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For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

South Africa’s primary health outcomes do not correspond to the country’s spending on public health, with South Africa ranking among the worst globally in the incidence of tuberculosis, HIV prevalence, infant mortality and life expectancy. In part, this poor outcome can be explained by high inequality in access to healthcare, which reflects South Africa’s grossly skewed income and wealth distributions, with the bulk of the country’s population reliant upon an underfunded, inefficient and poorly managed public health system. This substandard service for the working poor in South Africa’s townships with high population densities offered a profitable entrepreneurial opportunity to provide affordable and effective primary care with vast gains in quality and outcomes improved dignity for patients. After receiving her MBA, physician and entrepreneur Dr Nthabiseng Legoete self-funded the launch of Quali Health in 2017. The business model set out to disrupt healthcare delivery for South Africa’s poorest citizens. Drawing patients from the working poor in Diepsloot, Quali Health’s inaugural site was cash flow positive within five months when the facility hit only 30% of installed service capacity. With quick success, Dr Legoete faced the strategic question of how fast to scale and finance the expansion. She also considered a new micro-insurance product for her clientele.

For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

Teaching notes are available for educators only.

CSS: 3 Entrepreneurship.

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.

The subject areas are business communication, human resource management and health care.

The case was designed for use in a first-year MBA-level course in business communication but would serve well in a course for executives or for advanced undergraduates. It might also be assigned in general management courses to evoke discussion on communication skills required in sensitive and critical situations; human resource courses; and course on health care.

Palliative care is a specialized medical care focussing on improving the quality of life of patients suffering from life-threatening illnesses. It addresses symptom management and psychosocial and spiritual concerns of the patient and its caregivers. With the intent to alleviate the sufferings of terminally ill patients, Rajbala Foundation, a non-government organization (NGO), works at the psychosocial and spiritual levels. While training their volunteers in effective palliative care communication, it often encounters challenges such as socio-cultural variations, organizational challenges, appropriate verbal and nonverbal communication, etc. This teaching case focuses on the communication challenges faced by the volunteers of Rajbala Foundation. It would lead to a broader discussion on communicating empathically during critical situations. The case has a focus on NGOs, and non-profit organizations, public sector management, health-care management and human resources management. There is significant literature on communication skills for medical practitioners in palliative care. As an increasing number of NGOs step in to provide the second level of care to critically ill patients in non-physical domains, there is a need to understand the role of effective communication for such care providers. This case deals with non-medical care providers in palliative care; the issues of communication they face as they interact with patients; and the skills they require to address the emotional and spiritual needs of patients and their families.

The aim of this case is to raise awareness of the complexities involved in the communication process during an emotional and sensitive interaction. It aims to encourage volunteers involved in palliative care to reflect on good communication practices when communicating with patients and family members. After reading this case, the students should be able to discuss the complexities involved in the communication process when communicating in situations with high emotional involvement; understand the core elements of emotional interactions for effective practice; and emphasize the need for the development of communication skills within palliative 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 6: Human Resource Management

This case uses the concept of social entrepreneurship to analyze the entrepreneurial journey of Mr Suraj Prakash and his social enterprise, the Swasth Foundation. It further deepens our understanding of strategic decision-making by exploring the successful use of pivots.

The case was primarily developed through a series of interviews with the leadership team over a year. Secondary sources included literature about Swasth Foundation available on the internet and those shared by the founder.

In 2008, Suraj Prakash left McKinsey & Company after six and half years in the health and development sector as an engagement manager. Along with his friends, Aman Paul and Ankur Sharma, he established Swasth with the goal of building an ecosystem that delivered high-quality, affordable and accountable health services to low-income communities in India. Right from its inception, Swasth went through many fundamental shifts in terms of its business model, team composition and even the nature of its existence; however, this did not deter Suraj from pursuing his goal.

The case brings into focus the health-care system of India, especially in the context of the urban poor and the challenges they are facing, followed by the initiatives taken by Swasth Foundation and the impact it is trying to create. The remainder of the case delves into Suraj’s entrepreneurial journey and the three pivotal decisions that changed the course of his organization over 11 years. It will also provide a transpicuous view of the entrepreneurial decision-making process through the lens of pivoting. As Suraj and his team are trying to bring about the required changes through the third pivot, there remain some challenges that need to be addressed for a successful implementation.

