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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.

Describes Myriad Genetics and its struggle to develop a genetic testing service while facing challenges from competitors and activist organizations. After Myriad's discovery of the BRCA gene, capable of genetic testing for breast cancer in women, Myriad needed to choose a strategy to provide this service to the public. With several major competitors offering similar services, intense media scrutiny, and a charged activist and political climate, a poor Myriad decision could have major repercussions.

The case and supporting teaching note were developed through the use of secondary sources such as company documents and archives, news articles and academic publications.

Jane Fraser, Citigroup CEO and the first woman to lead a major Wall Street bank, found herself at a crossroads. Weeks prior to the company’s 2022 annual shareholder meeting, Citigroup announced it would provide reproductive health-care benefits to employees traveling out of state for an abortion. Prompted by legal developments that hinted at the potential for a widespread ban on abortions, the announcement resulted in threats from Republican lawmakers to change course or suffer financial consequences. Through the case, students explore the role of business and corporate leadership in response to controversial political issues, including the potential opportunities and threats.

The case is best-suited for management or other business students at the undergraduate or graduate/MBA level. The learning objectives of the case would fit well within any of the following courses: Corporate Social Responsibility (CSR)/Business and Society; Business Ethics and Decision-Making; and Strategic Management. Instructors should position the case after students have been introduced to the topic of corporate social responsibility, ethical decision-making and/or CEO activism.

By the end of their studies, students are expected to: undergraduate level. Learning objective 1: Describe the concept of social entrepreneurship. Learning objective 2: Explain the sources and challenges of funding social entrepreneurial activities. Learning objective 3: Discuss the different strategies that social entrepreneurs may use to raise funds. Postgraduate level. Learning Objective 1: Use theory to explain the concept of social entrepreneurship. Learning objective 2: Discuss the role of social capital in facilitating resource acquisition for social entrepreneurial activities. Learning objective 3: Evaluate the current action for fundamental change and development (AFFCAD) funding model and propose strategies that may be used by a social enterprise to achieve financial sustainability when donor funding expires.

The past decade has seen the emergence of many social enterprises from disadvantaged communities in low-income countries, seeking to provide solutions to social problems, which in developed countries would normally be addressed by government sponsored welfare programmes. The social entrepreneurs behind such initiatives are typically drawn from the disadvantaged communities they serve. They are often young people committed to improving the lives of their most disadvantaged community members. Being poor themselves and located in the poorest communities, establishing their enterprise faces fundamental challenges of obtaining resources and if accessed, sustaining the flow of resources to continue and grow their enterprise. Targeting external donors and mobilizing social resources within their community is a typical route to get their enterprise off the ground, but sustaining momentum when donor funding ceases requires changes of strategy and management. How are young social entrepreneurs dealing with these challenges? The case focusses on AFFCAD, a social enterprise founded by Mohammed Kisirisa and his three friends to support poor people in Bwaise, the largest slum in Kampala city. It illustrates how, like many other similar social enterprise teams, the AFFCAD team struggled to establish itself and its continuing difficulties in trying to financially sustain its activities. The case demonstrates how the youngsters mobilised social networks and collective action to gain access to donor funding and how they are modifying this strategy as donor funding expires. From an academic perspective, a positive theory of social entrepreneurship (Santos, 2012) is applied to create an understanding of the concept of social entrepreneurship. The case uses the social capital theory to demonstrate the role played by social ties in enabling social entrepreneurs to access financial and non-financial support in a resource scarce context (Bourdieu, 1983; Coleman, 1988, 1990). The National Council for Voluntary Organisations Income Spectrum is used as a tool to develop the options available for the AFFCAD team to sustain their activities in the absence of donor support. The case provides evidence that social entrepreneurs are not limited by an initial lack of resources especially if they create productive relationships at multiple levels in the communities where they work. However, their continued success depends on the ability to reinvent themselves by identifying ways to generate revenue to achieve their social goals.

This case study is aimed at Bachelor of Entrepreneurship students, MBA, MSc. Entrepreneurship and Masters of Social Innovation students.

Teaching Notes are available for educators only.

CSS 3: Entrepreneurship.

Students should be able to appreciate the exigencies of managing social enterprises in a largely profit-oriented economic domain; understand the interplay of choice and trade-offs in business management and be equipped to make optimal choices; and appraise new, creative and profit-making approaches for sustaining social enterprise.

Daniel Mensah and his team were to deliberate on options available for ensuring financial sustainability of HealthKeepers Network (HKN), a not-for-profit organization focused on community health and grassroots capacity development. As the economy of Ghana moved towards middle-income status, funding from global organizations had begun to decline. To ensure HKN’s continuity, Mensah needed to re-engineer HKN’s finances and consider options available for ensuring cash inflows to support the organization’s operations. Each of the available options involved specific setbacks or challenges for HKN to overcome to achieve financial sustainability. Mensah and his team were to engage in a brainstorming session analyse the available options and map the way forward for HKN.

