Publications

    Rosenberg J, Cole C, May M, Weintraub R. Voluntary Medical Male Circumcision in Nyanza Province, Kenya (Condensed Version). The Lancet Commission on Global Surgery. 2015.Abstract

    This case traces the development of the voluntary medical male circumcision (VMMC) campaign in Nyanza Province, Kenya as it transformed from the subject of a randomized clinical trial into national policy. After providing some background on the cultural, political, and scientific context surrounding male circumcision, the case traces the PEPFAR-funded implementers' advances in delivering male circumcision in Nyanza. It examines the various delivery models used in Nyanza and the evolution of the relationship between implementers as well as on the development of the national strategic plan for VMMC released in 2009. The case ends with the implementers having come together successfully for two rapid, aggressive, 30-day implementation campaigns and the head of Kenya's National AIDS and Sexually Transmitted Infections Control Programme wrestling with how to make such campaigns sustainable and what lessons from the campaign to pass on to the national program. This is a condensed version of the case Voluntary Medical Male Circumcision in Nyanza Province, Kenya.

    Teaching Note available through Harvard Business Publishing.

    Mobile Service Delivery Model
    (A) Group counseling on male circumcision; (B) mobile circumcision counseling site; and (C) circumcision being conducted in tented delivery site. Source: Nyanza Reproductive Health Society.

    Learning Objectives: To understand how a randomized controlled trial may be translated into a large-scale public health program; how a surgical campaign was designed and implemented for rapid impact; the role of national and international collaboration in large-scale health delivery; and the ethical tradeoffs that arise in large-scale public health programs.

    Supporting Content: This is a condensed version of the case Voluntary Medical Male Circumcision in Nyanza Province, Kenya.

    Keywords: Project management, AIDS, policy, supply and demand, partnerships, strategy, innovation

    Talbot JR, Bohrer M, Rhatigan J. Iran’s Triangular Clinic. Harvard Business Publishing. 2011.Abstract

    This case traces the development and implementation of Iran’s Triangular Clinic, an innovative health care delivery program, from its beginning as a site for counseling HIV-infected individuals to an integrated facility offering comprehensive HIV, sexually transmitted disease (STD), and drug addiction treatment, care, and support. The case examines the need for such services among the marginalized population that the first clinic served within the historical, political, economic, and health context of Iran and, specifically, in Kermanshah province, where the project begins. The case raises the question of how the clinic model might be integrated into primary health care and replicated throughout the country as part of the Iranian Ministry of Health’s Integrated Health Program.

    Teaching Note available through Harvard Business Publishing.

    Triangular clinic model
    Triangular clinic model. Source: World Health Organization and Regional Office for the Eastern Mediterranean, Best Practice in HIV/AIDS Prevention and Care for Drug Abusers: The Triangular Clinic in Kermanshah, Islamic Republic of Iran 2004, WHO: Cairo.

    Learning Objectives: To examine how health care delivery organizations can configure their services to deliver high value health care to the populations they serve and to understand methods to engage marginalized populations in order to increase their access to and demand for health services.

    Supporting Content: The sequel to this case is titled Scaling up Iran's Triangular Clinic.

    Keywords: Marginalized populations, comprehensive HIV prevention, harm reduction

     

    Kleinman S, Talbot JR, Harris J, Ellner A. The AIDS Support Organization (TASO) of Uganda. Harvard Business Publishing. 2011.Abstract

    This case traces the development of The AIDS Support Organization (TASO), a Ugandan non-governmental organization, from 2001 to 2006. One of the first organizations to become involved in HIV/AIDS in the late 1980s, TASO began as a meeting place for people infected and affected by HIV/AIDS, helping people to live positively. The organization provided free counselling, social support, limited medical care, community mobilizing, advocacy and networking. TASO worked alongside government facilities and trained government medical personnel in HIV counselling. After many years, TASO got a new director who brought management skills, a commitment to professionalizing the organization, and a drive to expand services. TASO began incorporating antiretroviral therapy (ART) into its offerings. The ART delivery model combined home and clinic-based care in order to maximize patient adherence. The case follows the development of the organization and scale up of services and raises the question of how to deliver care most cost effectively while maintaining its values and meeting the changing needs of the population and clients.

    Teaching Note available through Harvard Business Publishing.

    Training health workers to care for HIV/AIDS patients in Uganda. Credit: Sarah Kleinman; TASO
    Training health workers to care for HIV/AIDS patients in Uganda. Credit: Sarah Kleinman; TASO

    Learning Objectives: Students should learn how a healthcare delivery organization can expand and evolve over time in response to changes in external context and the needs of its clients; how public and private organizations can coordinate to meet the varied needs of a population; and the importance of leadership, management, and strategic vision in creating successful global health programs.

    Keywords: Service expansion, Home- and clinic-based care, HIV prevention and treatment.