Madore A, Rosenberg J, Dreisbach T, Weintraub R. Positive Outlier: Health Outcomes in Kerala, India over Time. Harvard Business Publishing. 2018.Abstract

    This case explores how Kerala, India developed a reputation for exemplary health outcomes despite low per capita income. After providing historical background, including the social, political, and health system factors that contributed to a culture of seeking health care, the case describes Kerala’s health system and outcomes. The case describes how the fiscal decline in the latter half of the 20th century led to decreased spending on public services, including health, creating an opening for private-sector providers to meet a growing share of the demand for health services and the impact on out-of-pocket health spending. Readers must think about how emerging health threats such as noncommunicable diseases should be addressed in the 21st century, including the health department’s response and a new initiative to increase capacity in the public health sector, including efforts to improve the quality and reliability of health data through an electronic medical record system. The case concludes with Additional Chief Secretary for Health and Family Welfare Rajeev Sadanandan wondering if the new strategy will succeed and if Kerala can maintain its status as a positive outlier in health for the decades to come.

    Teaching Note available for registered faculty through Harvard Business Publishing and the Case Centre.

    Learning Objectives: to appreciate the relationships between education, literacy, and health; what the components of a health system are; the limitations of health indicators as measures of a national health system’s effectiveness; and, the challenges of sustaining demand and maintaining the supply and quality of public health services over time.

    Key words: health care policy, universal health care, demand generation, health care delivery, health system, health outcomes, social determinants of health

    Sue K, Rosenberg J, Weintraub R. Addressing Tanzania’s Health Workforce Crisis Through a Public-Private Partnership: The Case of TTCIH. Harvard Business Publishing. 2016.Abstract

    Set in rural Tanzania, this case traces the founding and development of the Tanzanian Training Centre for International Health (TTCIH) from the early 2000s through 2015. It begins with an overview of the political, socioeconomic, and epidemiological context of Tanzania, followed by a detailed description of the human resource for health crisis in Tanzania and the landscape of available health care training programs. The case then explores the origins and evolution of TTCIH, launched through a unique collaboration between private industry, a public health institute, local stakeholders and educators, and the Tanzanian Ministry of Health and Social Welfare. It describes the evolution of TTCIH as leaders strive to make it self-sustaining and responsive to Tanzania’s health workforce crisis. The case highlights the challenges of successfully integrating corporate management practices and values into a global health program and the role of strategic leadership to sustain TTCIH.

    Teaching Note available through Harvard Business Publishing.

    TTCIH Income and Number of Students, 2005–2013
    TTCIH Income and Number of Students, 2005–2013

    Learning Objectives: A productive class discussion will allow students to appreciate the challenges of designing sustainable, high-quality health training institutions in low-resource settings; the training and resources needed to support task shifting and to address health workforce shortages in health care delivery; and, the importance of maintaining a sound strategy for medical education programs in the midst of changing national health needs and the evolving medical education landscape.

    Keywords: Global health, public health, health care delivery, education, government, value creation, Human Resources for Health, health care, nongovernmental organizations, Public-Private partnerships, learning, revenue growth, organizational effectiveness


    Sullivan E, ole-MoiYoi K, Weintraub R. Concept Note: The Global Fund to Fight AIDS, Tuberculosis and Malaria. Harvard Business Publishing. 2012.Abstract

    This concept note explains the history, management, structure, financing, and strategy of the Global Fund to Fight Aids, Tuberculosis and Malaria-a public-private partnership and international financing institution created to attract and disburse resources to prevent and treat HIV and AIDS, tuberculosis, and malaria. The note also provides some insight to its impact on grantees. Because the Global Fund plays an important role for many of the organizations featured in the Cases in Global Health Delivery Series, this note will be useful background reading for students engaging in those cases.

    Global Fund–Supported Program Results

    Global Fund–Supported Program Results. Source: Making a Difference, Global Fund 2011 Results Report. (Exhibit 3 from "Concept Note: The Global Fund to Fight AIDS, Tuberculosis and Malaria.")

    Learning Objectives: To understand the structure, management, and role of the Global Fund to Fight AIDS, Tuberculosis and Malaria as an international financing institution.

    Keywords: Structure, financing, tuberculosis and malaria, history, Global Fund to Fight Aids, strategy, management