Publications

    Arnquist S, Rosenberg J, Weintraub R. The Indus Hospital: Building Surgical Capacity in Pakistan (Condensed Version). The Lancet Commission on Global Surgery. 2015.Abstract

    Set in Karachi, Pakistan, this case examines a private hospital's potential to impact health in a resource-constrained setting. Within Pakistan's health care system and its political, socioeconomic, and epidemiological context, the case focuses on the Indus Hospital, a charity hospital started in 2007. The case explores the effect of financing, leadership, and a mission-driven culture on health care delivery and the hospital's efforts to provide high-quality care for free to poor patients. It concludes with Indus' leaders planning how to expand their service delivery to include primary and preventative care. This is a condensed version of the case The Indus Hospital: Delivering Free Health Care in Pakistan

    Teaching Note available through Harvard Business Publishing.

    Indus Hospital Open-Air TB Clinic
    Indus Hospital Open-Air TB Clinic. Pakistani architect Tariq Quaiser designed the Indus Hospital’s open-air TB clinic with a specialized design that optimized natural ventilation for increased airflow that effectively minimized the spread of disease. Source: Case writers.

    Learning Objectives: To understand a private hospital's potential to impact health in a resource-constrained setting, how private financing impacts health care delivery, and the impact of leadership on health care delivery.

    Supporting Content: This is a condensed version of the case The Indus Hospital: Delivering Free Health Care in Pakistan.

    Keywords: Human rights, workforce management, sustainability, role of civil society, information systems, organizational culture

    Chao T, Patel P, Rosenberg J, Riviello R. Surgery at AIC Kijabe Hospital in Rural Kenya (Condensed Version). The Lancet Commission on Global Surgery. 2015.Abstract

    This case traces the development of surgical and anesthesia services at a rural mission hospital in Kijabe, Kenya. After providing some background of the health system in Kenya, it follows the history of AIC Kijabe Hospital from its founding in 1915 to 2013. The hospital provided high quality surgical services that were supported by many long-term missionary staff members, updated operating theaters, an intensive care unit, and a robust surgical training program. The case describes how the mission of the hospital affects its culture of care provision. It follows the executive director, Mary Muchendu, and her process in turning a mission-focused hospital into a business-focused hospital. The case ends with Muchendu weighing the tradeoffs of providing sustainable growth versus caring for the poor. This is a condensed version of the case Surgery at AIC Kijabe Hospital in Rural Kenya

    Teaching Note available through Harvard Business Publishing.

    Postoperative recovery area
    Postoperative recovery area with wall oxygen, suction, and vital sign monitoring at AIC Kijabe Hospital Surgical Facilities. Source: Case Writers.

    Learning Objectives: This case documents the development of a robust surgical program at a mission hospital in rural Kenya, including human resource training and infrastructure improvement. A productive class discussion will allow students to appreciate the factors that allow high-quality surgical care to be delivered in a resource-limited setting; how a mission-driven culture affects a hospital, its sustainability, and the care it provides; what is required to provide high-quality surgical training; and the tensions and tradeoffs between sustainable growth and care for the poor.

    Supporting Content: This is a condensed version of the case Surgery at AIC Kijabe Hospital in Rural Kenya

    Keywords: Surgical disease, mission-based hospitals, rural surgery services, management, speciality training, global health care delivery, faith based organizations, human resources for health, anesthesia

    Chao T, Patel P, Rosenberg J, Riviello R. Surgery at AIC Kijabe Hospital in Rural Kenya. Harvard Business Publishing. 2015.Abstract

    This case traces the development of surgical and anesthesia services at a rural mission hospital in Kijabe, Kenya. After providing some background of the health system in Kenya, it follows the history of AIC Kijabe Hospital from its founding in 1915 to 2013. The hospital provided high quality surgical services that were supported by many long-term missionary staff members, updated operating theaters, an intensive care unit, and a robust surgical training program. The case describes how the mission of the hospital affects its culture of care provision. It follows the executive director, Mary Muchendu, and her process in turning a mission-focused hospital into a business-focused hospital. The case ends with Muchendu weighing the tradeoffs of providing sustainable growth versus caring for the poor.

