The Ethio-American Doctors Group (EADG), a cohort of 250 physicians, is building a state-of-art hospital in Addis Ababa, Ethiopia. The hospital is expected to consist of 300 hospital beds, 8 operating rooms, and an 80-room multi-specialty clinic. A team was engaged to identify best practices for governance, and highlight aspects that would be most suitable for the overall EADG entity to operate with its current/future partners efficiently in Addis Ababa, Ethiopia. Specific research objectives included recommendations for EADG within the following areas: (1) Overview of authorities, rights and responsibilities; (2) Partner relations; (3) Cultural management; (4) Operations and evaluation; (5) Financial management
From WDI’s “Designing Global Health Supply Chains for the Future” report.
Across the Global South, the coming decades will likely bring rapid urbanization, changing demographics, increased non-communicable disease burden, and a rising threat of pandemics. All of these factors will place unique strains and increased demand on emerging market health systems and their supply chains.
A new WDI report, “Designing Global Health Supply Chains for the Future,” proposes a series of initiatives that governments, global development agencies, and those in the private sector should undertake immediately in order to build supply chain capacity to anticipate these increasing demands in the coming decades. (Read the full report here.)
The report, funded by the Bill & Melinda Gates Foundation (Gates Foundation), was written by WDI Research Fellow Maeve Magner and former WDI Senior Fellow Prashant Yadav.
“Important shifts taking place in the economic environment, as well as new supply chain technology and business models, represent a watershed moment in supply chains for health products,” said Yadav, who recently joined the Gates Foundation as a Strategy Leader-Supply Chains. “Unless we pay close attention to these, we risk losing some significant opportunities for supply chain improvement.”
To research and write the report, Magner and Yadav reviewed the future trends reports of various think tanks, institutions, and logistics companies. They also gathered the opinions of experts from numerous industries, including pharmaceutical, consumer packaged goods, high-tech electronics, and logistics. The two then analyzed the implications of these trends and opinions for global health supply chain actors.
From this research, the authors identified six forces that have the greatest likelihood of impacting global health supply chains in 2030 and beyond. They are: economic growth; shifting disease burden; urbanization; increased patient-centric care; proliferation of data; and, the rapid pace of innovation.
Given these upcoming challenges, the authors posed questions that governments, development partners, and private actors should be asking today, which will enable them to make relevant and timely investments to build and strengthen supply chains of the future.
“We identify questions that organizations in this space should be asking now,” Yadav said. “While we don’t always know what the right answers are, just the process of asking these questions and reflecting on them will help organizations become better in their supply chain design and operation.”
By anticipating and preparing for likely future scenarios, Yadav and Magner reason, those leaders charged with managing their health system’s supply chain can more efficiently recognize and adapt to changing conditions.
Since 1999, WDI has been working to improve healthcare in low- and middle-income countries. A critical focus of this work has been shaping the global discussion on the future of the supply chains that deliver medicines and health commodities to patients, thereby improving their access to quality healthcare.
WDI has worked with the Gates Foundation through a 2015 grant to develop strategies for, and build a common vision towards, more effective and efficient health supply chains.
This report, “Designing Global Health Supply Chains for the Future,” advances WDI’s mission of developing knowledge and capability to improve the effectiveness of firms and increase social welfare in low- and middle-income countries.
As the academic year comes to a close, the 13 MAP teams organized and funded by WDI have finished their projects and successfully delivered final reports to their sponsoring organizations.
Multidisciplinary Action Projects, or MAP for short, is an annual, action-based learning course offered at the Ross School of Business in which MBA students work on projects for organizations all over the world under the guidance of faculty advisors. Each project requires analytical rigor, critical thinking, and teamwork among students. Sponsoring organizations receive first-rate deliverables and data-driven recommendations from the teams of students. (Learn more about this year’s MAP projects organized by WDI here; find more information on WDI’s MAP projects over the years here.)
After learning about their projects and conducting secondary research for several weeks, the students then spend two to four weeks working with their organizations in the field.
Two of those projects – in Hanoi, Vietnam and Madurai, India – focused on laying the groundwork for centers designed to support local entrepreneurs and are part of a joint effort between WDI and the Zell Lurie Institute (ZLI). To assist the students on their projects, WDI Education Initiative Vice President Amy Gillett and Program Coordinator Nathan Rauh-Bieri provided advice and guidance based on WDI’s prior work in entrepreneurship development (see WDI’s newly-launched Entrepreneurship Development Center).
