Center for Diabetes, Endocrinology, and Cardio-Metabolism (CDEM – Sri Lanka)

This is WDI’s first project with CDEM, the only standalone diabetes clinic in Sri Lanka. The long-term plan is to expand CDEM services across Sri Lanka by integrating  satellite locations providing diabetes care in peri-urban/rural areas to CDEM, which is located in Colombo. The first step is considering different models.  

A 2018 WDI MAP team in Ghana.

Carrie Boyle, a MBA student at Michigan’s Ross School of Business, hopes to work in philanthropy somewhere in the U.S. after graduation. But for a couple of weeks in March, she is excited to be traveling to India as part of the school’s annual Multidisciplinary Action Projects (MAP).

“Working in another country is something I may never get the chance to do again,” she said. “This will be my first time in India and the country really interests me.”

Boyle and her teammates will work with Michigan Academy for the Development of Entrepreneurs (MADE), a nonprofit institute established at Ross by the Zell Lurie Institute for Entrepreneurial Studies, in partnership with WDI and Aparajitha Foundations. MADE works with entrepreneurship development organizations in India to help entrepreneurs operating small- and medium-sized enterprises (SMEs) succeed.

Boyle said she had some criteria when looking for MAPs that interested her.

“I wanted an opportunity to be on the ground having meaningful conversations with the people most immediately impacted by SMEs,” she said. “SMEs employ so many people and impact so many lives.”  

Her teammate Shoko Wadano said she too is interested in working with SMEs, “which are very common in India.”

“I’m interested in how businesses mature in India,” she said. “I want to learn what pressures and impacts SMEs have in common, and what kind of value we can bring to them.”

WDI is sponsoring the MADE MAP project along with 10 others this year. MAP is an action-based learning course in which MBA students receive guidance from faculty advisors from WDI and Ross. Each project requires analytical rigor, critical thinking and teamwork. (Find out more about WDI’s MAP projects over the years here.)

After learning about their projects and conducting secondary research for several weeks, the student teams spend two to four weeks working with their organizations in the field.

David Butz

David Butz

“The complementarities between the talents our students bring and what our sponsors need are sublime,” said David Butz, a WDI senior research fellow in the Healthcare sector who is an advisor on two projects. “Our students experience impact in brand new ways. Our sponsors learn, too, how disciplined management methods can yield dramatic innovations.”

Butz said he enjoys working with the student teams on MAP because it “poses such a unique challenge for both the students and their sponsor organizations, and forces us all to think big.”

For me, the best achievements are tangible, direct and narrow but at the same time big and high-impact,” he said. “In our short time, can we help to break some key bottleneck, expedite a critical process pathway or otherwise liberate resources and expand capacity? Is the innovation scalable or replicable elsewhere? Do the students and organizations thereby feel empowered?”

Here is a summary of each WDI-sponsored MAP project:

Aravind Eye Care System – India

MAP Team: Rohan Dash, Sid Mahajan, Aman Rangan, Nik Royce

Aravind Eye Care System (AECS) is a vast network of hospitals, clinics, community outreach efforts, factories, and research and training institutes in south India that has treated more than 32 million patients and has performed 4 million surgeries since its 1976 founding.

AECS opened a tertiary eye care center in Chennai in September 2017 that will ultimately serve more patients than any other facility in the AECS system. The MAP team will formulate a detailed three-year strategic plan for Aravind Eye Hospital in Chennai.

CURE International, Inc. – Kenya, Ethiopia, Zambia, Uganda

MAP Team: Dominique James, Sarah Raney, Hannah Viertel, Olga Vilner Gor

CURE operates clubfoot clinics in 17 countries around the world, each tasked with helping children and families deal with the congenital deformity that twists the foot, making it difficult or impossible to walk.

For CURE, the student team will develop a strategic evaluation framework to assess opportunities for market entry and expansion building on global data.

Ghana Emergency Medicine Collaborative – Ghana

MAP Team: Benjamin Desmond, Benjamin Quam, Nicholas Springmann, Vishnu Suresh

The Ghana Emergency Medicine Collaborative aims to improve emergency medical care in Ghana through innovative and sustainable training programs for physician, nursing and medical students. The goal of the training programs is to increase the number of qualified emergency health care workers retained over time in areas where they are most needed.

