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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 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.

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, policy-making, sustainable development, post-Communism.

The case is designed to be used with undergraduate-level and MBA/MPA students. With undergraduate levels, the case can be used on the subject strategic management. In MBA/MPA programs, this case can be used in subjects such as strategic planning for public administration. Here, it can be stressed as being about the problems faced by a country on the long road toward democracy. Issues to be discussed in class include: environmental scanning, competitiveness, public policies and strategic agenda.

At the most general level, the case allows for the analysis and evaluation of the strategy and performance of the Albania from 1928 to 2014 along economic, political and social dimensions, using the techniques of country analysis (see Country Analysis Framework, HBS No. 389-080). Depending on time limitations and the particular objectives of the individual instructor, the case can be used to explore all phases of the nation's development or, alternatively, to focus on a specific era, such as Albania, in the way toward a free market economy. The case provides a setting in which to explore the diamond model as a tool for analyzing competitiveness and setting the economic policy agenda. In the Albania case, we highlight diamond analysis in an emerging economy. Albania also highlights the transition from a planned economy to a market economy, and the importance of a cross-border regional integration in competitiveness.

The case is written to serve a number of purposes: Understanding the problems and challenges to sustainable development, especially in a post-communist emerging economy like Albania. The transition/changes that all policymakers have to go through in their efforts for sustainable development of the country. To discuss production factors and the importance of a growth model based on the production factors.

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

It is January 2014, and the case protagonist, David Milestone (senior advisor at the Center for Accelerating Innovation and Impact at the U.S. Agency for International Development's Global Health Bureau), is preparing for a meeting of global stakeholders and pharmaceutical manufacturers who are interested in reducing mortality caused by childhood pneumonia and are prepared to donate $10 million to support this effort.

Milestone's goal is to propose a strategy to address childhood pneumonia in Uganda, toward which the $10 million donation would go. In addition to effectively and sustainably reducing childhood pneumonia deaths, the plan must align the interests of various stakeholders behind the problem. A successful strategy in Uganda could be a model for interventions elsewhere. The United Nations Commission on Lifesaving Commodities for Women and Children recently identified Uganda as a “pathfinder” country, meaning it could serve as the example for other countries wrestling with the same issues. This is a remarkable opportunity to change the lives of children in Uganda—and all around the world.

After reading and analyzing the case, students will be able to:

• Perform a stakeholder analysis

• Appreciate the challenges involved in improving public health, especially in developing countries

• Create a patient journey and use it to identify potential impact points

Perform a stakeholder analysis

Appreciate the challenges involved in improving public health, especially in developing countries

Create a patient journey and use it to identify potential impact points

This case will help students to understand the following: Develop a basic understanding of competency building processes. Learn about the mentoring process and its application in leadership development. Develop awareness about the methodology for assessment of the effectiveness of training.

Dr A. R. K. Pillai founded the Indian Leprosy Foundation in 1970 in response to the national call by late Mrs Indira Gandhi, prime minister of India, to the public-spirited people to take up leprosy eradication. It collaborated with international agencies to reduce leprosy drastically in India from four million, in 1982 to around a hundred thousand cases in 2006. In 2006, the Indian Leprosy Foundation was renamed as Indian Development Foundation (IDF) as the trustees decided to expand the work of IDF in the areas of health, children’s education and women’s empowerment. Dr Narayan Iyer, Chief Executive Officer (CEO) of IDF initiated a leadership development intervention called the Students’ leadership programme (SLP) for children in the age group of 12 to 14, from the urban poor households in 2014. It was a structured mentoring programme spanning over three months in collaboration with the schools. It aimed at incubating skills in the areas of leadership, teamwork, personality, behavioural traits and provided career guidance. It had a humble beginning in 2014 with a coverage of 50 students. Initially, IDF welcomed executives from the corporate sector as mentors. As there was a need to rapidly expand the scope of SLP to the other cities of India, IDF tied up with the graduate colleges and invited the students to be the mentors. The other objective behind this move was to create social awareness among the students from more affluent strata of society. IDF was able to dramatically increase the participation of the students through SLP by approximately up to 100,000 by 2020. However, rapid progress threw up multiple challenges. The teachers complained about the non-availability of the students for regular classes to teach the syllabus as the students were busy with SLP. The schools forced IDF to shorten the duration of SLP to two months. Also, many undergraduate mentors were unable to coach the participants due to lack of maturity and found wanting to strike a rapport with them. There was a shortage of corporate executives who volunteered for the mentoring, due to work pressures. Dr Narayan, CEO & National Coordinator and Ms Mallika Ramchandran, the project head of SLP at IDF, were worried about the desired impact of SLP on the participants and its sustainability due to these challenges. So, with the support of Dr Narayan, she initiated a detailed survey to assess the ground-level impact of SLP. The objective was to get clarity about what was working for SLP and what aspects needed to improve, to make the programme more effective. Overall feedback from the survey was very positive. The mothers had seen very positive changes in the participants’ behaviour post-SLP. The teachers had specific concerns about the effectiveness of undergraduate mentors. The need for a refresher course to inculcate ethical behaviour and the inadequacy of the two-month duration of the SLP to reinforce values were highlighted. Respondents also voiced the requirement to build responsible citizenship behaviours among the participants. Mallika was all for preparing a model to further enhance the effectiveness of SLP. Dr Narayan and Mallika embraced the challenge and they were raring to go to develop SLP as a cutting-edge leadership programme and to take it to new heights.

