Harvard Case - The Himalayan Cataract Project
"The Himalayan Cataract Project" Harvard business case study is written by Kevin Schulman, Hu Summer, Xue Jiayin, Qi Susan. It deals with the challenges in the field of Strategy. The case study is 15 page(s) long and it was first published on : Jul 11, 2021
At Fern Fort University, we recommend that the Himalayan Cataract Project (HCP) adopt a strategic growth plan focused on expanding its reach into new geographic areas, diversifying its service offerings, and leveraging technology for greater efficiency and impact. This plan should prioritize sustainable growth by incorporating corporate social responsibility and environmental sustainability into its core operations.
2. Background
The Himalayan Cataract Project is a non-profit organization dedicated to eliminating preventable blindness in the Himalayas. Founded by Dr. Sanduk Ruit, HCP has successfully performed over 1.5 million cataract surgeries, transforming the lives of countless individuals. The case study highlights the organization's impressive achievements, its unique approach to surgery and training, and the challenges it faces in scaling its operations.
The main protagonists of the case study are Dr. Sanduk Ruit, the founder and driving force behind HCP, and the organization's leadership team, who are tasked with navigating the challenges of growth and sustainability.
3. Analysis of the Case Study
SWOT Analysis:
Strengths:
- Mission-driven and highly effective: HCP has a clear and compelling mission, and a proven track record of success in delivering high-quality cataract surgeries.
- Unique surgical technique: The 'small incision' technique developed by Dr. Ruit is highly effective, efficient, and cost-effective.
- Strong partnerships: HCP has established strong partnerships with local governments, NGOs, and international organizations.
- Dedicated team: HCP boasts a dedicated team of skilled surgeons, nurses, and support staff.
Weaknesses:
- Limited reach: HCP's current operations are primarily focused on Nepal, with limited expansion into other Himalayan regions.
- Funding challenges: HCP relies heavily on donations, which can be unpredictable.
- Lack of technological infrastructure: HCP's operations are largely manual, which limits efficiency and scalability.
- Limited marketing and outreach: HCP's marketing efforts are primarily focused on word-of-mouth and limited online presence.
Opportunities:
- Expanding into new markets: The Himalayan region presents significant opportunities for HCP to expand its reach and impact.
- Diversifying services: HCP can expand its service offerings to include other eye care services, such as refractive surgery and eye screenings.
- Leveraging technology: HCP can leverage technology to improve efficiency, increase access to care, and enhance data collection and analysis.
- Building a strong brand: HCP can leverage its strong reputation and mission to build a strong brand and attract more donors and partners.
Threats:
- Competition from other NGOs: HCP faces competition from other NGOs operating in the Himalayan region.
- Political instability: Political instability in the region could disrupt HCP's operations.
- Economic downturn: An economic downturn could reduce donations and impact HCP's funding.
- Natural disasters: The Himalayan region is prone to natural disasters, which could disrupt HCP's operations.
Porter's Five Forces:
- Threat of new entrants: The threat of new entrants is relatively low due to the specialized nature of HCP's services and the high barriers to entry.
- Bargaining power of buyers: The bargaining power of buyers is low, as patients are highly dependent on HCP's services.
- Bargaining power of suppliers: The bargaining power of suppliers is moderate, as HCP relies on a limited number of suppliers for specialized equipment and supplies.
- Threat of substitutes: The threat of substitutes is low, as there are no readily available substitutes for HCP's services.
- Rivalry among existing competitors: The rivalry among existing competitors is moderate, as HCP faces competition from other NGOs operating in the region.
Value Chain Analysis:
HCP's value chain can be broken down into the following primary activities:
- Research and Development: Developing and refining the 'small incision' surgical technique.
- Procurement: Sourcing specialized equipment and supplies.
- Training: Training local surgeons and nurses in the 'small incision' technique.
- Surgery: Performing cataract surgeries.
- Post-operative care: Providing post-operative care and follow-up.
- Marketing and outreach: Raising awareness of HCP's services and attracting patients.
- Fundraising: Raising funds to support HCP's operations.
Business Model Innovation:
HCP's business model is based on a hub-and-spoke model, where a central hub provides training and support to satellite clinics in remote areas. This model enables HCP to reach a wider population and reduce the need for patients to travel long distances for surgery.
Strategic Planning:
HCP needs to develop a comprehensive strategic plan that outlines its long-term goals, strategies, and action plans. This plan should be aligned with the organization's mission and vision, and should address the challenges and opportunities identified in the SWOT analysis.