The case is written for business management students and can be used in general management, entrepreneurship and strategy classes. The case can be used for discussions on leadership, social entrepreneurship and strategic decision-making. It is suited for both undergraduate and postgraduate levels.

This paper aims to explain the theory of stakeholder, value chain analysis and triple bottom line sustainability approach.

The present case was developed from both primary and secondary data sources. The primary sources included visits to Global Enterprises and collected data through a structured interview. The secondary sources included enterprise annual reports and websites.

This case presents the innovative approach adopted by a for-profit social enterprise, utilizing locally available resources, changed products and an improved business model to deliver the desired social impact. It highlights the challenges social entrepreneurs face and how the people at the grass-root level are uplifted through the success of a social entrepreneurial venture. The case study is based on an interview conducted with the founder and managing director of Global Enterprises and other stakeholders (farmers, women artisans and employees). An interview schedule was used for conducting the interviews. The researchers tried to understand the business model deployed, stakeholders involved, challenges faced, competencies needed and strategic decisions made by the social entrepreneur that helped the enterprise become sustainable. The social problems identified by the entrepreneur include unavailability of quality raw material at a reasonable price on time; financial scarcity and massive dependence on non-institutional financial sources; lack of product development, market research and production; and the high price of handmade products compared to factory-made products. The case explains how the entrepreneur addressed the problems of cotton farmers, women artisans and local youths through his enterprise. The case also explains how he could make a social venture sustainable in the long run.

This case targets graduate-level students and is designed to be taught in Entrepreneurship, Social entrepreneurship, Rural entrepreneurship, Business administration and Entrepreneurship development. It can also be used for other programmes, where problem identification, opportunity recognition, stakeholder analysis and porter's value chain analysis are taught.

The assignment is to design a plan that aligns patient satisfaction scores with quality care metrics. The instructor’s manual (IM) introduces models for designing and implementing a strategic plan to approach the quality improvement process.

This is a field research case. The author(s) had access to the Chief Operating Officer (COO) and other members of the management team, meeting with them on numerous occasions. Cleveland Clinic Florida (CCF) provided the data included in the appendices. Additionally, relevant hospital data, also included in the appendices, is required to be made public on Centers for Medicare and Medicaid Services (CMS) databases. Accordingly, all data and information are provided by original sources.

Osmel “Ozzie” Delgado, MBA and COO of CCF was faced with a dilemma. Under the new CMS reimbursement formula, patient satisfaction survey scores directly impacted hospital reimbursement. However, the CCF patient satisfaction surveys revealed some very unhappy patients. Delgado pondered these results that really made no sense to him because CCF received the highest national and state rankings for its clinical quality at the same time. Clearly, patients were receiving the best medical care, but they were still unhappy. Leaning back in his chair, Delgado shook his head and wondered incredulously how one of the most famous hospitals in the world could deliver such great care but receive negative patient feedback on CMS surveys. What was going wrong and how was the hospital going to fix it?

This case is designed for graduate Master’s in Business Administration (MBA), Master’s in Health Sciences Administration (MHSA) and/or Public Health (PA) audiences. While a healthcare concentration is useful, the case raises the generic business problems of satisfying the customer to increase brand recognition in the marketplace and displacing competition to increase annual revenues. Indeed, the same analysis can be applied in other heavily regulated industries also suffering from a change in liquidity and growth occasioned by regulatory change.

In early 2004, residents of Inglewood, California, a working-class community just outside Los Angeles composed primarily of African- and Hispanic-Americans, were preparing to vote on a referendum that would change the city charter to allow Wal-Mart to build a supercenter on a huge, undeveloped lot in the city. Walmart had put forward the measure after the city council refused to change the zoning of a sixty-acre plot on which it held an option to build. Numerous community and religious groups opposed Wal-Mart's entry and campaigned against the referendum. Walmart promised low-priced merchandise and jobs, but these groups were skeptical about the kinds of jobs and compensation that would be offered, the healthcare that would be provided to employees, and the broader impact Walmart would have on the community. Inglewood was a pro-union community, so there was also opposition based on Walmart's anti-union position. On April 6 Inglewood residents voted to reject the referendum by a margin of 60.6 percent to 39.9 percent. Though smaller, less organized, and with fewer resources than Walmart, this coalition of community and religious leaders had defeated the global retailing behemoth.

