Harvard Case - The Punjab Health Foundation: Governance Structure and Programme Portfolio
"The Punjab Health Foundation: Governance Structure and Programme Portfolio" Harvard business case study is written by Ahsan Rana. It deals with the challenges in the field of Business & Government Relations. The case study is 20 page(s) long and it was first published on : Dec 1, 2014
At Fern Fort University, we recommend that the Punjab Health Foundation (PHF) adopt a comprehensive strategic framework to enhance its governance structure, streamline its program portfolio, and maximize its impact on public health in Punjab. This framework should prioritize public-private partnerships to leverage private sector expertise and resources, strengthen government relations to align with policy priorities and secure funding, and implement a robust risk management strategy to mitigate potential challenges.
2. Background
The Punjab Health Foundation is a non-profit organization established by the Government of Punjab in 2008 to improve the health of the province's population. The foundation's mission is to 'promote health and well-being through innovative programs, partnerships, and advocacy.' However, the PHF faces challenges in achieving its mission due to a complex governance structure, a fragmented program portfolio, and limited financial resources. The case study highlights the need for a more strategic approach to address these issues.
The main protagonists of the case are:
- Dr. Asim Khan: The CEO of the PHF, who is tasked with leading the organization's transformation.
- The Board of Directors: The governing body of the PHF, which is responsible for setting strategic direction and overseeing the organization's operations.
- The Government of Punjab: The primary stakeholder in the PHF, providing funding and setting policy priorities.
- The Private Sector: Potential partners for the PHF, offering expertise, resources, and innovative solutions.
3. Analysis of the Case Study
The PHF's challenges can be analyzed through the lens of corporate governance, program portfolio management, and strategic partnerships.
Governance: The PHF's current governance structure is characterized by a lack of clarity, accountability, and transparency. The board of directors lacks experience in health management and faces challenges in effectively overseeing the organization's operations. This lack of governance weakens the PHF's ability to attract funding, build trust with stakeholders, and implement effective programs.
Program Portfolio: The PHF's program portfolio is fragmented and lacks a clear strategic focus. The organization operates a wide range of programs with varying degrees of success, leading to inefficiencies and a lack of impact. This fragmented approach makes it difficult to measure the PHF's overall contribution to public health and undermines its ability to prioritize resources effectively.
Strategic Partnerships: The PHF has limited experience in forging strategic partnerships with the private sector. While there is potential for collaboration, the organization lacks the necessary expertise and resources to effectively engage with private partners. This missed opportunity limits the PHF's ability to leverage private sector innovation, funding, and expertise to improve public health.
4. Recommendations
To address these challenges, the PHF should implement the following recommendations:
1. Strengthen Governance:
- Redefine Board Roles: The board should be composed of individuals with expertise in health management, finance, and governance. The board should define clear roles and responsibilities for its members, ensuring accountability and transparency.
- Develop a Strategic Plan: The board should develop a comprehensive strategic plan that outlines the PHF's mission, vision, and key objectives. This plan should be aligned with the government's health policy priorities and include measurable targets for program impact.
- Implement Performance Monitoring: The PHF should establish a robust performance monitoring system to track the effectiveness of its programs and measure its impact on public health. This system should be transparent and accessible to stakeholders.
2. Streamline Program Portfolio:
- Prioritize Programs: The PHF should prioritize its program portfolio based on their potential impact on public health and alignment with the strategic plan. The organization should focus on programs with a strong evidence base and a clear path to sustainability.
- Develop a Program Evaluation Framework: The PHF should develop a rigorous program evaluation framework to assess the effectiveness of its programs and identify areas for improvement. This framework should be used to inform program design, implementation, and resource allocation.
- Explore Program Consolidation: The PHF should consider consolidating or merging programs with similar objectives to enhance efficiency and impact. This process should involve stakeholder engagement and ensure that the consolidation does not compromise program effectiveness.
3. Foster Strategic Partnerships:
- Develop a Partnership Strategy: The PHF should develop a comprehensive partnership strategy that outlines its objectives for engaging with the private sector. This strategy should identify potential partners, define partnership models, and establish clear expectations for collaboration.
- Build Capacity for Partnership Management: The PHF should build its capacity for managing partnerships by developing expertise in contract negotiation, project management, and stakeholder engagement. This can be achieved through training programs, mentorship, and collaboration with experienced organizations.
- Leverage Public-Private Partnerships: The PHF should actively pursue public-private partnerships to leverage private sector expertise, resources, and innovation. These partnerships can take various forms, including joint ventures, co-funding arrangements, and technology transfer agreements.
5. Basis of Recommendations
The recommendations are based on the following considerations:
- Core Competencies and Consistency with Mission: The recommendations align with the PHF's mission to promote health and well-being through innovative programs, partnerships, and advocacy. They also leverage the organization's core competencies in program development and implementation.
- External Customers and Internal Clients: The recommendations address the needs of the PHF's external customers, including the Government of Punjab, beneficiaries of its programs, and potential private sector partners. They also consider the needs of the PHF's internal clients, including its staff and board members.
- Competitors: The recommendations consider the competitive landscape of the health sector in Punjab and aim to position the PHF as a leader in innovation and impact.
- Attractiveness ' Quantitative Measures: The recommendations are expected to improve the PHF's financial sustainability, increase its impact on public health, and enhance its reputation as a trusted and effective organization.
6. Conclusion
By implementing these recommendations, the PHF can transform itself into a more effective and impactful organization. The foundation can leverage its unique position as a public-private partnership to drive positive change in the health sector in Punjab, contributing to the province's economic growth and social development.
7. Discussion
Alternative approaches to addressing the PHF's challenges include:
- Privatization: This option would transfer the PHF's operations to the private sector, potentially leading to increased efficiency and innovation. However, it raises concerns about access to healthcare for vulnerable populations and the potential for profit-driven decision-making.
- Nationalization: This option would bring the PHF under full government control, potentially leading to greater policy alignment and resource allocation. However, it could also lead to bureaucratic inefficiencies and a lack of innovation.
The chosen approach, a comprehensive strategic framework, balances the benefits of public and private sector engagement, enabling the PHF to leverage the strengths of both while mitigating the risks associated with each.
8. Next Steps
The PHF should implement the recommendations in a phased approach, starting with:
- Phase 1 (3 months): Conduct a comprehensive assessment of the current governance structure and program portfolio.
- Phase 2 (6 months): Develop a strategic plan, including a clear vision, mission, and key objectives.
- Phase 3 (9 months): Implement a pilot program to test the effectiveness of the new governance structure and program portfolio.
- Phase 4 (12 months): Expand the implementation of the strategic framework across the organization.
By following these steps, the PHF can ensure a smooth and effective transition to a more strategic and impactful organization.
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Case Description
This case is about the Punjab Health Foundation (PHF), which has not performed well during the last two decades of its existence. It is February 2013 and the Secretary of the Punjab Health Department, Arif Nadeem, has some serious decisions to make. Created in 1992 to support and finance the private sector in providing healthcare to the public at large, the foundation has only extended a small amount of loan (Rs 773 million) to an unimpressive number of borrowers (951 health practitioners and 52 NGOs). These small-scale operations do not justify the existence of a full-fledged institutional infrastructure. Over the years, the realisation has grown at higher levels in the Punjab Government that the organisation is contributing little towards the achievement of health policy objectives. Nadeem is perturbed over this poor performance. He can either close down the foundation or prepare a plan for its revitalisation. Both options are open to consideration.
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