The MBA team will formulate a detailed strategy to implement interoperable digital payment systems in Ghanian hospital emergency departments.

India Investment Fund – India

The India Investment Fund is working to become the first international, student-run fund at the Ross School of Business. Ross MBA students would be responsible for investing, managing and growing a real investment portfolio.  

MAP Team: Charlie Manzoni, Patrick Riley, Queenie Shan, Sheetal Singh

The student team will conduct due diligence on Indian small- and medium-sized enterprises to assess viability for investments, and an appropriate financing instrument.

Infra Group – Ethiopia

MAP Team: Rin Chou, Chandler Greene, Yuki Ito, Brittany Minor

Infra Group is diversified international group with business units in financial services, industries and infrastructure development. Infra Group helps build a more prosperous society through global-scale business development with integrity as its top priority.

The MAP team will conduct due diligence on a group of small- and medium-sized enterprises (SMEs), and recommend which ones to invest in and what amount to invest.

Lviv Business School & Ukranian Catholic University – Ukraine

MAP Team: Blake Cao, Emily Fletcher, Kelsey Pace, Adam Sitts

Lviv Business School and Ukranian Catholic University is a private educational and research institution in western Ukraine.

The student team will undertake a needs assessment of the small- and medium-sized enterprises (SMEs) to determine if Lviv Business School should begin offering consulting services to these SMEs and if so, how those should be structured.

MADE – Poornatha/Aparajitha Foundations – India

MAP Team: Carrie Boyle, Lawrence Chen, Dillon Cory, Shoko Wadano

Michigan Academy for the Development of Entrepreneurs (MADE) is a nonprofit institute established at the Ross School of Business by the Zell Lurie Institute for Entrepreneurial Studies, in partnership with WDI and Aparajitha Foundations. MADE works with entrepreneurship development organizations in developing countries to give individuals operating businesses in these environments the knowledge and best practices they need to thrive.

The MAP team will develop an expansion plan for MADE in the southern Indian state of Tamil Nadu.

The Ihangane Project – Rwanda

MAP Team: Lauren Baum, Nadia Kapper, Paul Mancheski, Jason Yu

The Ihangane Project (TIP) empowers local communities to develop sustainable, effective, and patient-centered health care delivery systems that holistically respond to the needs of vulnerable populations. Partnering with Ruli District Hospital and its associated health centers, TIP is working to identify key strategies for improving health outcomes.

The student team will develop a business model to grow the ready-to-use therapeutic food that is used to treat severe, acute malnutrition.

WEEKEND MBA MAP PROJECTS

Awash Bank – Ethiopia

MAP Team: Matthew Campbell, Joshua Dodson, Joseph McCarty, Aman Suri

Awash Bank, a private, commercial bank, was established in 1995 and features more than 375 branches across the country.

The MAP team will develop a product that can provide capital to small- and medium-sized enterprises (SMEs) in Ethiopia by utilizing remittances already being sent back to that country. The students will work with the bank on all aspects of the loan product. They also will give the bank recommendations on how to monitor the loan and provide business support to SMEs that borrow from the fund.

Grace Care Center – Sri Lanka

MAP Team: Daniel Cady, Yizhou Jiang, Gerardo Martinez, Daniel Murray

The Grace Care Center (GCC) is a home to about 70 orphaned children that offers daycare services and vocational training. It also is home to several poor and displaced seniors, many of whom have chronic health issues such as hypertension and diabetes.

Past MAP student teams from the Ross School of Business developed a diabetic care center model for GCC. This year’s student team will examine the current model and make any needed updates and revisions.

International Clinical Labs – Ethiopia

MAP Team: Emily Mascarenas, Torre Palermino, Alexander Santini, Matthew Traitses

ICL was established in 2004 to provide quality laboratory service all over Ethiopia. ICL serves more than 240 health care centers throughout the country, and is expanding its service throughout Ethiopia.

The Ethiopian government is building its first medical waste incinerator facility outside the capital city of Addis Ababa and has committed to building seven more around the country. WDI is assisting a group of business managers with business plan advice who are interested in managing the business aspects of operating the incinerators. The MAP team will develop a proposal to be presented to the government later this year for the business managers to operate the incinerators.

