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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.

Impact investing, Social entrepreneurship.

MBA, EMBA, Executive Education.

CareCross Health describes the impact due diligence leading up to an investment into CareCross Health by impact investor Palm Capital. The case follows the protagonist, Caitlin Stevens, CEO of Palm Capital, as she identifies CareCross Health as a potential investment target, performs an initial screening of the company and visits the company and its sites as part of an in-depth impact due diligence.

By the end of this case, the student should be able to consider the critical steps associated with conducting an impact due diligence; understand the challenges associated with conducting an impact due diligence, with a particular focus on due diligence in an emerging market scenario; analyse a potential impact investment, in this case CareCross Health, and make a preliminary recommendation on whether the investment is viable from an impact perspective; identify the trade-offs between private sector and public sector provision of services to low-income groups, and consider unintended consequences in analysing the impact of a social enterprise; and prepare possible scenarios and weigh the potential outcomes of various arrangements to ensure alignment of investor objectives.

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 1: Accounting and Finance.

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.

Teaching objective 1: Students are able to identify and apply characteristics of a social entrepreneur, and social enterprise, as defined by Dees (2001). Teaching objective 2: Students are able to identify and apply the four tensions identified by Smith, Gonin and Besharov (2013) that manifest in social enterprises. Teaching objective 3: Students are able to apply Institutional Theory to social entrepreneurship. Students are able to explain legitimacy and the influence of context on the social enterprise. Teaching objective 4: Students through using the Change Canvas, are able to distinguish between profit and purpose characteristics of the organisation; and are able to make recommendations based on the process they have followed.

Kovin Naidoo is the CEO Of a multi-national social enterprise, Australia-based The Brien Holden Institute. The case explores Naidoo's journey as a social entrepreneur, and the partnership forged with Brien Holden as they built their multinational social enterprise. Naidoo is catapulted to the position of CEO after the sudden death of his friend, and is trying to balance the competing pressures of profit and purpose. The case introduces the foundational characteristics of social entrepreneurship, before exploring Institutional Theory and the Change Canvas as a tool for managing tensions between profit and purpose.

This case study is aimed at students of entrepreneurship, social entrepreneurship, corporate social investment, development studies, innovative health-care systems, sustainable livelihoods and asset-based development. It is written at an Honours / Masters level and is therefore also appropriate for use in customised or short programmes.

Videos (including a TedX by Naidoo), Web materials and a book chapter are included in the supplementary materials list.

CSS 3: Entrepreneurship.

At the macro level, the case study enables the students to appreciate the complexity emerging market economies face in achieving economic development and environmental sustainability without comprising each other. The students understand the importance of behavioural change and empowerment of communities in projects dealing with transformational social changes. Theoretically, the students learn about the change mechanisms and organisational practices market-based organisations install to drive their positive social change (PSC) projects. At the micro level, students learn about the process of setting up Mangalajodi Ecotourism Trust (MET) – that not only enthused the local community economically but also instilled it with awareness and motivation towards sustaining its ecosystem. Analytically, at macro level, it assists the students to have a lens of PSC framework to examine corporate social responsibility, social entrepreneurship and BoP strategies of market-based organisations to affect social change. Application/problem solving: The case study explains to the students how the PSC levers of motivation, capability and opportunity structures were applied by NatWest Bank during different phases of project execution. As management grapples with new problems, the students are encouraged to use the levers to recommend an action plan. It allows students to apply SWOT and think of competitive strategies for MET. It allows students to think of strategies that may apply for a better management of Ecotourism at Mangalajodi.

As part of its broader commitment to sustainable development and climate change action, the NatWest Group (formerly Royal Bank of Scotland Group) launched its Supporting Enterprise Programme in India in the year 2007. The project aimed at creating income-generating opportunities for indigenous and economically vulnerable sections of society living in critical natural ecosystems. The project was under the leadership of N. Sunil Kumar, a zealous nature lover, with over two decades of experience in business strategy and public affairs and a specialty in environmental sustainability. He headed Sustainable Banking at NatWest and was head of NatWest Foundation-India. The Mangalajodi project shared the problems many of NatWest’s other projects in India presented. Poor communities that relied solely on natural resources for their sustenance slid deeper into poverty as ecosystems degraded. Lacking alternative sources of livelihood and facing scantier resources, the communities helplessly caused additional damage to weak ecosystems when they drew on the resources even more vigorously. Poaching of migratory birds for supplemental income was a huge problem at Mangalajodi; it was not only rapidly altering the ecosystem to sustain the birds but also deteriorating and weakening its ecology as a whole. Measures to eliminate poaching were failing in the absence of alternate means of livelihoods and a strong incentive to protect the birds. MET was established under the project in 2009. A decade later, it had become a resounding success. A community-owned and run enterprise, MET was providing direct employment to over 100 poorest families at the tiny village and creating income-generating opportunities and entrepreneurial ventures for many others. Poaching was practically negligible at Mangalajodi, and the community was drawing huge admiration for its role in conserving the ecosystem. However, the progress of Mangalajodi Ecotourism was paradoxical, on the one hand; its popularity was rising but, on the other hand, it was becoming overcrowded and looked ill managed. Its rising commercial value was bringing in more land developers, builders and investors, but permanent concrete structures were also coming up quite unscrupulously. There were many challenges – how should growth of ecotourism at Mangalajodi be managed? What mechanisms and practices ensured that the community was empowered enough to participate in decisions of land use, infrastructure, energy and waste management at Mangalajodi? How should MET become more competitive and innovative to grow despite future challenges?