After students have analyzed the case they will be able to (a) appreciate the importance of nonmarket factors to execute growth and market entry strategies, (b) understand how the decisions of political institutions depend on the issue context and the alignments of coalitions of interest, (c) formulate and assess strategies to overcome nonmarket barriers to entry.

Non-profit management and corporate strategy.

The case is appropriate for teaching undergraduate students, executive MBAs and graduate students. The case is useful for an overview of hospice and palliative care in the developed and developing world, and for class room discussions of external analysis of non-profit organizations' ecosystems, funding needs and industry analysis.

Hospice care in the developed parts of the world is well established but in most developing countries, there are no organized hospice care facilities. This case focuses on a charitable organization, Brthya – Add Value to Life (Brthya – AVTL), that established and operates hospice care in Chennai, India. The Indian context for hospice care, and the ecosystem needed to sustain ongoing operations, are described along with a summary of four different models of hospice care used in other parts of the world.

The case will help students to understand: what hospice care is and its various forms; management issues related to funding and operating hospice care in particular and a non-profit in general; ecosystems that make non-profits sustainable in emerging economies; and managing expansion and growth in non-profit organizations, in emerging economies and globally.

Teaching notes are available; please consult your librarian for access.

The learning outcomes of this study are to assess the shared value model and elaborate on new multi-stakeholder approaches to business, where the stakeholders include the founders, investors, partners, employees, clients and the surrounding community; to consider the synergies between community development, environmental stewardship, sustainable business practices and the long-term health of organisations and communities, considering these as the new fundamentals of business; to examine the interconnectedness of vision, strategy, purpose and leadership in creating and evolving the shared value model; to explore the relationship between shared value practices and collective well-being, and a specific reference to nurturing transformative experiences through nature, personal development and community upliftment is made; and to assess Grootbos’ ability to translate their purpose and value proposition into a strategy and sustainable vision with a possibility of Grootbos achieving global impact through its evolving model, beyond the founder.

This case study explores the evolution of Grootbos Private Nature Reserve and Foundation, a luxury hospitality lodge and award-winning ecotourism destination, from humble beginnings in the Western Cape of South Africa to a global example of conservation, community, commerce sustainability and transformative experiences. The establishing of Grootbos and its growth and widespread recognition can be attributed to the vision and inspirational leadership of its founder, Michael Lutzeyer. Although much success has been achieved in conservation, community upliftment and individual development of community members within their region, Lutzeyer’s and ultimately, Grootbos’ vision extended well beyond South Africa and aspired to elevate their floral kingdom and model of development and conservation to a global platform of awareness. Although a shared value vision and strategy had transformed the business, placing Grootbos as a leader in transforming their industry and sparking an evolution in the shared value model itself through the interjection of transformative experiences, the larger question remained: How can Grootbos extend the impact, towards people and planetary well-being, beyond the scope of their individual place-based business and their industry? And in terms of the dilemma Lutzeyer and the management team at Grootbos faced: How will this vision and global ambition continue through succession, beyond Luzeyer’s personal drive at the helm?

Experienced leaders within a graduate degree program, executive Master of Business Administration (MBA) or executive education in the areas of leadership development, strategy, shared value and international business.

Teaching notes are available for educators only.

CSS4: Environmental management.

Nina, a 30-year old Asian Indian female, joined Morris University in the fall 2006 semester after completing her doctorate. She was an instructor and course designer at this historical black institution in a rural town in the southern part of the US. Ninety percent of the students and staff of Morris University (MU) were African-American. MU was committed to the objective of educating African-American youth and the concept of “students first” was one of its core institutional values. Nina's experience teaching an organizational learning course was very unpleasant. Her student evaluations were poor with harsh comments about her and the course. Nina was asked by the department head to prepare a teaching improvement plan for herself.