Harvard Case - Last Mile Health (A)
"Last Mile Health (A)" Harvard business case study is written by Brian Trelstad, V. Kasturi Rangan. It deals with the challenges in the field of General Management. The case study is 20 page(s) long and it was first published on : Mar 19, 2020
At Fern Fort University, we recommend that Last Mile Health (LMH) implement a strategic growth plan focusing on expanding its reach and impact while maintaining its core values of quality, sustainability, and community ownership. This plan should leverage LMH's existing strengths in community health worker (CHW) training and deployment, technology-enabled data collection and analysis, and strong partnerships with local governments and communities.
2. Background
Last Mile Health is a non-profit organization operating in Liberia and Sierra Leone, aiming to improve healthcare access in remote and underserved communities. They achieve this by training and deploying CHWs who provide essential healthcare services, collect data, and build community trust. LMH faces the challenge of scaling its operations while maintaining high-quality service delivery and financial sustainability.
The case study focuses on LMH's founder and CEO, Dr. Raj Panjabi, who faces critical decisions regarding the organization's future direction. He needs to navigate the complexities of international business, corporate social responsibility, and growth strategy while ensuring LMH remains true to its mission.
3. Analysis of the Case Study
Strategic Framework: We utilize a SWOT analysis to understand LMH's internal and external environment:
Strengths:
- Proven model: LMH's CHW program has demonstrated effectiveness in improving health outcomes.
- Strong partnerships: LMH enjoys strong relationships with local governments and communities.
- Technology-driven approach: LMH leverages technology for data collection, analysis, and program management.
- Dedicated team: LMH has a passionate and committed team dedicated to its mission.
Weaknesses:
- Limited funding: LMH relies heavily on donor funding, which can be unpredictable.
- Scaling challenges: Expanding operations to new regions requires significant resources and infrastructure.
- Sustainability concerns: LMH needs to develop a sustainable model to ensure long-term impact.
Opportunities:
- Growing demand for healthcare services: The need for accessible healthcare in developing countries is increasing.
- Government support for community health: Many governments are prioritizing CHW programs.
- Technological advancements: New technologies can further enhance LMH's data collection and analysis capabilities.
Threats:
- Competition from other organizations: LMH faces competition from other NGOs and government-run programs.
- Political instability: Political instability in the operating regions can disrupt LMH's operations.
- Economic downturn: Economic downturns can impact donor funding and reduce demand for healthcare services.
Porter's Five Forces Analysis:
- Threat of new entrants: High, as the healthcare sector in developing countries is attractive to many NGOs and businesses.
- Bargaining power of buyers: Low, as communities are highly dependent on LMH's services.
- Threat of substitutes: Moderate, as other healthcare providers, including government-run programs, exist.
- Bargaining power of suppliers: Low, as LMH relies on local suppliers for many services.
- Competitive rivalry: High, as LMH competes with other NGOs and government programs.
4. Recommendations
LMH should implement the following strategic initiatives:
1. Expand Geographic Reach:
- Targeted expansion: Focus on expanding to regions with high unmet healthcare needs and supportive government policies.
- Strategic partnerships: Develop partnerships with local organizations, NGOs, and government agencies to leverage resources and expertise.
- Franchise model: Explore a franchise model to allow local communities to own and operate LMH programs, promoting sustainability and local ownership.
2. Enhance Technology and Data Analytics:
- Invest in technology: Upgrade data collection and analysis tools to improve program effectiveness and efficiency.
- Develop data-driven insights: Utilize data to identify trends, optimize resource allocation, and personalize healthcare services.
- Leverage AI and machine learning: Explore the use of AI and machine learning to enhance data analysis and predict health outcomes.
3. Diversify Revenue Streams:
- Social impact bonds: Explore social impact bonds to attract private investment and ensure long-term financial sustainability.
- Fee-for-service models: Develop fee-for-service models for certain services to generate revenue and increase community ownership.
- Partnerships with pharmaceutical companies: Partner with pharmaceutical companies to provide affordable medicines and generate revenue.
4. Strengthen Organizational Capacity:
- Talent management: Invest in training and development programs for staff, particularly in leadership, data analysis, and program management.
- Diversity and inclusion: Promote diversity and inclusion within the organization to ensure representation of the communities LMH serves.
- Organizational learning: Establish a culture of continuous improvement and learning by sharing best practices and analyzing program data.
5. Enhance Brand Management and Communication:
- Develop a strong brand identity: Communicate LMH's mission, values, and impact effectively to donors, partners, and the public.
- Leverage digital marketing: Utilize social media and digital platforms to raise awareness and connect with potential donors and partners.
- Engage with stakeholders: Foster open communication and transparency with stakeholders to build trust and support.
5. Basis of Recommendations
These recommendations align with LMH's core competencies in community health worker training, technology-enabled data collection, and strong partnerships. They also consider the external environment, including the growing demand for healthcare services, government support for CHW programs, and the need for sustainable financing models.
The recommendations aim to enhance LMH's competitive advantage by expanding its reach, improving program effectiveness, and diversifying revenue streams. The attractiveness of these recommendations can be measured through metrics like increased patient access, improved health outcomes, and increased financial sustainability.
6. Conclusion
LMH is at a critical juncture, facing the challenge of scaling its operations while maintaining its core values and impact. By implementing the recommended strategic initiatives, LMH can achieve sustainable growth, expand its reach, and continue to improve healthcare access in underserved communities.
7. Discussion
Other alternatives not selected include:
- Merging with another organization: This could provide access to resources and expertise but might compromise LMH's independence and mission.
- Focusing on a single country: This would allow for greater depth and impact in one region but limit LMH's potential for broader influence.
Risks and Key Assumptions:
- Political instability: Political instability in operating regions could disrupt LMH's operations.
- Donor funding fluctuations: Dependence on donor funding could lead to financial instability.
- Competition from other organizations: Competition from other NGOs and government programs could limit LMH's market share.
8. Next Steps
LMH should develop a detailed implementation plan with timelines and key milestones for each initiative. This plan should include:
- Year 1: Focus on developing a strategic growth plan, securing funding, and expanding to one new region.
- Year 2: Implement technology upgrades, diversify revenue streams, and expand to another region.
- Year 3: Strengthen organizational capacity, enhance brand management, and evaluate the effectiveness of the growth strategy.
By taking these steps, LMH can position itself for continued success and make a lasting impact on the lives of millions in underserved communities.
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Case Description
As the Ebola outbreak threatens the fragile health system of Liberia, Raj Panjabi, the founder of Last Mile Health, faces a dilemma: should he expand beyond the organization's core mission to help the country build emergency health care capacity, or should he stick to his knitting? Panjabi, a Liberian who immigrated with his family to the United States during the Liberian Civil War, founded Last Mile Health as a non-profit organization to recruit and train community health workers to reach remote rural communities with basic health services. The case traces the founding and early years of Last Mile Health, before the organization has to decide whether they pursue a significant amount of new funding to expand into other areas.
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