Harvard Case - Tuberculosis in Dhaka: BRAC's Urban TB Program
"Tuberculosis in Dhaka: BRAC's Urban TB Program" Harvard business case study is written by Maria May, Joseph Rhatigan, Richard Cash. It deals with the challenges in the field of Strategy. The case study is 12 page(s) long and it was first published on : Apr 29, 2011
At Fern Fort University, we recommend BRAC to adopt a multi-pronged strategy that leverages its existing strengths, embraces innovation, and addresses the unique challenges of urban TB control in Dhaka. This strategy will focus on strengthening BRAC's competitive advantage by:
- Expanding the scope of its program to address the social determinants of TB, including poverty, homelessness, and lack of access to healthcare.
- Adopting a data-driven approach to improve program efficiency and effectiveness, leveraging technology and analytics for patient tracking, early detection, and intervention.
- Building strategic partnerships with government agencies, NGOs, and private sector players to create a business ecosystem for sustainable TB control.
- Developing a robust financial model to ensure the long-term sustainability of the program, exploring innovative funding mechanisms and corporate social responsibility initiatives.
2. Background
This case study focuses on BRAC, a leading international development organization, and its efforts to combat tuberculosis (TB) in Dhaka, Bangladesh. BRAC's Urban TB Program faces challenges in reaching vulnerable populations, managing complex cases, and ensuring adherence to treatment regimens. The case highlights the need for BRAC to adapt its approach to address the specific needs of the urban context.
The main protagonists are:
- BRAC: A non-profit organization with a long history of combating poverty and disease in Bangladesh.
- The Government of Bangladesh: The primary stakeholder responsible for public health and disease control.
- Urban residents of Dhaka: The target population for BRAC's TB program, facing challenges such as poverty, overcrowding, and limited access to healthcare.
3. Analysis of the Case Study
SWOT Analysis:
Strengths:
- Strong reputation and network: BRAC enjoys a strong reputation in Bangladesh and has a vast network of community health workers and volunteers.
- Experience in TB control: BRAC has a long history of implementing successful TB programs in rural areas.
- Commitment to social impact: BRAC is driven by a strong commitment to improving the lives of marginalized communities.
Weaknesses:
- Limited resources: BRAC faces financial constraints in expanding its urban TB program.
- Lack of specialized expertise: BRAC may lack the specialized expertise needed to address the complexities of urban TB control.
- Challenges in reaching vulnerable populations: Reaching marginalized communities in urban areas can be difficult due to factors like poverty and lack of trust in healthcare systems.
Opportunities:
- Growing government support for TB control: The government of Bangladesh is increasingly prioritizing TB control efforts.
- Technological advancements: New technologies can be leveraged for patient tracking, early detection, and improved treatment outcomes.
- Partnerships with private sector: Collaboration with private sector players can bring financial resources and expertise to the program.
Threats:
- Emergence of drug-resistant TB: The emergence of drug-resistant TB poses a significant threat to public health.
- Limited access to healthcare: Many urban residents lack access to quality healthcare, hindering early detection and treatment.
- Competition from other NGOs: BRAC faces competition from other NGOs working in the field of TB control.
Porter's Five Forces:
- Threat of new entrants: Low, due to the high barriers to entry in the field of TB control.
- Bargaining power of buyers: Low, as patients have limited options for TB treatment.
- Bargaining power of suppliers: Moderate, as BRAC relies on suppliers for essential medical supplies and equipment.
- Threat of substitute products: Low, as there are no readily available substitutes for TB treatment.
- Rivalry among existing competitors: Moderate, as BRAC faces competition from other NGOs and government agencies.
Value Chain Analysis:
BRAC's value chain for TB control involves the following activities:
- Research and development: Developing innovative approaches to TB control.
- Program design and implementation: Developing and implementing TB programs tailored to specific needs.
- Patient outreach and education: Reaching vulnerable populations and educating them about TB prevention and treatment.
- Diagnosis and treatment: Providing quality diagnosis and treatment services.
- Monitoring and evaluation: Tracking program performance and making necessary adjustments.
Business Model Innovation:
BRAC can leverage business model innovation to address the challenges of urban TB control. This can include:
- Developing a tiered pricing strategy: Offering different treatment packages based on patient income and ability to pay.
- Partnering with private sector pharmacies: Expanding access to essential medications through partnerships with private sector pharmacies.
- Leveraging technology for patient engagement: Utilizing mobile apps and telehealth platforms to improve patient adherence and communication.
Corporate Governance:
BRAC's strong corporate governance practices ensure transparency, accountability, and ethical conduct in its operations. This is crucial for maintaining public trust and attracting funding for its programs.
4. Recommendations
Expand Program Scope: BRAC should expand its urban TB program to address the social determinants of TB, including poverty, homelessness, and lack of access to healthcare. This can be achieved through:
- Community-based interventions: Implementing community-based programs to address poverty, improve housing conditions, and promote access to basic necessities.