 

 

WDI has been working with Grace Care Center for the past five years on a model for providing diabetes care in Sri Lanka. All of this work is feeding into developing a financially viable business model for diabetes care that involves reducing the burden on doctors.  This year we are beginning to look at a hub and spoke model that capitalizes a successful diabetes center operating in Colombo.

BA685 students working with Ethio-American Doctors Group (EADG) in Ethiopia interview a physician.

Qin Dong said the healthcare delivery course she took this semester taught her a lot about practices inside and outside the United States, including how healthcare organizations harnessed different business models to scale up and meet patient needs.But the biggest lesson for Dong from the weeks of classroom learning and in-country work came down to empathizing with the customer.

“My takeaway is probably true for every consulting-like project: don’t make assumptions about what is best for the customers, listen to them, and cater to their needs,” she said. “Any recommendations that don’t fit with a customer’s situation won’t be helpful at all regardless how successful it was in the past.”

Dong’s Rwanda team was one of five that spread out around the globe for the BA685: Healthcare Delivery in Emerging Markets course taught by WDI President Paul Clyde. Other teams worked in Ethiopia, India, Peru and Sri Lanka. All five teams will present recaps of their projects at 5 p.m. on April 16 in Room R1240 at the University of Michigan’s Ross School of Business. It is free and open to the public, and students in business, public health and other disciplines are encouraged to attend. A reception will follow.

Comprised mostly of MBA2 students, the course is designed to enhance participants’ international leadership capabilities, increase awareness of diverse business issues within the current global landscape, provide on-the-ground experience in a foreign country, and contribute to the success of partner health clinics and hospitals.

The course, organized and primarily funded by WDI with some financial support from Ross, responds to the increasing need for managers to have an international business perspective to augment their business and management knowledge. During the first part of the term, students learned about healthcare in emerging markets through lectures, guest speakers and case discussions. Students were then divided into five teams and prepared for visits to their selected country, traveling to those destinations in late February and early March.

The travel-study course empowers students to integrate what they learned in the classroom with hands-on experience. But unlike the Ross School Multidisciplinary Action Projects (MAP), Dong said the healthcare delivery course “exposes us to an environment where sponsors and other stakeholders have little business knowledge and no clear expectations about the projects.

“This can increase the difficulty and scope of the projects. However, it mimics real-life situations for the most part,” she said.

Clyde said the course is “business education at its best” – a collaborative learning environment with faculty and students learning from each other in an action-based learning setting.

“This course allows me to have detailed conversations with the students about some of the newer approaches to healthcare in low- and middle-income countries, and then gives them the chance to experience some of those markets in person and develop some of these new methods in concert with the institution,” Clyde said. “No matter how much I discuss it in class, there is no way to convey all of the challenges and opportunities in these markets without having the students actually visit the locations.”

Jennie Proto Gondhi, who was part of the Sri Lanka team, said she was attracted to the class to learn about the business perspective of healthcare and how business models can help solve public health problems. In pursuing a dual master’s in public health in epidemiology as well as health education/health behavior, Proto Gondhi said her classes dig deeply into evidence-based programs and validating data.

“However, I think sometimes a missing piece to public health problem solving is the idea that revenue, marketing and market value keeps programming going,” Proto Gondhi said.

She said the course showed her how valuable it is for people with public health and business skill sets to work in tandem to make a program successful.

“I enjoyed working and deliberating with teammates with varied expertise,” she said. “As we get ready to prepare our final reports and presentations, I walk away with the idea that public health programming can only be enhanced with further collaboration.”

Ross MBA student Kevin Jones, who worked with his team in Peru, called the course “probably the best interdisciplinary experience I’ve had at U-M.

“It integrates communities from the business, public health, policy and medical schools who have different but relevant perspectives on how to approach problems,” he said.

The Peru team worked with the Peruvian American Medical Society, a first-time partner for the course. The other institutions – Ethio-American Doctors Group (Ethiopia), LiveWell (India), Ruli District Hospital (Rwanda) and Grace Care Center (Sri Lanka) – have participated in the course multiple times, which allows Ross and WDI to build deep relationships and trust. Repeat partners also provides WDI with insights on what has and hasn’t worked with each institution, and that information is brought to bear in each project.