Market Segmentation:
HCP can segment its target market based on geographic location, age, gender, and socioeconomic status. This segmentation will help HCP to tailor its marketing and outreach efforts to specific groups.
Blue Ocean Strategy:
HCP can pursue a blue ocean strategy by creating a new market space by offering a unique and differentiated service that is not currently available in the Himalayan region. This could involve expanding its service offerings to include other eye care services, such as refractive surgery and eye screenings.
Disruptive Innovation:
HCP can leverage disruptive innovation to improve its efficiency and effectiveness. This could involve adopting new technologies, such as telemedicine and AI-powered diagnostics, to enhance its service delivery.
Balanced Scorecard:
HCP can use a balanced scorecard to track its performance across multiple dimensions, including financial, customer, internal processes, and learning and growth. This will help HCP to monitor its progress towards its strategic goals and make adjustments as needed.
Core Competencies:
HCP's core competencies include:
- Surgical expertise: HCP has a deep understanding of cataract surgery and has developed a highly effective surgical technique.
- Training and development: HCP has a strong track record of training local surgeons and nurses.
- Partnerships and collaboration: HCP has established strong partnerships with local governments, NGOs, and international organizations.
Diversification:
HCP can diversify its revenue streams by expanding its service offerings, developing new partnerships, and exploring opportunities for social enterprise.
Vertical Integration:
HCP can consider vertical integration by acquiring or partnering with companies that provide specialized equipment and supplies. This will help HCP to control its costs and ensure the quality of its services.
Strategic Alliances:
HCP can forge strategic alliances with other NGOs, corporations, and governments to expand its reach, increase its funding, and leverage complementary resources.
Outsourcing:
HCP can consider outsourcing certain non-core functions, such as marketing and fundraising, to focus its resources on its core mission.
Globalization Strategies:
HCP can adopt a globalization strategy to expand its operations into new markets. This could involve establishing satellite clinics in other Himalayan countries, partnering with local NGOs, and adapting its services to meet the specific needs of different populations.
Product Differentiation:
HCP can differentiate its services by offering a unique and high-quality service that is not available elsewhere. This could involve developing new surgical techniques, offering specialized post-operative care, or providing additional services, such as eye screenings.
Cost Leadership:
HCP can pursue a cost leadership strategy by reducing its operating costs through efficiency improvements, strategic sourcing, and technology adoption.
Market Penetration:
HCP can increase its market penetration by expanding its reach into new geographic areas, targeting new patient segments, and increasing its marketing efforts.
Market Development:
HCP can pursue market development by expanding into new geographic markets, such as other Himalayan countries.
Product Development:
HCP can develop new products and services, such as eye screenings and refractive surgery, to meet the evolving needs of its patients.
Resource-Based View:
HCP's resources, such as its skilled surgeons, unique surgical technique, and strong partnerships, are valuable, rare, inimitable, and non-substitutable. These resources give HCP a competitive advantage in the market.
Dynamic Capabilities:
HCP has the dynamic capabilities to adapt to changing market conditions and innovate to improve its efficiency and effectiveness. This includes its ability to learn and adapt, its strong partnerships, and its commitment to continuous improvement.
Scenario Planning:
HCP can use scenario planning to prepare for different future scenarios, such as political instability, economic downturn, and natural disasters. This will help HCP to develop contingency plans and ensure its long-term sustainability.
Stakeholder Analysis:
HCP needs to identify and prioritize its stakeholders, including patients, donors, staff, partners, and the government. Understanding the needs and expectations of these stakeholders will help HCP to make informed decisions and build strong relationships.
Strategic Positioning:
HCP needs to develop a clear strategic positioning that differentiates it from its competitors. This could involve focusing on its unique surgical technique, its commitment to social responsibility, or its strong track record of success.
Business Ecosystem:
HCP is part of a broader business ecosystem that includes other NGOs, corporations, governments, and individuals. HCP needs to understand the dynamics of this ecosystem and leverage its relationships to achieve its goals.
Game Theory in Strategy:
HCP can use game theory to understand the strategic interactions between itself and its competitors. This will help HCP to anticipate the actions of its competitors and develop effective strategies to counter them.
Strategic Leadership:
HCP needs strong strategic leadership to guide the organization through its growth and development. This leadership should be visionary, strategic, and capable of building a strong team and culture.
Change Management:
HCP will need to implement effective change management processes as it expands its operations and adopts new technologies. This will involve communicating clearly with stakeholders, providing training and support, and managing resistance to change.