Here is a recap of the two projects.
The Vietnam Partners MAP project was co-funded by ZLI, and hosted by Vietnam Partners, LLC. The project’s goal was to create a launch plan for an entrepreneurship service center in partnership with Hanoi Business School (HSB). The student team conducted more than 45 interviews with entrepreneurs, HSB administrators, and other stakeholders. They discovered that Vietnam’s entrepreneurs need help growing their business – not just starting them – and would welcome an entrepreneurship development center.
“The environment in Vietnam is ripe for this kind of organization,” said Bradley LaLonde, the team’s supervisor at Vietnam Partners.
At the end of their project, the students presented a business plan for a Center for Entrepreneurship and Innovation at HSB. The team identified a local hunger for practical rather than theoretical training, and training customized to the local ecosystem. More specifically, the MAP team identified a lack of local business cases. After a conversation with WDI, the MAP team suggested that a sustained effort around creating local cases, similar to WDI’s Philippines Case Collection, could be high-potential way to train Hanoi’s practice-hungry entrepreneurs.
Team member Juan Recalde said the project taught him that entrepreneurs have different needs.
“That was a very important learning because we could segment different types of entrepreneurs and based on the segmentation, determine which segment to target,” he said.
Recalde said he will take what he learned – specifically market research and creating a launch strategy for an entrepreneurship development center – and try to replicate it in his hometown.
“Formosa is one of the poorest provinces of Argentina and the government plays a big role in the economy, while the private sector is small,” he said. “I believe that entrepreneurship is the answer to the growth issues that my province faces.”
Stewart Thornhill, executive director of ZLI and the team’s academic advisor, praised the team for how well they represented U-M, WDI and ZLI and for their mature analysis of the project.
“They didn’t treat entrepreneurs as a generic class, but were able to identify specific personas,” he said. “Their in-depth qualitative research will serve this center’s clients well in the future.”
WDI President Paul Clyde, who also advised the team, said they gave Vietnam Partners good insights into the current situation with the country’s entrepreneurs.
“There is no substitute for having information from people who have spent time on the ground to get a good feel for what is going on,” Clyde said. “This is exactly the type of situation in which MAP projects are effective tools for us and for sponsors.”
The MAP team, based in Madurai, India, was tasked with setting up a business model for Aparajitha Foundation to provide services to the city’s Madurai’s micro, small, and medium enterprises – or MSMEs. This work builds on last year’s MAP project with Aparajitha.
The student team’s final report outlined the gaps in the entrepreneurial ecosystem in Madurai, the market opportunity, business model, financial model, implementation plan, and key learnings. The team recommended that GROW, a conceptual organization to meet the needs of growth-stage entrepreneurs, be launched. The students also provided an outline of what was needed to have GROW operating within two years and expand to a second locale within five years.
Clyde, the team’s academic advisor, lauded the students’ efforts.
“They were able to get up to speed quickly on the current situation and combined that with some careful thinking about different models for providing services to entrepreneurs,” he said. Aparajitha “has already made significant progress in (its) engagement with the entrepreneurs in Tamil Nadu.”
The project left a definite impression on team member Nancy McDermott, who, though having a background in the community development aspects of business, experienced “what a big impact supporting entrepreneurs locally has on the local economy.”
Particularly, the project’s scope exposed her to how entrepreneurship can “spark job creation at a grassroots level,” she said, adding that she saw “what a big impact this is having on Madurai’s economy, and what kind of impact it can have on other economies as well.”
This summer, a WDI intern will pick up where the student MAP team left off and develop diagnostic tools that will identify the challenges a given entrepreneur faces and thus how GROW can work with the entrepreneur most effectively.
As their 2017 MAP project, U-M students Florian Eizaguirre, Amelia Harris, Matilda Narulita and Chris Atkins are advising Boond, a renewable energy firm in India.
Tom Reidy’s previous work experience and core MBA classes this year at U-M’s Ross School of Business have focused on operating a business in the developed world. That’s one reason Reidy is excited to head to South Africa to work for the startup organization, Mbuyu, as part of the school’s annual Multidisciplinary Action Projects (MAP).