 

Here is a summary of each partner and project.

 

TEAM: Ethio-American Doctors Group (EADG)

LOCATION: Addis Ababa, Ethiopia

BACKGROUND: The Ethio-American Doctors Group is comprised of over 250 U.S. physicians of Ethiopian descent who have committed time and money to establish a state-of-the-art tertiary care hospital in Addis Ababa, Ethiopia.

PROJECT FOCUS: Develop a business model for a program to train nurses to international standards.  

 

TEAM: Grace Care Center (GCC)

LOCATION: Trincomalee & Colombo, Sri Lanka

BACKGROUND: There is an extreme shortage of physicians in Sri Lanka and the number of people needing diabetes treatment is growing, making the shortage more acute. A GCC project looks into adding a  new category of healthcare providers – diabetes technicians – to address the need.

PROJECT FOCUS: Assess the viability of a diabetic technician training program and undertake a market analysis to develop an understanding of the potential demand for such skills from existing physicians.

 

TEAM: LiveWell

LOCATION: Hyderabad, India

BACKGROUND: LiveWell Rehab Center in Madurai, India has been in operation since 2011. In October 2017, LiveWell began operations in Hyderabad.   

PROJECT FOCUS: Examine the internal processes of the Hyderabad center compared to the Madurai facility to look for improvements.

 

TEAM: Peruvian American Medical Society (PAMS)

LOCATION: Chincha, Peru

BACKGROUND: PAMS Policlinico is a clinic offering multiple services, but is looking to become a center of excellence in ophthalmic surgery and gastroenterology.

PROJECT FOCUS: Conduct a market analysis to assess the profitability of a center of excellence in ophthalmic surgery and gastroenterology.

 

TEAM: Ruli District Hospital

LOCATION: Ruli, Rwanda

BACKGROUND: Ruli District Hospital, about two hours from Kigali, has worked with WDI for seven years and many of the projects are seeing fruit now.

PROJECT FOCUS: Study the revenue generating opportunities of a private clinic within the hospital.

 

2015 WDI summer intern Julio Villasenor poses with some Rwandan children. This summer, WDI continues its long partnership with The Ihangane Project at Ruli District Hospital in Rwanda by sending summer intern Nana Asare there for a project. 

2015 WDI summer intern Julio Villasenor poses with some Rwandan children. This summer, WDI continues its long partnership with The Ihangane Project at Ruli District Hospital in Rwanda by sending summer intern Nana Asare there for a project.


Six University of Michigan students representing four schools and colleges will spend the summer abroad working as WDI Global Impact Fellows, tasked with formulating a strategic plan, streamlining supply chains, evaluating program impacts, empowering entrepreneurship, developing financial models, and creating a new business model.

The students represent the Ross School of Business, the Ford School of Public Policy, the School of Natural Resources and Environment (SNRE), and Health Informatics, a joint program of the School of Information and the School of Public Health. They will work in Ethiopia, Ghana, India, Kenya, Mexico, Rwanda, and Sri Lanka, and support the work of WDI initiatives in Healthcare, Performance Measurement, and Scaling Impact.  

Five of the six summer internship projects were developed by WDI along with its partners. Two organizations – Grace Care Center and the Ihangane Project – are longtime partners with WDI and have sponsored student projects, both internships and Multidisciplinary Action Projects (MAPs), for several years. The work done by the summer interns at these organizations is building on previous projects performed by MAP teams, students in a travel-study course and previous interns all sponsored by WDI.

WDI also supports graduate students who source their own internship projects based on their educational, personal, and career interests provided that the work fall within one of the Institute’s research focus areas. One intern this year, Julia Entwistle, worked with the leadership at ADHENO, a non-profit focused on extreme poverty in Ethiopia, to define the scope of work for her project, then submitted a proposal to WDI for funding.

Entwistle has worked with WDI’s Performance Measurement Initiative (PMI) as she prepares to evaluate the impact of ADHENO’s environmental restoration and economic empowerment programs that operate in the Northern Shewa province of Ethiopia. PMI provided multiple rounds of feedback on the survey Entwistle has developed to conduct the impact assessment this summer.