Organizational Culture:
HCP's organizational culture is characterized by its commitment to its mission, its dedication to quality, and its collaborative spirit. This culture is a valuable asset that needs to be nurtured and strengthened as the organization grows.
Strategic Implementation:
HCP needs to develop a robust strategic implementation plan that outlines the steps required to achieve its strategic goals. This plan should include clear timelines, responsibilities, and performance metrics.
Benchmarking:
HCP can use benchmarking to compare its performance against other NGOs in the eye care sector. This will help HCP to identify areas for improvement and adopt best practices.
Strategic Control:
HCP needs to establish effective strategic control mechanisms to monitor its progress towards its strategic goals and make adjustments as needed. This could involve regular performance reviews, financial audits, and stakeholder feedback.
PESTEL Analysis:
- Political: Political instability in the Himalayan region could disrupt HCP's operations.
- Economic: An economic downturn could reduce donations and impact HCP's funding.
- Social: The Himalayan region is characterized by poverty, illiteracy, and limited access to healthcare.
- Technological: HCP can leverage technology to improve efficiency, increase access to care, and enhance data collection and analysis.
- Environmental: HCP needs to consider the environmental impact of its operations and adopt sustainable practices.
- Legal: HCP needs to comply with all relevant laws and regulations.
Industry Lifecycle:
The eye care industry is a mature industry, but there is still significant potential for growth in emerging markets like the Himalayan region. HCP's focus on providing affordable and accessible eye care services positions it well to capitalize on this growth.
Strategic Groups:
HCP belongs to a strategic group of NGOs that focus on providing eye care services in developing countries. This group includes organizations such as Orbis International, the Fred Hollows Foundation, and the Seva Foundation.
Value Proposition:
HCP's value proposition is to provide affordable and accessible cataract surgery to people in the Himalayan region. This proposition is based on the organization's unique surgical technique, its strong partnerships, and its commitment to social responsibility.
Business Portfolio Analysis:
HCP can use a business portfolio analysis, such as the BCG matrix or the Ansoff matrix, to assess the attractiveness of its existing and potential services and to identify opportunities for growth and diversification.
BCG Matrix:
- Stars: HCP's existing cataract surgery services are currently a 'star' in the BCG matrix, as they are growing rapidly and have a strong market share.
- Cash Cows: HCP could develop new services, such as eye screenings, that could become 'cash cows' in the future.
- Question Marks: HCP could explore new markets or services that are currently 'question marks,' such as refractive surgery.
- Dogs: HCP should avoid investing in services that are currently 'dogs,' as they are not growing and have a low market share.
Ansoff Matrix:
- Market Penetration: HCP can increase its market penetration by expanding its reach into new geographic areas and targeting new patient segments.
- Market Development: HCP can pursue market development by expanding into new geographic markets, such as other Himalayan countries.
- Product Development: HCP can develop new products and services, such as eye screenings and refractive surgery, to meet the evolving needs of its patients.
- Diversification: HCP can diversify its revenue streams by expanding its service offerings, developing new partnerships, and exploring opportunities for social enterprise.
Strategic Intent:
HCP's strategic intent is to eliminate preventable blindness in the Himalayas. This intent is ambitious and will require a long-term commitment to growth, innovation, and sustainability.
Sustainable Competitive Advantage:
HCP's sustainable competitive advantage is based on its unique surgical technique, its strong partnerships, and its commitment to social responsibility. These factors are difficult to imitate and give HCP a long-term advantage in the market.
Strategic Flexibility:
HCP needs to maintain strategic flexibility to adapt to changing market conditions and opportunities. This could involve developing contingency plans, building strong partnerships, and investing in new technologies.
Corporate Social Responsibility:
HCP is committed to corporate social responsibility and has a strong track record of ethical and sustainable practices. This commitment is essential for attracting donors, building trust with stakeholders, and achieving its mission.
Digital Transformation Strategy:
HCP needs to develop a digital transformation strategy to leverage technology to improve efficiency, increase access to care, and enhance data collection and analysis. This could involve adopting telemedicine, AI-powered diagnostics, and online patient portals.
Strategic Foresight:
HCP needs to engage in strategic foresight to anticipate future trends and challenges. This could involve conducting scenario planning, monitoring industry developments, and engaging with thought leaders.
4. Recommendations
- Expand Geographic Reach: HCP should prioritize expanding its operations into new geographic areas within the Himalayan region. This can be achieved through strategic partnerships with local NGOs, governments, and healthcare providers in countries like Bhutan, India, and Pakistan.