“I’m interested in learning how business strategy differs in low-income, or base of the pyramid, markets because the frameworks we learned in our core classes over the last year have focused on developed markets,” said Reidy, a first-year MBA student. “Also, this will be my first time working with a start-up and dealing with impact investing, so I’m hoping to achieve a good understanding of how those things function.”
Mbuyu is working with South African National Parks to protect some of the world’s most critical honey bee ecosystems while developing a business to produce and sell organic honey. The MAP in South Africa is one of 11 student projects organized and sponsored by WDI. The Institute also is providing funding for two additional MAP projects.
MAP is an action-based learning course offered at Ross in which MBA students receive guidance from faculty advisors. Each project requires analytical rigor, critical thinking, and teamwork. Participating organizations receive top-notch deliverables and data-driven recommendations from the teams of students. (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 students then spend two to four weeks working with their organizations in the field.
Carissa De Young, a second-year MBA who is a dual degree student at Ross and the School of Natural Resources, will travel to India with her MAP team to work for GE Power.
“I’m most looking forward to learning more about the challenges in rural areas and how large companies can use their expertise to provide solutions,” she said.
Below is a summary of each WDI-sponsored MAP project.
African Institute of Management (IAM) – Senegal
Advised By: Paul Clyde, WDI and Ross School of Business
Team Members: Paul Miyamoto, Kaitlyn Fischer, Bradley Rollins
Founded in 1996, the Institut Africain de Management Group (IAM) is one of the leading private business schools in Central and West Africa. IAM is developing a master’s degree program in supply chain. This program will address the needs in Senegal and West Africa generally, by increasing the supply chain management talent available in the region.
The goal of this project is to develop a market entry strategy for a supply chain program at IAM. The team will learn about the program and then conduct competitive analysis and interview businesses that either are or employ potential customers in Senegal.
Aparajitha Foundation – India
Advised By: Paul Clyde, WDI and Ross School of Business; Bob Dittmar, Ross School of Business
Team Members: Diocelyn Batista Rijo, Rachel De Leon, Adam Fitzmaurice, Nancy McDermott
The Aparajitha Foundation is an arm of the Aparajitha Group. It is committed to the cause of creating transformational change in adolescents by using audiovisual technology to deliver life skills training to economically disadvantaged children in India’s Tamil Nadu state.
The MAP team will conduct a market analysis that will enable the creation of a financial model for an overarching ecosystem to support the micro small medium entrepreneurs (MSME) sector in Madurai, India.
Aravind Eye Care System – India
Advised By: Paul Clyde, WDI and Ross School of Business; Thomas Buchmueller, Ross School of Business
Team Members: Kaitie Conrad, Nikita Jambulingam, Siddhi Kaul, Ravi Patel
Aravind Eye Care System is a 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.
The student team will work with Aravind’s senior leadership to develop a roadmap for the eyecare system’s future growth.
Banyan Global – Ghana
Advised By: Ted London, WDI and Ross School of Business; Jim Walsh, Ross School of Business
Team Members: Vagisha Goel, Eric Perrin, Adi Singhal, Courtney Tatum
Banyan Global is a development consulting firm that works in five continents. It is implementing a USAID-funded project to increase access, improve efficiencies and expand quality maternal-child healthcare in rural areas. Banyan is working with private maternity home owners who may be nearing retirement on “transformation” options – selling the facility, leasing out the facility, bringing on a partner, bringing on a manager, or bringing on a specialist who will enable the facility to diversify its service offerings.
The MAP team will focus on an in-depth investigation into the the financial constraints and opportunities for private maternity homes in Ghana, with a specific focus on the projected return on specific potential investments, and the feasibility of various credit options to finance those investments.
Boond Engineering & Development – India
Advised By: Ted London, WDI and Ross School of Business; Jane Dutton, Ross School of Business
Team Members: Chris Atkins, Florian Eizaguirre, Amelia Harris, Matilda Narulita
The students will build a strategy around data collection and analysis and finding ways to monetize it. Boond collects a lot of consumer demographic data along with energy usage data from its portfolio of micro-grids in rural communities. It wants to analyze the data and explore ways of sharing its findings to those interested for a price.