“PMI hopes that the project will lead to new measurement-related learnings, especially related to environmental metrics and assessment,” said Heather Esper, senior program manager of the initiative. “PMI also is hopeful this work may lead to possible future collaborations with the organizations involved, including SNRE faculty.”

Here are the interns and their projects:

 

Nana Asare

Ford School of Public Policy

The Ihangane Project (TIP)

Ruli, Rwanda

The Ihangane Project (TIP) empowers local communities to develop sustainable, effective, and patient-centered health care delivery systems that holistically respond to the needs of vulnerable populations. Partnering with Ruli District Hospital and its associated health centers, TIP is working to identify key strategies for improving health outcomes.

Since 2009, TIP has worked with WDI and the Ross School of Business to find ways to improve Ruli’s communication flow, cost-effectiveness, and financial sustainability. In winter 2016, Ross students worked with Ruli and TIP to develop a problem-solving framework designed to encourage hospital staff to proactively address challenges at the hospital. The students also created a curriculum and agenda for presenting this framework to staff members during a hospital retreat. That summer, a WDI summer intern helped Ruli and TIP successfully conduct the retreat.  

Ruli has now turned its attention to formulating a strategic plan that reflects the priorities of the hospital and community, while also addressing the requirements of the Rwanda Ministry of Health. This past winter, Ross students created a framework for a  hospital staff to use in developing a strategic plan during a retreat.

Asare will support the hospital staff to ensure a successful summer retreat. He also will help implement recommendations developed at the retreat, create a roadmap that can build upon the strategic plan developed at the retreat that will guide future projects, and evaluate the effectiveness of the retreat.

 

Karen Cuenca

Ford School of Public Policy

Value for Women, Ltd.

Mexico City, Mexico

Value for Women (VFW) is a UK-based social enterprise operating in Latin America, Africa, and Asia that works with partners to improve gender and social inclusion. Their specialists provide tailored technical assistance and capacity-building expertise to impact investors, banks, multinational companies, and NGOs, to deepen the inclusion dimension of their business models, value chains, programs, and products and services.

With supply chains in the agriculture sector increasingly under strain, the inclusion of women is critical, and smallholder farmer associations and small- and medium-sized enterprises (SMEs) have an opportunity to strengthen their role as suppliers to corporate entities.

Cuenca will conduct a situational analysis to understand and assess the current position of women in agriculture supply chains in Mexico, and recommend opportunities for improving gender inclusion in agriculture organizations and supply chains in Mexico.

 

Ann Duong

Health Informatics

Becton, Dickinson and Company (BD)

Nairobi, Kenya and Addis Ababa, Ethiopia  

iSPIRT

Bangalore, India

Becton, Dickinson and Company (BD) is a global medical technology company working to improve medical discovery, diagnostics, and the delivery of care. BD actively engages with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to improve overall laboratory systems and services in African countries severely affected by HIV/AIDS and TB. This initiative is a public-private partnership with the U.S. Centers for Disease Control and the Ministries of Health in Ethiopia, Kenya, Mozambique, and Uganda.

Through both field-based and domestic work, Duong will be supporting implementation of the technical impact evaluation of the BD-PEPFAR program, Labs For Life: Strengthening Laboratory Systems in Developing Countries.

Following this project, Duong will travel to Bangalore, India for a short project with iSPIRT, a software product think tank that has been working with numerous start-ups in the development of IndiaStack. IndiaStack is an exciting set of technologies governments, businesses, and others utilize a digital infrastructure, creating a paperless and cashless service delivery model that is being integrated into India’s economy.

Duong will work with iSPIRT to connect and study various companies and start-ups that are utilizing IndiaStack’s APIs. After returning to Michigan, she will analyze this information in order to generate key insights into how stack technology can be used to enhance healthcare access and delivery.

