news from GlobalHealth @MIT Sloan

GlobalHealth Lab and our work in global health delivery

GlobalHealth Lab blends classroom learning and action-based field projects. Over the course of several months, including an intensive period on site, teams of four students each partner with an organization on the front lines of care delivery. Together, they design an action learning project to address factors that limit their delivery of health care. Students work with MIT faculty, domain experts, and the leaders and staff in the partner enterprise and bring to bear the best of their MBA toolkit to help generate real value for all.

Since 2008,over 160 experienced MIT graduate students have conducted 41 unpaid projects in Kenya, Uganda, Tanzania, South Africa, Ghana, Sierra Leone, Zambia, Malawi, Mozambique, Botswana, India, each around 1,000 person-hours. Partner organizations set their project’s focus and offset some costs. Support from MIT Sloan School of Management’s generous alumni and friends makes up the rest.

In 2010, a new course on business models for global health delivery and management added the study of scale and sustainability in business models for global health delivery.

An impact assessment under way in 2011-2012 is revealing how ghdLAB may benefit partners and others. Briefings, video and blog postings, project reports and tools are being refined and shared.

Two years of practical experience with global health delivery (August 2010)

In 2008 we embarked on a new experiment. It was built on a solid foundation: over the past decade, thanks to a course called G-Lab, MIT Sloan has put some thousand graduate students to work with entrepreneurial firms in emerging and developing markets to address growth and business challenges. Could similar approaches alleviate bottlenecks for enterprises delivering healthcare in resource-limited settings? In our first tests of the concept, 100 MIT Sloan MBA, Sloan Fellow, and other MIT graduate students partnered with a wide variety of organizations to tackle health delivery challenges. Students had the

extraordinary experience of pairing learning in the classroom—often directly from leading experts—with collaborative team projects in which they worked first at MIT and then for three-week on site alongside the leaders and staff of partner enterprises. Taking on operational, business, and management needs defined by our partners, students worked in a variety of settings in Kenya, Uganda, Tanzania, South Africa, Ghana, Sierra Leone, Zambia, and Malawi. And outside this course, we linked the global with the local via a set of similar projects in Cambridge, Massachusetts.

Beyond offering our students what could be a life-changing learning experience, our hope was that we could collaborate in building a new science of delivery studies, and of course to help our partners working on the front lines of care delivery by designing, testing, and implementing practical improvements that would enable enterprises to deliver more and better health care.

Along the way we learned to think of health in much broader terms than we had originally imagined. When we started this course, I expected to work on supply chain and inventory management, organizational strategy, business models, staffing issues, and process improvement, which we did. We also worked on cost accounting, risk management, job design, income generation, change management, market research, road safety, IT, and social marketing. We learned some Swahili and other languages, a few songs, some basics of agriculture, and a lot about mobile phones and their potential. We learned how little we know of funding challenges, monitoring and evaluation, household economics, and

marketing in resource-constrained settings. We drew on our colleagues’ expertise to learn about these areas, about the contexts in which we worked, and to develop a necessary foundation of knowledge about diseases, health systems, nutrition, and sanitation.

We also learned, first-hand, about the talent, skills, and commitment of people that we were lucky enough to work with in a wide range of organizations. We were humbled by the leadership and commitment to excellence and service that we saw in action everywhere. Our own experience of resource constraints—rained-out roads, spotty internet, challenges with water or electric power, or, for one team, figuring out how to cook cabbage for dinner almost every night—taught us about the pervasiveness of the challenges. But perhaps most of all, we were inspired by the potential for shared learning by doing and collaborating (e.g., see my comments in “Looking abroad for health lessons from the field”).

To all of you—my students!—and our many partners including dozens of organizations on the front lines of health care delivery in sub-Saharan Africa, as well as MIT staff, faculty, and alumni, thank you. We would not be able to offer our students this unique experience without the generous and inspiring help of our supporters, and I am deeply grateful for all the ways our alumni have partnered with us (an alumna’s comments on the class appear in a recent article in the MIT Sloan Alumni Magazine on pages 18-20). Nor would our work be possible without faculty colleagues and domain experts from Partners in Health and Brigham and Women’s and Massachusetts General Hospitals who helped us to learn about the field. A special thanks to Dr Rebecca Weintraub and her colleagues including Dr. Erin Sullivan and Maria May at the Global Health Delivery Project whose insights and ideas inspired the course and who provided crucial content and connections.

Earlier this year, the second set of students teams turned in their final reports and team learnings. We have a store of fascinating material to explore capturing each team’s journey in global health delivery over almost six months at MIT and on site. We plan to generate practical, useful content from the detailed documentation, having discovered that others would like to learn from our experience (see observations by a US pediatrician who sees much to learn from our students’ work in a Kenyan pediatric clinic).

We also seek to continue exploring how management and the other social sciences, along with engineering, technology, and science, can collaborate with medicine and public health to tackle pressing needs. There’s an academic case to be made and research agendas to develop. And on the teaching front, I’ll continue to collaborate as we go from a single GLab GHD course to a pair of courses: one on Global Health Delivery and Management, focused on enterprise models, and a new project-based class in the Spring of 2011.

Our first set of students distilled their experiences into a short video: see Student Experience in Africa: Highlights from G-Lab. Reaching back two years, our class blog (here) captures our course and is the place where we share materials, including videos, as they are made ready. Meanwhile, please contact us if you’d like to see a summary of the projects, learn more about the experience and its impact, or propose a project for Spring 2011.

—Anjali Sastry