Harvard Case - Surgical Care For Low-Income, Rural Populations: An Alternative Delivery Model From Jan Swasthya Sahyog, India
"Surgical Care For Low-Income, Rural Populations: An Alternative Delivery Model From Jan Swasthya Sahyog, India" Harvard business case study is written by Kannan Sethuraman, Devanath Tirupati, Nakul P. Raykar, Prakash Awasthy. It deals with the challenges in the field of Operations Management. The case study is 48 page(s) long and it was first published on : Sep 1, 2016
At Fern Fort University, we recommend that Jan Swasthya Sahyog (JSS) leverage its successful model of providing affordable surgical care in rural India by expanding its reach through a combination of strategic partnerships, technology adoption, and operational optimization. This expansion should focus on replicating the JSS model in other underserved regions of India and potentially even expanding internationally, while maintaining its core values of affordability, accessibility, and quality.
2. Background
Jan Swasthya Sahyog (JSS) is a non-profit organization that provides affordable surgical care to low-income populations in rural India. Founded in 2003, JSS has established a network of hospitals and clinics across several states, offering a range of surgical procedures at significantly lower costs than private hospitals. Their success is attributed to a unique operating model that combines efficient operations strategy, a strong supply chain management system, and a commitment to quality management.
The case study focuses on JSS's challenges in scaling its operations to meet the growing demand for its services. The main protagonists are the JSS leadership team who are navigating the complexities of expansion while maintaining their core mission.
3. Analysis of the Case Study
The case study highlights several key challenges JSS faces in scaling its operations:
- Demand Forecasting: JSS struggles to accurately predict demand for surgical procedures across its network, leading to potential shortages or overstocking of supplies.
- Capacity Planning: JSS needs to optimize the capacity of its facilities to handle the increasing patient volume while maintaining quality standards.
- Supply Chain Management: Ensuring a reliable and cost-effective supply chain for medical equipment, pharmaceuticals, and consumables is crucial for JSS's sustainability.
- Information Systems: JSS needs to upgrade its information systems to manage patient data, track inventory, and analyze operational performance more effectively.
- Financial Sustainability: JSS faces the challenge of balancing its social mission with financial sustainability, particularly as it expands into new regions.
To analyze these challenges, we can utilize the Porter's Five Forces Framework to assess the competitive landscape and identify potential growth opportunities for JSS:
- Threat of New Entrants: The barrier to entry for new entrants in the rural healthcare market is relatively low, as several private hospitals and clinics are already present. However, JSS's unique model and reputation for quality and affordability create a competitive advantage.
- Bargaining Power of Buyers: Patients in rural areas have limited options for affordable surgical care, giving JSS significant bargaining power.
- Bargaining Power of Suppliers: JSS's large volume of purchases gives it some leverage with suppliers, but it still needs to ensure a reliable supply chain for essential medical supplies.
- Threat of Substitutes: There are limited substitutes for surgical procedures, but patients may opt for alternative treatments if they cannot afford JSS's services.
- Competitive Rivalry: Competition in the rural healthcare market is intense, with private hospitals and clinics offering a range of services. JSS needs to differentiate itself through its commitment to affordability, accessibility, and quality.
4. Recommendations
JSS should pursue the following recommendations to address its scaling challenges and achieve sustainable growth:
- Invest in Technology and Analytics: JSS should invest in advanced information systems and technology to improve demand forecasting, inventory management, and operational efficiency. This includes implementing an Enterprise Resource Planning (ERP) system, utilizing data analytics to predict patient demand, and adopting Lean manufacturing principles to optimize resource allocation.
- Optimize Supply Chain Management: JSS should implement a robust supply chain management system to ensure a reliable and cost-effective supply of medical equipment, pharmaceuticals, and consumables. This includes establishing strong relationships with suppliers, implementing Just-in-Time (JIT) production strategies, and exploring outsourcing opportunities for non-core functions.
- Expand Through Strategic Partnerships: JSS should explore strategic partnerships with other organizations, such as NGOs, government agencies, and private healthcare providers, to expand its reach and access new funding sources. These partnerships can leverage each organization's strengths and create a more sustainable model for providing affordable healthcare.
