Harvard Case - Muskaan: How to Ensure Sustainability
"Muskaan: How to Ensure Sustainability" Harvard business case study is written by Tushar Sankar Banerjee, Arunaditya Sahay. It deals with the challenges in the field of Social Enterprise. The case study is 10 page(s) long and it was first published on : Jul 13, 2018
At Fern Fort University, we recommend that Muskaan adopt a hybrid organizational structure, leveraging the strengths of both for-profit and non-profit models to achieve long-term sustainability and maximize social impact. This approach will enable Muskaan to attract diverse funding sources, expand its reach, and build a robust infrastructure for delivering high-quality healthcare services to underserved communities in India.
2. Background
Muskaan, a non-profit organization founded by Dr. Anjali, provides free healthcare services to the underprivileged in rural India. The organization faces challenges in securing consistent funding, scaling its operations, and ensuring the quality of its services. Dr. Anjali is seeking a sustainable model to ensure the long-term viability of Muskaan and its ability to serve more people.
The main protagonists in this case study are:
- Dr. Anjali: The founder and driving force behind Muskaan, deeply committed to providing healthcare to the underprivileged.
- Muskaan's Board of Directors: Responsible for guiding the organization's strategy and ensuring financial stability.
- Muskaan's Staff: Dedicated professionals providing healthcare services and managing the organization's operations.
- The Underprivileged Communities: The beneficiaries of Muskaan's services, facing significant barriers to accessing quality healthcare.
3. Analysis of the Case Study
This case study presents a classic dilemma faced by many social enterprises ' balancing social impact with financial sustainability. To analyze Muskaan's situation, we can apply the Social Enterprise Canvas framework, which considers nine key elements:
1. Mission: Muskaan's mission is clear: providing free healthcare to the underprivileged in rural India. This mission aligns with the Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being.
2. Target Beneficiaries: Muskaan's target beneficiaries are the underprivileged communities in rural India, who lack access to quality healthcare due to poverty, geographic isolation, and limited infrastructure.
3. Value Proposition: Muskaan offers free healthcare services, including consultations, diagnostics, and basic treatments, addressing a critical need in the target communities.
4. Activities: Muskaan's activities include running mobile clinics, organizing health camps, providing training to local healthcare workers, and collaborating with government agencies.
5. Resources: Muskaan relies on donations, grants, and volunteer contributions for funding. It also leverages partnerships with other NGOs and healthcare providers.
6. Partnerships: Muskaan has established partnerships with local NGOs, government agencies, and medical institutions to enhance its reach and impact.
7. Revenue Model: Muskaan currently operates on a non-profit model, relying solely on donations and grants.
8. Impact Measurement: Muskaan tracks the number of patients served, the types of services provided, and the overall health outcomes achieved.
9. Sustainability: This is the key challenge for Muskaan. The organization needs to find a sustainable model to ensure its long-term viability and ability to scale its operations.
Challenges:
- Funding: Muskaan faces challenges in securing consistent funding, relying heavily on donations and grants, which are often unpredictable.
- Scaling Operations: Expanding services to reach more people requires significant investments in infrastructure, staff, and logistics, which are difficult to manage with limited resources.
- Quality Control: Maintaining high-quality healthcare services requires skilled personnel, adequate equipment, and robust training programs.
Opportunities:
- Growing Demand: The need for affordable healthcare in rural India is significant and growing, presenting a large market opportunity for Muskaan.
- Government Initiatives: The Indian government is increasingly focusing on improving healthcare access in rural areas, creating potential for partnerships and funding opportunities.
- Social Impact Investing: The growing interest in impact investing offers potential for Muskaan to attract capital from investors seeking both financial returns and social impact.
4. Recommendations
To address Muskaan's challenges and capitalize on its opportunities, we recommend the following:
1. Hybrid Organizational Structure:
- Establish a for-profit subsidiary: This subsidiary will offer affordable healthcare services to a wider population, including those who can pay a small fee. This will generate revenue to support Muskaan's non-profit operations and expand its reach.
- Maintain the non-profit core: Muskaan will continue to provide free healthcare services to the most vulnerable communities, ensuring its social mission remains at the forefront.
- Create a clear governance structure: Establish a board of directors that oversees both the for-profit and non-profit entities, ensuring alignment of goals and transparency in operations.
2. Sustainable Business Model:
- Develop a 'pay-what-you-can' model: Offer tiered pricing for services, allowing patients to pay according to their ability. This will ensure affordability for the underprivileged while generating revenue from those who can afford it.