The case study is useful for students of Management at Under Graduate and Post Graduate Levels for understanding the following: the sustainability of fragile ecosystems; the community at the intersection of sustainable development and natural resources conservation and protection of biodiversity; knowing in detail about the planning, implementation and management of ecotourism projects; and decisions regarding community-based ecotourism projects.

Teaching Notes are available for educators only.

CSS 7: Management Science

At midnight on Thursday, 26 March 2020, the South African government ordered a three-week lockdown in response to the COVID-19 pandemic and subsequently extended this lockdown for a further two weeks until the end of April 2020. Among other measures, businesses not classed as “essential” had to cease operation. This meant that Jonathan Robinson, founder of the Bean There Coffee Company had to close his trendy Cape Town and Milpark coffee shops, as well as the company’s hospitality and corporate business. At the same time, Bean There’s costs increased by 25%, as the rand: dollar exchange rate worsened substantially. A glimmer of hope was that the company was able to continue roasting coffee and supplying its retail clients. Unlike most captains of industry, Robinson was not driven by the bottom line and clamouring shareholders. His corporate strategy was driven by a single, simple purpose: to achieve ethical sustainability aspirations while still running a profitable business. The question for him now, however, was how to ensure that his company could survive in the short term, so that it could achieve these goals in the longer term, and whether he could take this opportunity to think about whether his business was best positioned to achieve these goals when things returned to normal.

The learning outcomes are as follows: conduct a thorough analysis of a specific company and its industry, including its markets, competitors, and other aspects of the internal and external business environment, using a range of tools, including a Business Model Canvas (BMC), SWOT analysis and PESTLE analysis; analyse and explain the market outlook of a company; identify and analyse a company’s competitors; discuss and explain a detailed implementation plan showing the way forward for a company, considering its current challenges, including integrating a range of conceptual and analytical fields of knowledge to assess a management dilemma, and arrive at a creative and innovative management solution; and be able to present information and defend substantial insights and solutions to a management dilemma in oral and written modes, appropriate in standard for both the academic and business communities to analyse and appreciate.

Postgraduate Diploma in Management, MBA, Masters in Management, Executive Education.

Teaching notes are available for educators only.

CSS 11: Strategy.

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.

1. Analyze the factors influencing the creation of a social enterprise, while appreciating the theoretical perspectives on social entrepreneurship and social innovations. 2. Analyze the impact of social enterprises on sustainable development. 3. Recognize the need for different types of strategies in the varied situation. 4. Analyze the business model.

Shashi Kumar, the CEO of Akshayakalpa Farms & Foods Pvt Ltd (Akshayakalpa), is determined to take the business to the next growth level. He has integrated technology to measure and monitor the quality of milk and to reach out to tech-savvy customers. Owing to the preservative-free and short life of milk, he believes that redesigning the marketing and distribution strategies is the only way to ensure the massive expansion and growth that will enable Akshayakalpa to reach out to customers directly and quickly. Another issue he was facing was a lag in receivables. Their receivables from vendors were delayed and held up because of issues related to product spoilage and returns. This has posed a liquidity challenge to Akshayakalpa. Amidst all these challenges, he wants to develop the best strategy to take the business forward to the next level.

This case can be used in undergraduate or postgraduate courses in Management, Social Entrepreneurship and Business Sustainability with special relevance to social enterprise creation, enterprise growth strategies, sustainable development, sustainable business models, etc.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

Recognize the interest groups of the business as stakeholders and shareholders. Understand the role of strategic corporate social responsibility (CSR) in attaining competitive advantage for the firm. Apply the techniques of financial statement analysis such as common-sized financial statements and ratio analysis. Analyze the overall financial position of the company such as its liquidity, solvency and profitability position. Evaluate the appropriateness of various CSR activities given the size of the company, its business model and financial position. Create a suitable CSR policy draft incorporating the critical elements of a CSR policy that enables the firm to operationalize it and fulfill the disclosure norms.

The management of Ball Industry Limited (BIL) had overlooked the mandatory requirement of CSR policy formulation. The company had not yet spent anything on CSR since the regulation had come into force. The company’s financial position was not healthy. Still, it fell under the regulatory clause as a borderline case and must spend 2% of its average three years’ profit on CSR activities. The company had previously ignored the requirement of formally drafting a CSR policy and deciding about the actions it might want to carry out. Now that the regulator had started sending show-cause notices to several companies who had not yet begun CSR, BIL was under immense time pressure to draft its CSR policy and initiate the relevant CSR activities. Emily, the chief operating officer of BIL, was assigned the task of preparing the blueprint of the CSR policy of the company and made it available for discussion in the upcoming meeting. The task at hand was to formulate a sound CSR policy under the constrained financial state considering its strategic planning, including the SWOT analysis, competitive environment and the overall general market and economic conditions. She submitted that rather than a vanilla CSR activity, strategic CSR would support the firm to differentiate itself from competitors. She was struggling to formulate a CSR strategy that could achieve both economic and social goals.

The case will be most suitable for use in undergraduate and graduate courses.

Teaching notes are available for educators only.

CSS 1: Accounting and finance.

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.