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.

    ole-MoiYoi K, Talbot JR, Weintraub R. Roll-Out of Rapid Diagnostic Tests for Malaria in Swaziland. Harvard Business Publishing. 2012.Abstract

    After outlining the history of malaria in Swaziland, this focused case study examines the implementation of rapid diagnostic tests (RDTs) for malaria in Swaziland to improve case management and to strengthen the national malaria surveillance system as the National Malaria Control Program (NMCP) aims to implement a national elimination strategy. In addition to information on RDT selection, the case details Swaziland's quality assurance program-the first of its kind in the region, the public health benefits of the immediate disease notification system for active case detection, and Simon Kunene's leadership qualities as the manager of the NMCP for 24 years. The case addresses the necessary increases in financing and human resources to support the strategy and evaluates the impact of RDTs on the strategy. Challenges the NMCP faces in achieving malaria elimination include sustaining political will, interest, and financial commitments from donors and strengthening health workforce training and RDT procurement and distribution.

    Teaching Note available through Harvard Business Publishing.

    Milestones toward Malaria Elimination
    Milestones toward Malaria Elimination. Source: The Global Malaria Action Plan: For a malaria-free world. Roll Back Malaria Partnership, 2008. (Exhibit 4 from "Roll-Out of Rapid Diagnostic Tests for Malaria in Swaziland" case.

    Learning Objectives: To understand the role of diagnostics in a malaria elimination strategy, what it takes to effectively integrate a new diagnostic into care delivery, how leaders generate social and political capital over time, and the intricacies of managing a national disease program.

    Keywords: National strategy, supply chain management, diagnostic testing strategies, malaria eradication and control

    ole‐MoiYoi K, Rodriguez W. Building Local Capacity for Health Commodity Manufacturing: A to Z Textile Mills Ltd. Harvard Business Publishing. 2011.Abstract

    This case focuses on the establishment of the Olyset® Consortium—a public-private partnership that was created to facilitate the manufacture of long-lasting insecticidal bed nets to prevent malaria infection in sub-Saharan Africa—and A to Z Textile Mills (“A to Z”), the manufacturer of the nets in Arusha, Tanzania. The case examines how the public-private partnership was developed, its use of an incentive-based supply chain, A to Z’s business model and impact, and the sustainability of the venture. The case reveals that despite significant success in attaining objectives, the misaligned incentives of the many partners presented major obstacles to the overall sustainability of A to Z’s Olyset® production line.

    Teaching Note available through Harvard Business Publishing.

    Long Lasting Insecticide Nets and Olyset Production Process
    Long Lasting Insecticide Nets and Olyset Production Process. Source: A to Z Textile Mills Ltd., Arusha, Tanzania (Case Exhibit 9).

    Learning Objectives: To understand the potential for public-private partnerships to leverage innovation and scalability from the private sector and quality and equitable access from the public sector and to examine the costs and benefits of local manufacturing of technologically complex global health commodities in resource-limited settings.

    Keywords: Public-private partnerships, incentive-based supply chain, global health commodity manufacturing, malaria prevention