- Develop a Scalable Business Model: JSS should develop a scalable business model that can be replicated in other regions while maintaining its core values of affordability, accessibility, and quality. This includes standardizing its operating procedures, developing a clear organizational structure and design, and establishing a strong quality management system.
- Embrace Digital Transformation: JSS should leverage the power of the internet and digital technologies to improve patient engagement, streamline operations, and expand its reach. This includes developing a user-friendly website and mobile app for booking appointments, managing patient records, and providing educational materials.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core Competencies and Consistency with Mission: The recommendations align with JSS's core competencies in providing affordable surgical care and its mission to serve low-income populations.
- External Customers and Internal Clients: The recommendations address the needs of both external customers (patients) and internal clients (staff and partners).
- Competitors: The recommendations help JSS stay ahead of the competition by leveraging technology, optimizing operations, and expanding its reach through strategic partnerships.
- Attractiveness ' Quantitative Measures: The recommendations are expected to improve JSS's financial performance by increasing efficiency, reducing costs, and expanding its market share.
- Assumptions: The recommendations assume that JSS has the resources and commitment to invest in technology, develop strategic partnerships, and implement the necessary organizational changes.
6. Conclusion
By implementing these recommendations, JSS can overcome its scaling challenges and achieve its goal of providing affordable surgical care to a larger population. This expansion will not only improve access to healthcare for underserved communities but also contribute to JSS's long-term sustainability and impact.
7. Discussion
Other alternatives not selected include:
- Focusing solely on organic growth: This approach would be slower and more challenging, as JSS would need to rely on internal resources and organic growth strategies.
- Merging with another organization: While this could provide access to resources and expertise, it could also compromise JSS's mission and values.
Key risks associated with the recommendations include:
- Technology implementation challenges: JSS needs to ensure that the technology it adopts is user-friendly, reliable, and integrated with its existing systems.
- Partner selection and management: JSS needs to carefully select and manage its partners to ensure that they share its values and commitment to quality.
- Financial sustainability: JSS needs to ensure that its expansion plans are financially sustainable and do not compromise its core mission.
8. Next Steps
JSS should implement the following next steps to achieve its expansion goals:
- Develop a detailed implementation plan: This plan should outline the specific actions, timelines, and resources required for each recommendation.
- Allocate resources: JSS needs to allocate sufficient resources, including financial, human, and technological, to support the implementation of the recommendations.
- Monitor progress and adjust as needed: JSS should regularly monitor the progress of its implementation plan and make adjustments as needed to ensure that it is on track to achieve its goals.
By taking these steps, JSS can successfully scale its operations and provide affordable surgical care to a wider population, making a significant impact on the lives of millions of people in India and beyond.
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Case Description
The case essentially describes the evolution of healthcare delivery model developed by Jan Swasthya Sahyog (JSS), a non-profit organization established in 1999 with the mission of providing affordable health care to the poor in the tribal and rural areas of Chhattisgarh state, one of the poorest states of India. The case begins with an overview of the demographics and background material on the healthcare sector in India, with particular reference to the gaps in health outcomes between rural and urban India and brings out clearly, the poor state of health of the rural population, even in comparison with some of the low- and middle-income countries (LMIC). This is followed by a detailed description of the initial efforts of the founders of the JSS - Dr. Raman Kataria and his team to locate and establish the clinic at Ganiyari village in Bilaspur district belonging to Chhattisgarh state. The case also demonstrates that it is not sufficient to just establish the clinic, but stresses the importance of developing the ecosystem to enable the population to seek and receive health care and take advantage of the facilities. These include development of a referral network, training of local volunteers and educating the public about the importance of seeking health care at the right time. The case also brings out the infrastructural limitations and difficulties encountered in providing even the most basic health care in remote rural settings. This is followed by an overview of the operations at the Ganiyari facility and provides a detailed description of the innovations developed and implemented to minimize the costs of healthcare delivery. It also provides a discussion of the costs and revenues and of JSS operations highlighting its dependence on external funding through donations and grants to keep the organization solvent.
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