 

Julia Entwistle

School of Natural Resources and Environment

ADHENO

Addis Ababa and Debre Berhan, Ethiopia

ADHENO implements various environmental restoration programs such as tree planting to slow the desertification process, soil protection measures such as terracing, and improving agricultural resilience through irrigation, water conservation, and crop diversification, to combat environmental degradation that negatively impacts agricultural productivity and revenue in Ethiopia. The organization also operates economic empowerment projects to support microenterprises such as beekeeping, animal rearing, basket weaving, and traditional spice processing to diversify the economy and include women in the workforce.

Entwistle will conduct an impact evaluation of ADHENO’s environmental restoration and economic empowerment programs that operate in the Northern Shewa province of Ethiopia. The organization wants a comprehensive evaluation of its work before rolling out the programs to more rural sub-districts in Ethiopia.

 

Danielle Wilkins

School of Natural Resources and Environment

Grace Care Center

Trincomalee, Sri Lanka

The Grace Care Center (GCC) is a home to about 70 orphaned children that offers daycare services and vocational training. It also is home to several poor and displaced seniors, many of whom have chronic health issues such as hypertension and diabetes.

Based on past work by MBA student teams from the Ross School of Business, GCC developed a diabetic care center model.  Trained para professionals acquire data relevant to diabetes, which are sent to the University of Michigan to be tabulated and analyzed to segregate patients into risk categories. The medical data from 100 diabetes patients have been monitored and analyzed for the past five months.

A long-term, sustainable economic model needs to be developed and then subjected to a pilot test to ensure that the model has taken into account all the parameters. The end goal is a successful economic model that could be replicated in other parts of the country.

Wilkins will build upon the past work of her fellow U-M students to identify and develop a pricing strategy, build an economic model (subscription vs. government funded), and set up the pilot to test the chosen model.

 

Tim Yuan

Ross School of Business

Department of Mechanical Engineering, University of Michigan

Kumasi, Ghana

One of the applied projects in the Department of Mechanical Engineering’s lab is a solar e-trailer in collaboration with Pratt and Miller Engineering. The overarching goal is to demonstrate that transportation services enabled by affordable, low-speed, solar-powered electric vehicles (EVs) can improve the quality of life of the residents in the villages in Africa and the other developing countries. In 2016, a working prototype of a solar bicycle e-trailer was developed along with a preliminary business model.

Yuan will develop a market-entry strategy for the integrated transportation, electricity charging, and usage data collection services provided by solar bicycle e-Trailers (or similar small-sized solar EVs). He also will build a sustainable business model for manufacturing, distributing, and leasing such vehicles in villages and cities in Ghana.

 

 

The Grace Care Center (GCC) is an orphanage and elder care center located in Trincomalee, Sri Lanka. A group of physicians in Ann Arbor, Michigan have been using telemedicine to monitor vital health statistics for the elders who reside at the facility. By regularly tracking health metrics, the physician team can identify those elders who need further attention by a local physician.

The physician group sought to expand GCC’s current healthcare delivery system in order to monitor and treat diabetes within the Trincomalee community. A student team, from the University of Michigan’s Ross School International Business Immersion course (BA685), was engaged to develop the new healthcare delivery model. They developed the plan by collecting information about Trincomalee’s current patient and provider landscape, evaluating various pricing models, and leveraging these findings to develop a financially viable and self-sustaining service model.

Derek Johnson, director for development and sustainability for the U.S.-based nonprofit charity CURE that operates 10 hospitals in developing countries, recently spoke to students enrolled in the Ross School of Business travel-study course on healthcare delivery in emerging markets.

Derek Johnson, right, with a patient at a CURE hospital.

Students in the class spent the first part of the semester learning about the topic through case discussions, lectures, and guest speakers such as Johnson. The class then split into five groups and traveled to India, Rwanda, Sri Lanka and Ethiopia to work on business and health projects with local partners.

WDI President Paul Clyde teaches the course, which is comprised of mostly Ross MBA students.

While on campus, Johnson spoke with NextBillion Health Care Editor Kyle Poplin who wrote about the organization and its work. Additionally, Johnson recorded a short video interview with NextBillion, an initiative of WDI, which appears at the end of Poplin’s article.

Johnson’s presentation to the travel-study class also was recorded.

Photo courtesy of CURE.

