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

    Park P, Bhatt A, Rhatigan J. The Academic Model for the Prevention and Treatment of HIV/AIDS. Harvard Business Publishing. 2011.Abstract

    This case traces the development of the Academic Model for the Prevention and Treatment of HIV/AIDS (AMPATH), and its founding organization, the Indiana University – Moi University (IU-MU) Partnership in Eldoret, Kenya. The case opens with a discussion of AMPATH’s new Home-Based Counseling and Testing Program (HCT) and its prospects for improving HIV care in Western Kenya. After providing some background on the general political, economic, and health situation in Kenya, it follows the development of the IU-MU Partnership from 1990 to 2000, its subsequent entry into HIV care services through AMPATH in 2001, and AMPATH’s rapid growth to become the largest provider of HIV services in Kenya. It then describes the organizational and operational characteristics of AMPATH and concludes with the organization wrestling with the opportunities and operational challenges that HCT presents.

    Teaching Note available through Harvard Business Publishing.

    AMPATH Center in Eldoret, Kenya
    AMPATH Center in Eldoret, Kenya. Source: Case writer. (Exhibit 12 in "The Academic Model for the Prevention and Treatment of HIV/AIDS " case.)

    Learning Objectives: To understand the development and design of a large scale HIV care program in a resource-limited setting and to examine how HIV treatment programs can effectively configure their services to provide maximum value to the populations they serve.

    Keywords: Service expansion, the role of academic medical centers, HIV treatment and prevention, home-based counseling and treatment