international donor funding to embed new practices in government service delivery. Ultimately, it asks participants to choose between the pursuit of new, small-scale innovative projects and the large-scale rollout of a national programme.

This teaching case is written for courses focused on social entrepreneurship, social innovation and social change. It can also be used in courses focused on non-profit management and public sector innovation. Specifically, the teaching case is suitable for two audiences: social enterprise and non-profit managers focused on strategy, development and operations (the case focuses on an enterprise that relies primarily on donor funding) and health-care managers and administrators. Generally, the case is suitable for undergraduates in their final year of study as well as graduate-level business and public administration courses, including MBA, MPH, MPA, EMBA and Executive Education courses.

Teaching Notes are available for educators only.

CSS 3: Entrepreneurship.

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.

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.

Public Sector Management.

MBA or postgraduate program courses in public policy and management. MBA or postgraduate program courses on social innovation, social entrepreneurship and public or collective entrepreneurship. Management development programs for public policy professionals, non-governmental organizations and social enterprises.

Despite several country-wide campaigns to improve sanitation levels, India continues to be the country with the highest number of people, over 600 million, practicing open defecation. This case outlines the Sabar Shouchagar Project (Toilets for Everyone) undertaken by the District Administration of Nadia District in West Bengal that transformed the region into the first open-defecation-free district in India. The case begins with providing the context of the problem of open defecation, why it has been hard to eliminate and how undertaking a project to eliminate open-defecation-free practices has myriad institutional and economic challenges. The case then details the conceptualization and execution of the complex Sabar Shouchagar Project which involved a loose coalition of various state programs and civil society organizations. The case ends with questions on the continuity of this project beyond the tenure of the current District Magistrate and on the replicability of such an ambitious project in other parts of the country. The setting of this case, a government agency, is different than most cases and provides an opportunity for students to talk about a state agency and its interstices with civil society. This case explores how to create change through large government machinery and allows the student to explore aspects of social mobilization, social change and social innovation. If taught within a postgraduate or MBA program, the case would serve well to dispel stereotypes and biases about government bureaucracies (such as slow timelines, limited efficacy of projects and so on).

After discussion and analysis of the case, students will be able to: appreciate how administrators within a large government bureaucracy address an ambitious and complex public health issue in a developing world context. Understand the on-the-ground challenges that arise when a change agent pursues a worthwhile goal. There are difficulties such as getting resources beyond what a government office has access to, getting alignments between different key actors within the local community and forging coalitions. Understand initiatives for social transformation within a developing country context. Specifically, the case unpacks the cultural, political, economic contexts that determine how social innovations may be pursued. Understand capacity-building and change management. Evaluate efforts required to sustain social change efforts and the challenges and pathways with respect to replication of successful social change projects in other geographies. Appreciate the design of civic engagement practices in public policy implementation.

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

CSS: 10: Public Sector management.