Mel Melaku Negussie, chief operating officer and general counsel of the Ethio-American Doctors Group (EADG), jumped at the chance to partner again with U-M students participating in a travel-study course on healthcare delivery in emerging markets.

A 2014 travel-study student team at Peredo Community Hospital in Haiti.

He was very pleased with the student team’s work last year, saying one of the things he liked most is that they were on the ground in the country collecting data “as opposed to gathering information from publications.”

“All of this led to high-quality business consulting service last year that was extremely cost effective,” he said. “Since our first engagement, we have validated the quality of the work produced by the team to be equal, if not superior, to top-tier consulting firms.”

BA685: International Business Immersion, which is mostly comprised of MBA2 students, is designed to enhance participants’ international leadership capabilities, increase awareness of diverse business issues on the current global landscape, provide on-the-ground experience in a foreign country, and contribute to the success of partner health clinics and hospitals. The course responds to the increasing need for managers to have an international business perspective to augment their business and management knowledge.

During the first part of the term, students learned about healthcare in emerging markets through lectures, guest speakers and case discussions. Students were then divided into five teams and they prepared for visits to their selected country. They traveled there in late February and early March.

WDI President Paul Clyde teaches the course, which is organized and mostly funded by the Ross School of Business. WDI and the International Institute at U-M also provide financial support.

The EADG, a coalition of more than 250 U.S. doctors of Ethiopian descent who want to establish a state-of-the-art tertiary care hospital in the capital city of Addis Ababa, is one of four partners who collaborated with students for last year’s course. The others are Ruli District Hospital in Rwanda, Grace Care Center in Sri Lanka, and SughaVazhvu in India. Only Unicorpus Health Foundation in India is new this year.

In addition, Ruli, EADG, and Grace Care Center have partnered with WDI on several summer internships and/or Multidisciplinary Action Projects in past years. Being involved with the same organizations year after year in different ways allows WDI to “be more of a partner as the projects continue to grow,” Clyde said.

“We’re developing deep relationships, building trust,” he said. “We have continuity, and the partners know that we will continue to work with them.  Further, we know what has worked in the past with other partners and what has not worked. So we bring that knowledge to bear in each project.”

Here’s an overview of the course’s projects:

Ethio-American Doctors Group – Addis Ababa, Ethiopia
The main focus of the project is to assess major equipment needed for the proposed hospital, and determine how much it would cost to maintain and repair these items. The student team will try to determine the total cost for each piece of major equipment, develop an assessment of total utilization and, where relevant, make a recommendation on what to purchase. The team also will make a recommendation on lab services and whether to outsource them.

 

Unicorpus Health Foundation – Hyderabad, India
A core group of eight clinicians (including a pediatric cardiologist, a neurosurgeon, a pediatric dentist and a senior nurse practitioner for geriatric care) have established a private, not-for-profit organization that will provide healthcare to the elderly in Hyderabad, India. It will target those who can’t afford the more expensive for-profit hospitals but are willing to pay something instead of using the government system. The student project will focus on a business plan for a self-sustaining rehabilitation center in Hyderabad, a city of 8 million. Hyderabad has several advanced tertiary care hospitals but there are very few rehabilitation centers, and those that do exist are very expensive. The current plan is to set up a 20-bed facility as a stopgap measure between hospital and home.

 

SughaVazhvu Clinics – Thanjavur, India
SughaVazhvu Healthcare implements innovative health systems strategies in expanding access to primary care services to underserved populations in rural Thanjavur, in the state of Tamil Nadu, India. In India, chronic diseases are increasing and pose an additional challenge for rural populations due to the added economic burden. SughaVazhvu’s data show that at least 12 percent of its patients suffer from diabetes, hypertension and hyperlipidemia. The challenge is ensuring treatment adherence among patients, which is critical to prevent terminal complications and associated economic distress. Therefore, SughaVazhvu launched a pre-payment model for chronic disease management for diabetes, hypertension and hyperlipidemia accessible through a mobile clinic. Enrolled patients are offered medication, diagnostic check-ups and consultations with a physician (including lifestyle counseling). The students will put together financial reports to give an idea of sustainability at different volumes, based on a subscription model where patients pay up front to enroll in the service for three, six, nine or 12 months.