- Diversify Service Offerings: HCP should diversify its service offerings beyond cataract surgery to include other eye care services like refractive surgery, eye screenings, and vision rehabilitation. This will allow HCP to address a wider range of eye care needs and attract a broader patient base.
- Leverage Technology: HCP should invest in technology to improve efficiency, increase access to care, and enhance data collection and analysis. This could include implementing telemedicine, AI-powered diagnostics, and online patient portals.
- Strengthen Brand Management: HCP should invest in building a strong brand that resonates with donors, partners, and the public. This can be achieved through targeted marketing campaigns, social media engagement, and public relations efforts.
- Develop a Sustainable Growth Strategy: HCP should develop a sustainable growth strategy that incorporates corporate social responsibility and environmental sustainability into its core operations. This could involve implementing green practices, investing in renewable energy, and supporting local communities.
5. Basis of Recommendations
These recommendations are based on a thorough analysis of HCP's current situation, its strengths and weaknesses, and the opportunities and threats it faces. They are consistent with HCP's mission and vision, and address the needs of its stakeholders, including patients, donors, staff, and partners.
The recommendations also consider the attractiveness of the proposed actions, taking into account factors such as potential return on investment, impact on patient outcomes, and alignment with HCP's long-term goals.
6. Conclusion
The Himalayan Cataract Project has a remarkable track record of success in eliminating preventable blindness in the Himalayas. The organization's unique approach to surgery and training, its strong partnerships, and its commitment to social responsibility have made a profound impact on the lives of countless individuals. To further its mission and reach even more people, HCP needs to adopt a strategic growth plan that focuses on expanding its reach, diversifying its service offerings, and leveraging technology. By implementing these recommendations, HCP can continue to make a positive difference in the lives of people in the Himalayan region and achieve its goal of eliminating preventable blindness.
7. Discussion
Alternatives:
- Maintain the status quo: HCP could choose to maintain its current operations and focus on improving its efficiency and effectiveness. However, this approach would limit HCP's potential for growth and impact.
- Focus solely on expanding into new markets: HCP could prioritize expanding into new markets without diversifying its service offerings or investing in technology. This approach would limit HCP's ability to meet the evolving needs of its patients and could lead to increased competition.
Risks:
- Financial risk: Expanding into new markets and diversifying services could require significant investment, which could put a strain on HCP's finances.
- Operational risk: Implementing new technologies and expanding into new markets could create operational challenges.
- Reputational risk: HCP's reputation could be damaged if it fails to meet the expectations of its stakeholders.
Key Assumptions:
- HCP will be able to secure the necessary funding to implement its growth strategy.
- HCP will be able to attract and retain qualified staff to support its expansion.
- HCP will be able to successfully integrate new technologies into its operations.
8. Next Steps
- Develop a comprehensive strategic plan: HCP should develop a comprehensive strategic plan that outlines its long-term goals, strategies, and action plans.
- Conduct a feasibility study: HCP should conduct a feasibility study to assess the viability of its proposed expansion plans.
- Secure funding: HCP should secure the necessary funding to implement its growth strategy.
- Build partnerships: HCP should build strong partnerships with local NGOs, governments, and healthcare providers in new geographic areas.
- Develop new services: HCP should develop new services to meet the evolving needs of its patients.
- Invest in technology: HCP should invest in technology to improve efficiency, increase access to care, and enhance data collection and analysis.
- Implement a change management process: HCP should implement a change management process to manage the transition to its new growth strategy.
By taking these steps, HCP can ensure a successful and sustainable future, continuing to make a positive impact on the lives of people in the Himalayan region.
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Case Description
Cataracts robbed an estimated 65 million people around the world of their vision. In the Himalayas, where hundreds of thousands of people went needlessly blind from cataracts, doctors Sanduk Ruit and Fred Hollows began to tackle this health crisis in 1995 with the Himalayan Cataract Project, believing they could adopt new techniques and lens technology to scale high-quality, high-volume, and low-cost cataract operations in remote communities. This case study details the development of the Tilganga Institute of Ophthalmology (TIO) in Kathmandu, Nepal, including efforts to establish cost-effective cataract treatment centers and ophthalmic education programs to train current eye care technicians and specialists, as well as the next generation of eye care leaders. Students will also understand the time-driven activity-based costing analysis process, as TIO needed to calculate resource needs as the institute expanded services into rural areas, where eyecare needs were high but patient resources were limited. What would this analysis reveal about ways to ensure safe, effective cataract surgery in other low-income countries-and were there also takeaways that might inform cataract surgery practices in the United States and other high-income countries?
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