In 2017, the International Finance Corporation (IFC) faced the first big investment decision in its new Scaling Solar project. Founded in 1956, IFC was an international investment body with national governments as shareholders, whose mission was to promote economic development. It achieved this primarily through debt financing, which allowed the organization to use covenants to exercise close stewardship of its investments. Beginning in the late 1990s, the organization’s mission had evolved to foreground environmental and social sustainability in its development projects. Scaling Solar, launched in collaboration with the World Bank, would be one of IFC’s marquis projects in promoting a sustainable energy future. In this case, students will review the history of IFC (a pioneer in the burgeoning field of impact investing), explore the uses of debt as an instrument for development financing, consider how sustainability fits into the impact investing framework, and evaluate a potential new investment in solar power in Zambia.
Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and efficient use of available resources. Methods: A multi-disciplinary team applied time-driven activity-based costing (TDABC) to develop process maps and measure the cost of clinical pathways used for Drug Susceptible TB (DS-TB) at urban polyclinics, rural district and provincial hospitals, and community based targeted screenings for TB. Findings: Twenty-five stages were identified in the TB care pathway. Considerable variations were observed among the facilities in how health care professionals performed client registration, taking of vital signs, treatment follow-up, dispensing medicines and processing samples. The average cost per patient for the entire DS-TB care was $324. The average cost for diagnosis and treatment was higher in clinics than in hospitals largely due to nurses in clinics being 1.6 times more expensive than in hospitals. Conclusion: TDABC is a feasible and effective costing and management tool in low-resource settings. The TDABC process maps and treatment costs revealed several opportunities for innovative improvements in care delivery. Re-engineering laboratory testing processes and synchronizing TB treatment follow-up with antiretroviral treatments could produce better and more uniform TB treatments at significantly lower cost in Zimbabwe.
See more research
Pippa Tubman Armerding joined Harvard Business School in 2017 as Executive Director for the HBS Africa Research Center, opened this year in Johannesburg, South Africa. Pippa’s work spans sub-Saharan Africa, with a particular focus on the development of cases and support for faculty research in the region. She also plays an important role in establishing and fostering relationships with companies and alumni in Africa on behalf of HBS.
A lawyer and strategist with 20 years of experience as an attorney and business professional operating across Africa, Europe and North America, Pippa has held a number of leadership roles with large multinationals working across the continent. Prior positions includes serving as Director of Legal and Corporate Affairs for Microsoft South Africa, and Director of Pan-African Strategic Initiatives for Coca-Cola South Africa.
As a graduate of Harvard College, Pippa has been an active alumnus, serving in a number of volunteer roles for the alumni community in South Africa. In addition, Pippa holds a JD from New York University, specializing in international law, and is fluent in French. Raised in Liberia, Pippa returned to Africa 13 years ago and has since lived in South Africa and Kenya.