CARE International – Egypt
Advised By: Ted London, WDI and Ross School of Business; Jane Dutton, Ross School of Business
Team Members: Andrew Hauser, Colleen Hill, Zack Molnar, Elizabeth Padilla
Working with the Danone Ecosystem Fund, CARE International is working to improve the socio-economic conditions of dairy farmers in Egypt using a collaborative model that engages cooperatives and community development associations in the country.
The MAP students will partner with Danone and CARE International to facilitate access to quality information for dairy farmers to improve their skills and productivity, and develop the institutional capacity, including good governance practices of farmers’ organizations.
GE Power – India
Advised By: Ted London, WDI and Ross School of Business; Sugato Bhattacharyya, Ross School of Business
Team Members: John Barbour, Carissa De Young, Claire Fletcher, Wiles Kase, Christina Lee, Jon McCartney
GE Power provides power generation, energy delivery, and water process technologies to solve issues in local markets.
The student team will develop a go-to-market recommendation for a new set of energy products and services that are focused on providing electricity in emerging markets.
Imperial Health Sciences – South Africa
Advised By: Paul Clyde, WDI and Ross School of Business; Ravi Anupindi, Ross School of Business
Team Members: Jaymon Ballew, Jeremy Egan, Francesco Esposito, Emily Lombardi, Mary Rockas
IHS provides supply chain solutions to the public and private pharmaceutical markets in Africa. It has partnered with several development and global health leaders from the public and private sectors to launch Lulama, an innovative financing partnership that will strengthen independent, community pharmacies in underserved areas, and enable access to quality, life-saving medicines to those who need them most.
The MAP team will assess the Lulama community pharmacy pilot program from the perspective of all the stakeholders for its potential to be a sustainable, scalable and replicable solution, and make recommendations.
ITC Limited – India
Advised By: Ted London, WDI and Ross School of Business; Sugato Bhattacharyya, Ross School of Business
Team Members: Gustavo Calzavara, Rakshit Gupta, Paula Luu, Linh Nguyen
ITC is a major diversified Indian conglomerate that creates multiple drivers of growth by developing a portfolio of businesses in the consumer goods, hospitality, paper, packaging, agribusiness, and information technology sectors.
The MAP team will develop a robust and scaleable business model in the fruits and vegetables space that could lead to a sustainable business that significantly enhances value for farmers in India.
Mbuyu Group – South Africa
Advised By: Ted London, WDI and Ross School of Business; Jim Walsh, Ross School of Business
Team Members: Megan Knoch-Dohlin, Ari Lowell, Tom Reidy, Christine Rickard, Sara Schmidt, Neil Tidwell
Mbuyu Group is working with South African National Parks to protect some of the world’s most critical honey bee ecosystems and strengthen the bee population. The group also hopes to become one of the largest global producers of organic honey.
The student project will develop a comprehensive fundraising communications strategy and materials recommendations to raise $5 million from international funding institutions and individuals. The money raised will support the purchase of 50,000 beehives on behalf of poor communities surrounding the nation parks.
Vayu – Malawi
Advised By: Paul Clyde, WDI and Ross School of Business; Thomas Buchmueller, Ross School of Business
Team Members: Jason Doran, Cazzie Palacios Brown, Maggie Vasquez, Charles Walton
Vayu is a Michigan start-up developing drones to aid medical care such as flying shipments of drugs, blood and other samples to remote villages.
The students will develop a market entry strategy plan for Vayu for Malawi.
Global Fairness Initiative – Nepal
Advised By: Mike Gordon, Ross School of Business; Paul Clyde, WDI and Ross School of Business
Team Members: Molly Hope, Kevin Jones, Julie Smith, Allen Xu
The Global Fairness Initiative promotes a more equitable, sustainable approach to economic development for the world’s working poor by advancing fair wages, equal access to markets, and balanced public policy to generate opportunity and end the cycle of poverty.
The student team will determine a sustainable financial model for Better Brick Nepal, a market-based program that is transforming Nepal’s brick industry by eliminating forced, bonded, and child labor.
Vietnam Partners, LLC – Vietnam
Advised By: Stewart Thornhill, Ross School of Business; Paul Clyde, WDI and Ross School of Business
Team Members: Niall Bachynski, Maddy Bourgeois, Nick Daen, Sara Faurer, Juan Recalde, Aaron Wolff
Vietnam Partners works with companies and investors to build successful businesses that exploit opportunities arising from Vietnam’s accelerating integration into the global economy.
