U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital outpatient department (HOPD) and an ambulatory surgery center (ASC), Aravind Eye Hospital in Pondicherry, India (AEH-P), and Tilganga Institute of Ophthalmology (TIO) in Kathmandu, Nepal. Indexing HOPD to $100 and correcting for purchasing power parity, the costs of cataract care were $42.00 at ASC, $21.50 at AEH-P, and $16.10 at TIO. Lower cost at the two South Asian sites can be attributed to faster patient throughput, avoidance of intravenous anesthesia, increased use of mid-level staff, and more frequent reuse of supplies. Adopting clinical processes from these high-quality, lower-cost providers, including a top-of-license approach that optimizes physician time; instituting detailed process flows, task-specific staffing models; and strengthening the focus on supply costs, could significantly reduce cataract surgery costs in the United States but may require new incentives within the nation’s health system.
This article examines non-profit investments by business in education in emerging markets between the 1960s and the present day. Using a sample of 110 interviews with business leaders from an oral history database, the study shows that more than three-quarters of such leaders invested in education as a non-profit activity. The article explores three different types of motivations behind such high levels of engagement with education: values driven, context focussed, and firm focussed. The article identifies significant regional variations in terms of investment execution, structure, and impact. In South and Southeast Asia, there was a preference for long-term investment in primary and secondary education. In Africa and Latin America, some initiatives sometimes had a shorter-term connotation, but with high-profile projects in partnerships with international organisations and foreign universities. In Turkey, there was heavy focus on training and the creation of universities. The article concludes by examining the impact of this investment, comparing Chile and India especially. It discusses issues such as the paucity of financial data and the challenges of comparing different types of educational spending, which make robust conclusions hard, but does suggest that although such spending did not resolve major educational roadblocks across the emerging world, it represented a positive overall social gain.
The founder and CEO of BYJU’S, India’s largest edtech firm and one of the world’s most valuable edtech companies, is considering acquiring Aakash Educational Services (Aakash), one of India’s largest brick-and-mortar test-prep firms, for $1 billion. Is this a good strategic investment for BYJU’S, a rapidly growing “tech-first” company that still had so much to achieve online?
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Anjali Raina is the Executive Director of the Harvard Business School India Research Centre. In her leadership role at the IRC, Anjali focuses on building and maintaining relationships with senior business leaders in the region to facilitate the work of the center in research, educational programs, community building and faculty development.
Under her leadership, the IRC has facilitated the writing of over 168 case studies on Indian Business Practice and supported half a dozen research projects. Anjali has co-authored several case studies such as Aadhaar: India’s ‘Unique Identification’ System, TeamLease: Putting India to Work (II) Legally; Pratham – Every Child in School and Learning Well; Naina Lal Kidwai: Investing in Her Country; Tech Mahindra and the Acquisition of Satyam Computers (A); HN Agri Serve : Growing Prosperity as well as an HBR Article on The Ordinary Heroes of the Taj.
Anjali wears several additional hats. She is a Director on the Board of Harvard Business Publishing, India, the Regional President (Western Region) of NHRDN, an Advisor to The Akanksha Foundation, Trustee to LIFE Trust, an Advisory Member on the Board of HBS Club of India, and on the Advisory Board of the Indian Business School.
Prior to joining HBS IRC Anjali spent 15 years with Citigroup India, most recently as Country Director, before which she worked for more than a decade with ANZ Grindlays Bank PLC. Anjali holds an MBA from the Indian Institute of Management, Calcutta, a bachelor's degree (Eng. Hons) from Loreto College and is an alumnus of HBS having completed the Advanced Management Program.