Partners in Health in Neno District, Malawi

This case focuses on the economic impact of investing in health care infrastructure in Malawi from 2007 to 2012. It examines management leaders’ decisions within Abwenzi Pa Za Umoyo (APZU) and its founding organization, Partners In Health (PIH), as they supported the Government of Malawi in building a hospital and scaling up the delivery of APZU clinical and social programs across Neno district. The case highlights how a non-governmental organization can navigate the politics and local culture to improve Malawi's health care system in close partnership with a strong, protocol-driven government. The case begins with Ophelia Dahl, co-founder and executive director of Partners In Health, reflecting on her December 2011 trip to Neno nearly four years after her first visit. She observed signs of progress unrelated to health: bank branches had opened in town, a new road had been built, and the market had expanded dramatically. Ultimately, the case explores what this demonstrates about the value of her organization's investments in health.

Learning Objectives: To understand the challenges of hiring and retaining local and expat staff, the complexity of an international NGO partnering with the government to improve health care, how leadership acumen and approaches impact scaling up and sustaining health care delivery, the relationship between the district hospital and the local economy, and how to assess impact beyond health measures.

The Global Health Delivery (GHD) Project, an interdisciplinary collaboration between Harvard Business School, Harvard Medical School, and Brigham and Women’s Hospital, investigates the management decisions behind disease treatment and prevention globally. The Global Health Delivery (GHD) Case Collection is a set of teaching case studies that are available for all at no cost online through Harvard Business Publishing, GHDonline, and The Case Centre.