- Explore microfinance options: Partner with microfinance institutions to provide low-interest loans to patients for healthcare expenses, promoting financial inclusion and access to care.
- Leverage technology: Implement telemedicine and mobile health solutions to reach remote areas and reduce operational costs.
3. Impact Measurement and Reporting:
- Develop robust impact metrics: Track key performance indicators (KPIs) such as the number of patients served, health outcomes achieved, and cost-effectiveness of services.
- Publish transparent impact reports: Share findings with stakeholders, including donors, investors, and the public, demonstrating Muskaan's impact and accountability.
4. Strategic Partnerships:
- Collaborate with pharmaceutical companies: Partner with pharmaceutical companies to secure affordable drug supplies and develop joint social responsibility initiatives.
- Engage with government agencies: Seek funding and support from government programs focused on healthcare access in rural areas.
- Build relationships with international organizations: Partner with international NGOs and foundations to access funding and expertise.
5. Marketing and Outreach:
- Develop a strong brand identity: Communicate Muskaan's mission and impact effectively through targeted marketing campaigns.
- Utilize social media: Leverage social media platforms to raise awareness, engage with potential donors and partners, and share stories of impact.
- Build community relationships: Engage with local communities to build trust and ensure the relevance of Muskaan's services.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core Competencies and Consistency with Mission: The hybrid model aligns with Muskaan's core competency in providing healthcare services while ensuring its social mission remains central.
- External Customers and Internal Clients: The recommendations cater to the needs of both external customers (patients) and internal clients (staff, donors, and partners).
- Competitors: The hybrid model allows Muskaan to compete effectively with both for-profit and non-profit healthcare providers, offering a unique value proposition.
- Attractiveness: The recommendations are attractive to potential investors and donors, as they demonstrate a clear path to financial sustainability and social impact.
- Assumptions: The recommendations assume a supportive regulatory environment, a growing demand for affordable healthcare, and the availability of skilled healthcare professionals.
6. Conclusion
By adopting a hybrid organizational structure, implementing a sustainable business model, and leveraging strategic partnerships, Muskaan can ensure its long-term sustainability while maximizing its social impact. This approach will enable the organization to reach more people, improve healthcare access in rural India, and become a model for other social enterprises seeking to address similar challenges.
7. Discussion
Alternative Options:
- Remaining solely non-profit: This would require Muskaan to rely heavily on donations and grants, limiting its ability to scale operations and secure consistent funding.
- Becoming fully for-profit: This would risk compromising Muskaan's social mission and potentially alienating potential donors who prioritize social impact.
Risks and Key Assumptions:
- Regulatory challenges: The hybrid model may face regulatory hurdles in India, requiring careful legal and ethical considerations.
- Market acceptance: The 'pay-what-you-can' model requires careful implementation to ensure fairness and affordability for all patients.
- Capacity building: Scaling operations requires investing in staff training, infrastructure, and technology, which may present challenges for Muskaan.
Options Grid:
| Option | Advantages | Disadvantages |
|---|---|---|
| Hybrid Model | Sustainable funding, scalability, market reach | Regulatory challenges, potential for mission drift |
| Non-Profit Model | Social impact focus, donor trust | Limited funding, scalability challenges |
| For-Profit Model | Financial sustainability, market efficiency | Potential for mission compromise, donor alienation |
8. Next Steps
- Conduct a feasibility study: Analyze the regulatory environment, market demand, and financial viability of the hybrid model.
- Develop a detailed business plan: Outline the specific activities, resources, and partnerships required to implement the recommendations.
- Secure funding: Seek investment from impact investors, foundations, and government agencies.
- Pilot the hybrid model: Implement the model in a pilot project to test its effectiveness and refine its implementation.
- Monitor and evaluate: Regularly track key performance indicators and adjust the model based on learnings and feedback.
By taking these steps, Muskaan can transform itself into a sustainable and impactful organization, improving healthcare access for millions of people in rural India.
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Case Description
Muskaan, a social enterprise based in Delhi, India, trained adults with intellectual disabilities to help bring them closer to mainstream society. The organization firmly believed that the "human mind is designed for learning," and that everyone, including those with intellectual and developmental disabilities, had the potential to succeed in doing great things in life. Muskaan had two revenue sources: grants, and income from the sale of goods produced by intellectually disabled craftspeople. In 2016, more than 11,000 Indian non-governmental organizations lost their licenses to receive foreign funding. Dr. Shanti Auluck, Muskaan's founder, worried that the funding needed for her business model might also soon dry up. To survive, grow, and ensure the sustainability of her social enterprise, Auluck had to change her business model and prepare a new business plan.
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