- Social support services: Providing social support services such as counseling, job training, and financial assistance to patients and their families.
- Advocacy and policy change: Advocating for policy changes that address the root causes of TB vulnerability.
Embrace Data-Driven Approach: BRAC should adopt a data-driven approach to improve program efficiency and effectiveness. This can be achieved through:
- Leveraging technology and analytics: Utilizing digital tools for patient tracking, early detection, and intervention.
- Developing robust monitoring and evaluation systems: Implementing comprehensive monitoring and evaluation systems to track program outcomes and identify areas for improvement.
- Building data-driven decision-making capacity: Empowering staff with data analysis skills to inform program design and implementation.
Build Strategic Partnerships: BRAC should build strategic partnerships with government agencies, NGOs, and private sector players to create a business ecosystem for sustainable TB control. This can be achieved through:
- Collaborating with government agencies: Working closely with the Ministry of Health and other relevant government agencies to align programs and leverage resources.
- Partnering with other NGOs: Collaborating with other NGOs working in the field of TB control to share expertise and resources.
- Engaging with private sector: Partnering with private sector players to access financial resources, technology, and expertise.
Develop a Sustainable Financial Model: BRAC should develop a robust financial model to ensure the long-term sustainability of its urban TB program. This can be achieved through:
- Exploring innovative funding mechanisms: Diversifying funding sources by exploring grants, social impact bonds, and corporate social responsibility initiatives.
- Developing a tiered pricing strategy: Offering different treatment packages based on patient income and ability to pay.
- Building a strong fundraising capacity: Developing a comprehensive fundraising strategy to secure long-term financial support.
5. Basis of Recommendations
These recommendations are based on a comprehensive analysis of BRAC's strengths, weaknesses, opportunities, and threats, as well as the external environment in which the organization operates.
- Core competencies and consistency with mission: The recommendations align with BRAC's core competencies in community health, program implementation, and social impact. They are also consistent with BRAC's mission to empower people and communities to overcome poverty and disease.
- External customers and internal clients: The recommendations consider the needs of both external customers (patients) and internal clients (staff) by focusing on improving access to care, enhancing program efficiency, and fostering a culture of collaboration.
- Competitors: The recommendations take into account the competitive landscape in the field of TB control, aiming to differentiate BRAC's program through innovation, partnerships, and a focus on social determinants.
- Attractiveness ' quantitative measures: While specific quantitative measures are not provided in the case study, the recommendations are expected to improve program efficiency, increase patient access to care, and ultimately contribute to a reduction in TB incidence in Dhaka.
All assumptions are explicitly stated, including the need for continued government support for TB control, the availability of technology and data analytics tools, and the willingness of private sector players to engage in partnerships.
6. Conclusion
BRAC's Urban TB Program has the potential to make a significant impact on TB control in Dhaka. By adopting a multi-pronged strategy that leverages its existing strengths, embraces innovation, and addresses the unique challenges of the urban context, BRAC can strengthen its competitive advantage and achieve sustainable TB control.
7. Discussion
Other alternatives not selected include:
- Focusing solely on traditional TB control methods: This approach would be less effective in addressing the complex needs of urban TB control.
- Outsourcing program implementation to other NGOs: This approach would limit BRAC's control over program design and implementation.
Risks and Key Assumptions:
- Government funding cuts: A reduction in government funding could negatively impact the program's sustainability.
- Lack of private sector engagement: Difficulty in securing partnerships with private sector players could limit access to resources and expertise.
- Resistance to change: Staff resistance to adopting new technologies and approaches could hinder program implementation.
8. Next Steps
- Develop a comprehensive strategic plan: BRAC should develop a comprehensive strategic plan outlining the goals, objectives, and implementation strategies for its urban TB program.
- Secure funding and resources: BRAC should secure funding and resources to support the implementation of the strategic plan.
- Build partnerships: BRAC should build strategic partnerships with government agencies, NGOs, and private sector players.
- Pilot test new approaches: BRAC should pilot test new approaches, such as data-driven interventions and community-based programs, before scaling them up.
- Monitor and evaluate program performance: BRAC should implement a robust monitoring and evaluation system to track program outcomes and make necessary adjustments.
By taking these steps, BRAC can effectively address the challenges of urban TB control in Dhaka and contribute to a healthier and more equitable future for all.
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Case Description
This case is a sequel to BRAC's Tuberculosis Program: Pioneering DOTS Treatment for TB in Rural Bangladesh. This case examines BRAC's experience expanding its rural TB program to the urban environment of Dhaka between 2002 and 2008. The case provides background information about Dhaka and describes what TB services existed at the time. The case then describes the expansion of BRAC's TB program into Dhaka and details innovations in the Urban program. Students should gain an understanding of how these program modifications were a response to the specific challenges the program faced in the urban setting. The case allows an exploration of how successful health care delivery program adapt to new environments.
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