Publications

    Rosenberg J, Dreisbach T, Donovan C, Weintraub R. Positive Outlier: Sri Lanka’s Health Outcomes over Time. Harvard Business Publishing. 2018.Abstract

    This case describes the development and structure of Sri Lanka’s health system, which has yielded health outcomes far superior to any of its South Asian neighbors. The case highlights factors supporting the health outcomes, including the availability of free health services to all citizens, government investment in the health workforce, and the care-seeking behavior of Sri Lankan citizens. After providing an overview of Sri Lanka’s history, geography, demographics, and economy, the case traces the evolution of the public sector health system from the precolonial era through the period of heavy investment in health from the 1930s through 1950s and on into the 21st century. The case describes the management of the system and the relationship between the national health ministry and provincial and local governments. It examines how health professionals are trained and deployed throughout the system, the supply chain, and financing. The case then examines the growing private health sector, its relationship with the public sector, and the role of innovation. After a summary of the country’s health outcomes, readers are pushed to think about what it will take to address the changing epidemiological burden to continue to boast exemplary health outcomes and provide quality health care to those who need it.

    ​​​​​​Teaching Note available to registered faculty through Harvard Business Publishing or the Case Centre.

    A productive class discussion will allow readers to appreciate the capabilities of a public payer system to improve the health of the population; the influence of the private sector in a “single payer system” and the downstream effects on demand and supply of services; the return on investment for a country offering free public medical and nursing education; and the relationship between literacy, demand generation, and health outcomes.

    Keywords: Universal health care, health care delivery, health system, health outcomes, social determinants of health.

    Rosenberg J, Donovan C, Madore A, Weintraub R. Working as an ASHA to Improve Maternal and Child Health in Uttar Pradesh, India. Harvard Business Publishing. 2018.Abstract

    Set in India’s most populous state, Uttar Pradesh, this case explores the complexity of addressing maternal and child health and care delivery by looking at health-related behaviors and decision making from the perspective of a frontline health worker. The case is intended to be used in conjunction with GHD-39N (Maternal and Child Health in Uttar Pradesh, India: A Mother’s Story) and GHD-040 (Improving Maternal and Child Health Outcomes in Uttar Pradesh, India).

    Teaching Note available through Harvard Business Publishing.Khairabad Community Health Center

    Learning Objectives: A productive class discussion will allow students to appreciate the decisions facing frontline providers and their beneficiaries, and the numerous factors that influence their choices; how households prioritize health among other needs; and the complexity of aligning health programs with beneficiary needs, cultural context, household dynamics, and other factors to impact health behaviors and outcomes.

    Keywords: public health, human resources, health care delivery, decision making, maternal and child health, behavioral economics, resource-limited settings, health care policy, data collection, performance management