Case studies examine principles of health care delivery in resource-poor settings

Dr. Paul Farmer, Dr. Jim Kim and professor Michael Porter

Today, the Global Health Delivery Project and Harvard Business Publishing released 21 teaching case studies examining the principles of health care delivery in resource-poor settings. The multidisciplinary body of work spans 13 countries and addresses the complexity of delivering life-saving health care technologies and care. These 21 teaching case studies are available to global health educators, students and practitioners at no cost through Harvard Business Publishing. To access the case studies, visit: www.ghdonline.org/cases.

Dr. Paul Farmer, chair of the Department of Global Health and Social Medicine at Harvard Medical School, said, "The publication of these cases-online, and freely accessible to the practitioners, students and educators who will benefit most from them-is an important step toward closing the know-do gap in global health. Increasingly, our feedback loop of research, teaching and service is directly strengthening the care we deliver on the ground and our ability to replicate and scale successes."

Four years ago, Harvard University Professors Farmer and Michael Porter, together with current President of Dartmouth College Dr. Jim Kim, launched this effort with the goal of systematizing the study of global health delivery and rapidly disseminating knowledge to implementers. The cases document the actual operations of health care delivery programs in resource-constrained settings, and include supplemental materials for instructors to help stimulate and guide discussions.

"I think of the [teaching] cases on a regular basisremembering what others have done, relating that to the options available to me, and trying to use their lessons to inform my own decisions," said Dan Schwarz, executive director of Nyaya Health, a community-based health care organization in rural Nepal. "To be able to share in [other leaders'] experiences and lessons has been, and continues to be, of profound benefit to my work." Mr. Schwarz attended the Global Health Effectiveness Program at Harvard in 2009.

All 21 case studies are being released by the Global Health Delivery Project, a collaboration among Harvard Medical School, Harvard Business School, and Brigham and Women's Hospital. This material is available to health care practitioners and implementers through Harvard Business Publishing and through www.GHDonline.org, a website where global health implementers connect and exchange lessons learned.

Professor Michael Porter, the Bishop William Lawrence University Professor at Harvard Business School, hopes that the body of case studies will inspire far more study of the science of global health delivery, a crucial bottleneck in improving health in impoverished settings. "These cases capture the richness and complexity of actually delivering care in a variety of settings to help practitioners understand the principles of delivering high value care tailored to the medical condition and the populations served," said Professor Porter.

The case studies describe public and private programs delivering treatment, care and prevention for a variety of diseases in developing countries, including Rwanda, Haiti and India. The case method, pioneered by the faculty of Harvard Business School, puts students in the roles of decision-makers and teaches them how to make decisions in real-life settings, where information can be ambiguous and where the politics, economics and geography of a country must be considered. These richly detailed cases offer students the opportunity to analyze the principles of health care delivery, strategy and management and to understand the complexities surrounding implementation, scale-up and sustainability over time.

"The release of these cases is an important next step toward our goal of improving health care delivery through global collaboration and is representative of Brigham and Women's Hospital's commitment to reducing health disparities for all communities. We are particularly gratified to be able to assist those global practitioners and educators for whom access to such high-quality information has been unattainable," said Dr. Elizabeth Nabel, President of Brigham and Women's Hospital.

The GHD Project aims to promote case-based learning globally by hosting faculty training workshops across Africa and by building a network of global health delivery educators.