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LifeBank is primarily focused on tackling the challenge of maternal mortality in Nigeria and other African countries by providing women access to blood, thereby tackling the challenge of gender inequality. The company employed both men and women at its workplace providing equal opportunities for men and women.

Discuss how women entrepreneurs are solving social problems in developing countries using technology and innovation.

Analyze the challenges faced by women entrepreneurs in getting the right human capital, raising funds and managing growth for their social business.

The case discusses how social entrepreneur Temie Giwa-Tubosun (Temie) founded LifeBank, a medical distribution company, to provide access to blood, medical oxygen and vaccines to hospitals in Nigeria. The company used technology to provide information to health providers about which blood bank stored the blood type they needed and delivered it quickly and safely to help save lives.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

This case, developed from a wide variety of publicly available information, presents ethical and economic issues arising from the development, marketing, and pricing of a biotech drug. Genentech developed TPA, the first genetically engineered drug that could be used in clot-dissolving therapy for heart attack, and marketed it as Activase. Public outrage focused on the disparity between the drug's $10 direct manufacturing cost and what Genentech charged for its drug. Activase/TPA was priced at $2200 a dose, raising immediate concerns about its affordability and therefore availability to those who needed it. Additional issues arise from other events, including concern over related-party relationships between the company and organizations which researched and recommended TPA, as well as aggressive marketing of TPA to physicians and the company's refusal to participate in an international drug study to compare TPA with competitor drugs.

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 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.

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.

This case is best taught in a first-year MBA finance course and with a series of cases based on cash flow analysis. Its primary objective is to portray the major differences in project analysis for nonprofit organizations compared to for-profit companies and to highlight the unique issues relevant in a health care environment. Students must decide, based on cash flow analysis and nonfinancial factors, whether or not to propose a long-term acute care hospital (LTAC) project to the board of directors of the U. Va. Health System. Students must use the assumptions outlined in the case to create a cash flow analysis and then compute a net present value (NPV) calculation and internal rate of return (IRR) for the project. After assessing the base-case results and sensitivity analysis of the assumptions driving those results, students must decide if the project should be taken to the board of directors.

It was mid-March 2014, and GE's John F. Welch Technology Centre in Bangalore, India was brimming with activity. GE had developed an advanced, scalable positron emission tomography-computed tomography (PET/CT) scanner as part of its global Healthymagination initiative to provide better healthcare for more people at a lower cost. Munesh Makhija, Managing Director, GE India Technology Centre and Chief Technology Officer (CTO), GE South Asia, was thumbing through a report prepared by the PET/CT product development team and GE's healthcare market research team. In another office, Suresh Kumar R.(Kumar), General Manager of the Essential PET Segment, was putting the finishing touches on a presentation outlining a commercialisation strategy for the new PET/CT product, Discovery IQ (Exhibit 1).

Discovery IQ was a revolutionary product that would be useful for staging, treatment planning and post-treatment planning assessment. Early reviews from nuclear physicians had been positive. However, the product was still too costly for the bottom of the pyramid (BoP) market. Kumar and his team were scheduled to meet with Makhija the following morning to discuss a “go-to-market strategy”. Kumar knew that Makhija would want to talk about their segmentation strategy and the underlying needs of various customer types. He also expected Makhija to focus on return on investment (ROI) projections because diagnostic centres in India first looked at various financial return measures before investing in any new equipment. Kumar wanted to present a commercialisation strategy for Discovery IQ, which required a significant commitment of resources to tackle supply and distribution challenges across tier II and tier III cities^a in India.

This case tackles the diaper industry in a developing country and can be applied to three different undergraduate or graduate level courses, including Marketing Management, Strategic Management, and Operations and Supply Chain Management. The case describes the industry, the manufacturing process, along with detailed information about Novatis Group's business and functions and the overall improving economic environment in Morocco.

The Novatis Group case has several objectives that can be applied to three different courses within undergraduate and graduate studies including Marketing Management, Strategic Management, and Operations and Supply Chain Management.

The case focuses on Novatis Group, a diaper manufacturing company located in Morocco which competes against multinational companies (MNCs) such as Procter and Gamble and Kimberly Clark in order to satisfy the rising diaper needs of the country. Morocco is a developing country that is strengthening its manufacturing industries. The rising economic conditions have given way to a growing middle class and an increased demand for disposable baby diapers. Novatis uses two distribution channels for the diapers: the multi-tiered distribution channel and the streamlined (straight to retailer) channel. Novatis Group is producing diapers at full capacity; still demand has exceeded supply.

Students will understand the business processes in a developing country and how a small, local company can compete against large MNCs.

Teaching notes are available, please consult your Librarian to access.

Entrepreneurship.

The case has been used at Master's level but it has direct application to any MBA programme or entrepreneurship module.

Adrian Gore started Discovery in 1992 with seed-funding of R10 million from merchant banking group, Rand Merchant Bank (RMB), as a health insurance company within the RMB stable. By 2009, Discovery had become a large, listed, financial services institution employing more than 5,000 people and comprising not only Discovery Health (DH), but also Discovery Life (DL), Discovery Invest (DI) and Discovery Vitality (a wellness programme). In addition, it had operations in the USA, where it licensed Vitality for use by employers and other health insurers, and in the UK where it operated two joint ventures with The Prudential plc – Pruhealth and Prulife.

To understand the similarities and differences between corporate and start-up entrepreneurship; to understand the entrepreneurial process within an established organization; to explore the environment within an established company in terms of how much it supports or constrains entrepreneurship; and to look at creative ways to overcome obstacles to entrepreneurship in established companies.

Teaching notes.

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.