    Teaching Note available through Harvard Business Publishing.

    Postoperative recovery area
    Postoperative recovery area with wall oxygen, suction, and vital sign monitoring at AIC Kijabe Hospital Surgical Facilities. Source: Case Writers.

    Learning Objectives: This case documents the development of a robust surgical program at a mission hospital in rural Kenya, including human resource training and infrastructure improvement. A productive class discussion will allow students to appreciate the factors that allow high-quality surgical care to be delivered in a resource-limited setting; how a mission-driven culture affects a hospital, its sustainability, and the care it provides; what is required to provide high-quality surgical training; and the tensions and tradeoffs between sustainable growth and care for the poor.

    Supporting Content: There is a shorter version of this case titled Surgery at AIC Kijabe Hospital in Rural Kenya (Condensed Version).

    Keywords: Surgical disease, mission-based hospitals, rural surgery services, management, speciality training, global health care delivery, faith based organizations, human resources for health, anesthesia

    Wachter K, Talbot JR, Weintraub R. Partners In Health in Neno District, Malawi. Harvard Business Publishing. 2013.Abstract

    Set in Neno District, Malawi from 2007–2012, the case focuses on the economic impact of investing in health care infrastructure. It examines management decisions that leaders of Abwenzi Pa Za Umoyo (APZU) and its founding organization—Partners In Health (PIH)—made as they supported the Government of Malawi in building a hospital and scaling up the delivery of APZU clinical and social programs across Neno district. The case highlights how a non-governmental organization can navigate the politics and local culture to improve Malawi’s health care system in close partnership with a strong, protocol-driven government. The case begins with Ophelia Dahl, co-founder and executive director of Partners In Health, reflecting on her December 2011 trip to Neno, nearly four years after her first visit. She observed signs of progress unrelated to health—bank branches had opened in town, a new road had been built, and the market had expanded dramatically. Ultimately, the case explores what this demonstrates about the value of her organization’s investments in health.

    Teaching Note available through Harvard Business Publishing.

    Neno rural hospital
    In the foreground: One-story original structures of Neno Rural Hospital used for outpatient and maternity services. In back: Two-story building constructed by APZU and partners used for inpatient wards, meetings, computer use, laboratory work, and government offices. Source: Keri Wachter, 2012.

    Learning Objectives: To understand the challenges of hiring and retaining local and expat staff, the complexity of an international NGO partnering with the government to improve health care, how leadership acumen and approaches impact scaling up and sustaining health care delivery, the relationship between the district hospital and the local economy, and how to assess impact beyond health measures.

    Keywords: Global health, social equality, project management, business and government relations, partnerships, strategy, economic development, health care policy, health care delivery, public health, human resource management, developing countries, innovation

    Arnquist S, Weintraub R. The Indus Hospital: Delivering Free Health Care in Pakistan. Harvard Business Publishing. 2012.Abstract

    Set in Karachi, Pakistan, this case examines a private hospital's potential to impact health in a resource-constrained setting. Within Pakistan's health care system and its political, socioeconomic, and epidemiological context, the case focuses on the Indus Hospital, a charity hospital started in 2007. The case explores the effect of financing, leadership, and a mission-driven culture on health care delivery and the hospital's efforts to provide high-quality care for free to poor patients. It concludes with Indus' leaders planning how to expand their service delivery to include primary and preventative care.

    Teaching Note available through Harvard Business Publishing.

    Indus Hospital Open-Air TB Clinic
    Indus Hospital Open-Air TB Clinic. Pakistani architect Tariq Quaiser designed the Indus Hospital’s open-air TB clinic with a specialized design that optimized natural ventilation for increased airflow that effectively minimized the spread of disease. Source: Case writers.

    Learning Objectives: To understand a private hospital's potential to impact health in a resource-constrained setting, how private financing impacts health care delivery, and the impact of leadership on health care delivery.

    Supporting Content: There is a shorter version of this case titled The Indus Hospital: Building Surgical Capacity in Pakistan (Condensed Version).

    Keywords: Human rights, workforce management, sustainability, role of civil society, information systems, organizational culture