Vietnam Partners in collaboration with the Hanoi School of Business has been requested to set up and lead the development of a Center for Entrepreneurship and Innovation (CEI) and establish a start up venture capital fund.
The Aravind Eye Care System (AECS), one of the most successful examples of sustainable healthcare in the world, is located in the city of Madurai in southern India. Starting with just 11 beds in 1976, the AECS comprises more than 4,000 beds today. The Aravind system consists of five tertiary hospitals with plans to open a sixth in Chennai, India in 2017. From April 2015 to March 2016, 4.7 million outpatients were treated and over 408,220 surgeries were performed at the AECS. Two-thirds of the outpatient visits and three-fourths of the surgeries were provided to the poor either free or at a highly subsidized rate.
WDI’s partnership with AECS spans over 15 years and includes the implementation of over 25 projects, ranging from human resource management and governance structure to expansion through partnerships in northern India.
In 2016, a University of Michigan Ross School Multidisciplinary Action Project (MAP) student team was engaged to adapt the Capability Maturity Model (designed for software development) to two AECS facilities. The model was applied at the facilities to develop an initial measurement of process performance. The model will also be used at the new hospital in Chennai to measure the performance of each unit.
The LiveWell Institute for Rehabilitation Medicine is based in the city of Madurai, India. It was established by Dr. Aravind Srinivasan of the Aravind Eye Care System (AECS) to address the growing need for rehabilitative care medicine in India. It provides step-down care for patients who have undergone a major illness or injury and need to relearn daily living skills in order to retain their mobility and independence.
University of Michigan student teams have worked with Dr. Srinivasan since 2010 when a market entry strategy for the geriatric rehab market was first developed. Since then projects have ranged from developing a community engagement model to developing a replicable model of LiveWell operations that could be used for expanding to other sites within India.
Over the next three to five years, LiveWell aims to expand its facility from 35 to 100 beds. A University of Michigan Ross School Multidisciplinary Action Project (MAP) student team was engaged to help LiveWell approach its growth through a cultural lens with focus on values, people, and operations. The objective of the project was to define the fundamentals required for the expansion of the facility with culture as the central focus.
Over the past few years, WDI has been working with the Ruli District Hospital and The Ihangane Project to improve healthcare service delivery and operations in Rwanda’s Gakenke District. The Ihangane Project is invested in the improvement of health in the Ruli area, through the provision of material, clinical, and technical assistance to the Ruli District Hospital Health System and Ruli community members.
Based on specific requests from hospital leadership, University of Michigan student teams have worked on a variety of projects to improve communication flow, cost-effectiveness and the financial sustainability of the healthcare delivery system.
In 2016, a student team from the University of Michigan’s Ross School International Business Immersion course (BA685), facilitated a hospital staff retreat to create a shared vision of high quality and patient-centered healthcare at Ruli, including an implementable framework for decision-making and problem solving.
The Ethio-American Doctors Group (EADG), a cohort of 250 physicians, is building a state-of-art hospital in Addis Ababa, Ethiopia. The hospital is expected to consist of 300 hospital beds, 8 operating rooms, and an 80-room multi-specialty clinic.
The EADG wanted to assess major equipment needed for the proposed hospital, and determine costs associated with maintenance and repair of these items. A student team, from the University of Michigan’s Ross School International Business Immersion course (BA685), was engaged to provide an analysis and evaluation of total annual operating costs for imaging equipment, linear accelerator options, a lab services model, and human capital strategies. Data for analysis and evaluation were gathered from both primary and secondary research.
The student team identified human resource needs as a priority over equipment procurement so they proposed obtaining human capital to manage and maintain equipment. Additionally, the team made recommendations for a manufacturing partner for imaging equipment, a linear accelerator brand, and lab services operations.
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.
Addis Hiwot is a private hospital in Addis Ababa, Ethiopia. The Ethiopia-Michigan Platform for Advancing Collaborative Engagement (EM-PACE) is supported by the Global Challenges for Third Century grant from the University of Michigan Office of the Provost. It seeks to address some of the most pressing problems identified by country leadership and stakeholders in Ethiopia. Student intern Nancy Kasvosve examined business models that allow private hospitals to also serve low income populations in Addis Ababa.