This case can be used in courses on human resource management in postgraduate and graduate management programmes. It can also be used in the general and development management courses and during executive education programmes to teach methodologies for evaluating the effectiveness of the training interventions, with emphasis on the voluntary sector.

Teaching notes are available for educators only.

CSS 6: Human Resource Management.

The case deals with project management principles that are required for implementing a social project in India.

The study has been carried out at primary schools in an underdeveloped state, namely, Odisha, in India.

The case illustrates a project management approach for improving primary education in a government set up. The bureaucracy set up in education in a state like Odisha, India, needs to undergo radical changes. To be effective, an education system requires an optimal integration of the three main components, namely, people, infrastructure (this includes technology) and pedagogical processes. Using a public–private partnership model, American India Foundation (AIF) through its Digital Equalizer (DE) Program has been able to make a positive impact in an underdeveloped tribal dominated district like Keonjhar. The case study also illustrates the detailed execution plan predicated on total system planning, required to achieve this amount of success. The case study also explains how to measure success through different metrics where intervention has to be at multiple levels. The learning from the case study can also be adopted for designing an implementation strategy in other states.

Expected learning outcomes are as follows: how to approach implementation of technology-based intervention with involvement of all stakeholders; learn project management techniques related to digital learning model implementation; understand the DE methodology; and understand the challenges faced while implementing the DE Program.

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.

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.

The learning outcomes are as follows: to understand the cultural and ethical dimensions revolving around the issue of female feticide; to apply the lens of institutional theory with respective change management measures; and to analyze and evaluate the impact of such intervention programs such as Beti Bachao Beti Padhao in the context of emerging economies such as India.

This case attempts to highlight the innovative and effective governance approach by the Government of Rajasthan (India) and, in particular, the State Health Assurance Agency to curb the menace of female feticide and the rising cases of abortion and sex determination in an attempt to favor a male child. The case concentrates on mainly three dimensions of Indian societal ecosystem, namely, the grave concern of preference of male child over female child leading to widespread cases of female feticide in different states in India with specific focus on the state of Rajasthan; the role of cultural dimension which primarily drives such preferential treatment in rural and urban areas in India; and the importance of using effective policy measures in monitoring various activities, introduction of incentive schemes to patients for preventing sex determination and promoting the birth of female child.

This case can be used as a teaching material in the Public Policy course – Social Welfare and Health Policy, Policy interventions, organization theory and change management at the Graduate/MBA level.

Teaching notes are available for educators only.

CSS 10: Public Sector Management.

This teaching case covers aspects of leadership development, strategy, change management, organisational behaviour, and people management. The case explores the following themes:

• Workplace transformation and culture: the challenges and opportunities of remote/hybrid work in large government enterprises and maintaining the culture when moving remote

• Leadership and change: the different perspectives that a leader can take into consideration when leading the business during turbulent and uncertain times and managing the change process in large organisations

• Strategic decision-making: the application of analytical skills by senior management when making strategic decisions in a business

Workplace transformation and culture: the challenges and opportunities of remote/hybrid work in large government enterprises and maintaining the culture when moving remote

Leadership and change: the different perspectives that a leader can take into consideration when leading the business during turbulent and uncertain times and managing the change process in large organisations

Strategic decision-making: the application of analytical skills by senior management when making strategic decisions in a business

The primary audience for this teaching case is management education programmes including: Master of Business Administration (MBA), Postgraduate Diploma (PGDip), specialist Masters in Management, and certain Executive Education programmes.

This case deals with a public-sector entity that collects taxation revenue for the South African government. In 2020, the operations of this public entity are severely affected by the Covid-19 pandemic. The mandatory shift of the workforce from in-office to a remote work-from-home set-up, results in the entity switching to a hybrid work model in order to achieve its goals as an essential service. Protagonist Dr Zanele Twazi, executive head of the public entity's research department, is tasked by the commissioner to conduct a review on the hybrid work model. As the commissioner is also in the process of reviving the organisational culture to regain public trust following multiple corruption scandals, the pandemic adds to this pressure. Dr Twazi must share employee feedback on the remote work option. Meanwhile, the leadership team has to decide if the work model will serve this public entity in achieving its strategy, and from an organisational culture viewpoint, if it is the best fit for the future.

The key learnings from this case include the following:

• Organisational work model: A suitable work model is dependent on the organisational mandate as well as its culture.

• Culture and organisational goals: An organisational work model additionally impacts the future sustainability of the organisation and its ability to achieve its short- and long-term goals.

• Change management framework: For teams to effectively adapt to a hybrid work model, managers have to be empowered to lead and be able to facilitate the change.

Organisational work model: A suitable work model is dependent on the organisational mandate as well as its culture.

Culture and organisational goals: An organisational work model additionally impacts the future sustainability of the organisation and its ability to achieve its short- and long-term goals.

Change management framework: For teams to effectively adapt to a hybrid work model, managers have to be empowered to lead and be able to facilitate the change.