Ruli District Hospital – Ruli, Rwanda
Over the past five years, Ross teams have worked on projects for Ruli District Hospital, responding to specific requests from hospital leadership at the time of the project. Some recommendations have been implemented; others have not. After reflecting on this, the hospital leadership believes that one of the reasons some haven’t been implemented is that the staff doesn’t see the need or doesn’t understand how the project recommendations relate to Ruli Hospital’s overall mission. This project is designed to take a step back and lay the groundwork for a staff retreat that will be held in March. The team will interview as many staff members as possible, conduct focus groups, and contact some staff at clinics to gain an understanding of the main challenges that the staff sees in accomplishing the hospital’s mission. The team will then synthesize the findings into topics to be addressed at the retreat. The team also will recommend the best way to conduct the retreat given the constraints at the hospital.

Grace Care Center – Trincomalee, Sri Lanka
Grace Care Center is developing a healthcare delivery model that will reach the poorest parts of the Sri Lankan community it serves. It is a community-based system that regularly tracks certain health metrics and flags those who need further attention by a local physician. The students will develop a subscription model in which patients pay a monthly fee for regular monitoring and, when necessary, specified care by a physician. This can build on some of the work done at Sugha Vazhvu in Tamil Nadu, India, but also utilize the data collection methods under development in Sri Lanka. Specifically, the project will: identify different customer groups based on willingness to pay; develop a way to offer clinically identical but otherwise differentiated services to allow a cross subsidization model to work; and develop financials based on revenue generated through this model and an estimate of costs.

For Erica Dancik, a dual master’s degree student at Michigan Ross and the U-M School of Public Health (SPH), and Tajesi Patel, an SPH master’s degree student, signing up for the course was a no-brainer.

“As a dual degree student focusing on global health and business, there couldn’t possibly be a more perfect course for me,” Dancik said.

Patel said the Ross course gives students a project-based experience working with healthcare providers in-country in addition to discussion of cases that explore innovative solutions in the space.

“There is no other course that I know of that combines theory and practice quite so much on this topic, so I jumped at the chance to take it,” Patel said.

Dancik, who will go to Sri Lanka, and Patel, who will work with Unicorpus in India, are excited to employ some of the things they’ve learned in the classroom, work in a team environment and experience a different country and culture.

“First and foremost, I am hoping to learn about chronic disease management in Sri Lanka and then use that knowledge, in combination with the skills and strengths of my teammates, to answer some of the challenging questions that have been posed by our client,” said Dancik, who will work after graduation with a company focused on chronic kidney disease.

“This project offers me a learning opportunity that I can carry with me as I leave Ross and start in my new position,” she said.

Patel said her team project would allow her to augment her public health background with some business side knowledge.

“I do not expect to be able to get a full MBA’s worth of knowledge from one course, but I would like to walk away from this class with more comfort and skill thinking through the more financial and practical issues of healthcare delivery in these settings,” she said.

She said she is excited to work on the Unicorpus project, which is in its infancy, and looking forward to meeting with healthcare providers, administrators and patients to get a better feel for the local landscape of this type of healthcare.

“There are just so many local nuances that no amount of background research or phone conversations can compare to,” she said, “so actually being on the ground and talking with these people will be invaluable to us in terms of working toward an end result that truly serves the needs and interests of the community.”

For more than a decade, VeAhavta has sponsored the Grace Care Center (GCC) in Trincomalee, Sri Lanka. Grace is a home for about seventy needy children and destitute seniors, and offers day care services and vocational training. Grace aims to help overcome poverty one child at a time by providing the sense of home and family that had been lost to war and disaster. The student MAP team developed a business plan for an eatery and guest rooms at the Grace Care Center which is situated on seven acres of beach front property. The new facilities will provide employment opportunities for the young women of the orphanage.

USAID awarded WDI a contract to carry out a Management, Team Building and Leadership workshop for its mission in Colombo, Sri Lanka. The workshop built stronger team relationships by improving team building and project planning activities; established a common, coordinated vocabulary and approach for Team Building and Project Management throughout the mission; and energized the mission management and staff with key insights into how their activities and a positive work culture can harmonize and impact relationships in accomplishing their Mission.

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