This case is suitable for undergraduate and graduate-level programmes in business management.

Teaching Notes are available for educators only.

CSS 3: Entrepreneurship.

Bottom of the Pyramid (BOP); social innovation and business modeling.

Undergraduate and graduate level management/business school students. It can be taught in marketing management and entrepreneurship/innovation courses.

LifeSpring Hospitals Pvt. Ltd is an expanding chain of hospitals that provide high quality health care to lower-income women and children across Andhra Pradesh. It is a 50-50 equity partnership between Hindustan Latex Ltd and the Acumen Fund. LifeSpring has demonstrated exceptional management principles, some of them being the most innovative and attractive ones. The entire focus of LifeSpring is on one particular niche: maternal care. Some argue about its strategy of not adopting diversification, but LifeSpring has proved its point by actually turning out to be a profitable business. The strategy of focusing on one niche has led to reduction in cost in terms of specialized doctors and the range of equipment needed to serve. Adding to the strategic strength of LifeSpring, its operations (management) is perfectly aligned with the organization's vision and quality is achieved via highly standardized procedures for maternal care service.

This case will cover two important aspects of BOP and social innovation. MBA students will investigate an innovative business model and apply their analytical skills to analyse the sustainability of the model.

Teaching notes and exercise for class-based discussion.

The subject areas are strategy, general management, health-care management, change management and inclusive growth model and application of technology to manage health care.

The case can be used to teach challenges in managing change in a health-care facility.

Tata Memorial Centre (TMC) is dedicated to provide best health-care services in the field of cancer cure. TMC established its credentials for service, education and research, which contributed to it being rated among the ten best hospitals year on year. Starting from humble moorings, TMC has grown to an institution of high repute from an 80-bed hospital to a 700-bed hospital. TMC held a number of pioneering efforts, which included bone marrow transplantation, external beam radiotherapy (linear accelerator), tumor tissue bank and bio-imaging to name a few. The management team of TMC had ensured that the growth had been orderly and appropriate to the changing needs of the community. Managing a hospital with disparate skill sets in the face of ever-increasing demand for services had always been a challenge in itself. As a government-run facility and well funded by the trust, TMC offered excellent services and post-operative care to the patients. So, it became imperative for the hospital to adopt technology to improve its hospital services and maintain transparency. Patients came to the hospital from different states in India and across the globe. TMC registered international and national patients online. Online medical reports were checked before the patients visited the hospital. TMC has developed an e-system that will allow patients around the world to send their tissue samples that are suspected to be cancerous for medical advice to the hospital. This case study is developed to provide insights into the transformation of TMC into an e-health-care service and explains the process of change management.

They are to provide insights into the challenges in health-care management, to illustrate the challenges faced by organization in implementing information and communication technology- managing change and to bring about best practices in the case organization and find solutions to the following questions: What are challenges faced by health-care officials in providing health care using new technological innovations? How can hospitals equip themselves with new technology? With the advent of improved and modern communication methods, medical practices and cases are more easily shared. Cases are discussed, recorded and, in many cases, put up for general public viewing through the electronic media. How can hospitals manage change? How can hospital administrators manage speed of delivery, quality healthcare, innovation and brand image?

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:11 Strategy.

A pitch deck for Girlythings has been provided as a supplementary material for this case. Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes

In the light of the case and the accompanying case questions, the students should understand the following: socio-cultural perspectives in adopting the use of taboo products in an emerging economy and a conservative society such as Pakistan; role of government and non-governmental agencies in influencing policy framework; the application of the theory of planned behavior in channeling positive attitudes toward the use of personal hygiene products; peculiarities of formulating an expansion strategy for entrepreneurial ventures; and idiosyncrasies of developing effective business pitches.

Founded in early 2018, Girlythings was a young startup spearheaded by Tanzila Khan. It aimed at not only improving the availability of sanitary products in the emerging Pakistan market but, over and above, also removing the stigma attached to the topic of menstruation in the society. While the startup was still nestled at an incubation center, the protagonist faced the utmost challenge of deciding the fate of the venture due to the taboo nature of the product. This case is a rich description of the stigma that prevails on the topic of women health in conservative societies like Pakistan. It will help students appreciate the idiosyncrasies of operating in emerging markets and spearheading ventures that deal with sensitive issues.

This case is geared toward undergraduate students enrolled in courses of strategy, strategic marketing and entrepreneurship.

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 3: Entrepreneurship

India's diagnostics business valued at USD 10 billion was growing at 20% annually. Several players with different business models competed. Dr. Lal PathLabs, the world's largest histopathology centre led with a menu of 3,500 tests, 1,600 collection centres and 7,000 pick-up points. Its Initial Public Offer had been oversubscribed 33.41 times and the team at Dr. Lal PathLabs was excited about expanding its international footprint. Two overseas companies were incorporated in Netherlands and Nepal. Yet, there were enormous unmet needs in India alongside potential for public-private partnerships. Trade-offs over portfolio choice and regional versus international footprint needed thinking through.

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.