Improving healthcare services access at the bottom of the pyramid: the role of profit and non-profit organisations in Brazil
TL;DR: The paper brings value by comparing for-profit and non-profit organisations, which have the same social goal of improving health-care access to low-income populations while developing different practices to deal with their own challenges.
Abstract: This study aims to highlight the processes that private organisations implement to improve access to health care services for low-income communities in Brazil.,A qualitative research based on a comparative case study was conducted in Sao Paulo. A for-profit organisation and a not-for-profit one were compared to scrutinise how they adapt themselves to the social context they are embedded in; while improving their service accessibility.,Both kinds of organisations have succeeded to reach their goal of improving the access and reducing the time frame of health care services to low-income populations. Their initial business model (BM) makes them face their own challenges that they face with different strategies. It affects their way of communicating, their organisational culture, the patients’ expectations and their level of inclusiveness.,The research is context-dependent because of the specific conditions of the health public system in Brazil. When shaping health care BMs, the national context must be taken into account and the service marketing components should be used to enhance patients’ value co-creation in the health care service delivery process.,The research gives insights to organisations that seek to adapt their BM to improve health-care access to low-income populations.,Health-care access plays a key role in improving populations’ living conditions and reach one of the sustainable development goals of the United Nation.,Health care services access at the bottom of the pyramid remains under-studied. The paper brings value by comparing for-profit and non-profit organisations, which have the same social goal of improving health-care access to low-income populations while developing different practices to deal with their own challenges.
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TL;DR: In this article, the authors uncover institutional voids as the source of market exclusion and identify two sets of activities: redefining market architecture and legitimizing new actors as critical for building "inclusive" markets.
Abstract: Much effort goes into building markets as a tool for economic and social development, often overlooking that in too many places social exclusion and poverty prevent many, especially women, from participating in and accessing markets. Building on data from rural Bangladesh and analyzing the work of a prominent intermediary organization, we uncover institutional voids as the source of market exclusion and identify two sets of activities – redefining market architecture and legitimating new actors – as critical for building ‘inclusive' markets. We expose voids as ‘analytical spaces' and illustrate how they result from conflict and contradiction among institutional ‘bits and pieces' from local political, community, and religious spheres. Our findings put forward a perspective on market building that highlights the ‘on the ground' dynamics and attends to the ‘institutions at play', to their consequences, and to a more diverse set of ‘inhabitants' of institutions.
739 citations
TL;DR: In this article , a systematic literature review explores the limitations of the dominant corporate-led market development model and proposes a more pluralistic route with greater roles for local, non-affiliated entrepreneurs, nonprofits, and the public sector.
Abstract: Markets not only enable wide technology diffusion but also shape sustainability transitions. From this perspective, it is critical to investigate the shaping effects of markets and market formation processes for human wellbeing and the environment. Through a systematic literature review, this study explores the limitations of the dominant corporate-led market development model. This constitutes the global compass for present-day energy access programs and international development policy, framed around the potential of foreign-affiliated corporate enterprises for the market-based diffusion of solar products in the Global South. Findings suggest that due to tradeoffs between people, planet, and profit-directed goals, the companies cannot enable sustainability transitions and equal and sustainable access to the energy poor. Instead, the corporate-led market development route reproduces structural injustices. A more pluralistic route with greater roles for local, non-affiliated entrepreneurs, non-profits, and the public sector is proposed for negotiating the tradeoffs to the extent possible.
9 citations
TL;DR: In this paper, a systematic literature review explores the limitations of the dominant corporate-led market development model and proposes a more pluralistic route with greater roles for local, non-affiliated entrepreneurs, nonprofits, and the public sector.
Abstract: Markets not only enable wide technology diffusion but also shape sustainability transitions. From this perspective, it is critical to investigate the shaping effects of markets and market formation processes for human wellbeing and the environment. Through a systematic literature review, this study explores the limitations of the dominant corporate-led market development model. This constitutes the global compass for present-day energy access programs and international development policy, framed around the potential of foreign-affiliated corporate enterprises for the market-based diffusion of solar products in the Global South. Findings suggest that due to tradeoffs between people, planet, and profit-directed goals, the companies cannot enable sustainability transitions and equal and sustainable access to the energy poor. Instead, the corporate-led market development route reproduces structural injustices. A more pluralistic route with greater roles for local, non-affiliated entrepreneurs, non-profits, and the public sector is proposed for negotiating the tradeoffs to the extent possible.
9 citations
01 Oct 2018
TL;DR: In this article, an exploration of the oeuvres of Alphonso Lingis, Kathleen Stewart and Mathieu Brosseau in regards to the (self-) reflexivity of the researcher is presented.
Abstract: Guest editorial. An exploration of the oeuvres of Alphonso Lingis, Kathleen Stewart and Mathieu Brosseau, in regards to the (self-) reflexivity of the researcher. Upon epistemological and ethical grounds, relatedness is methodically stripped out of our research. As organizational researchers, we usually write ourselves out of our research;research processes are disconnected to their manifold contexts. And the absence of relatedness prevents engagement, care and deep learning. Separation and distance preclude the challenging of one's presuppositions and thought. On the contrary, research is here presented as learning and performance, and following the footsteps of Lingis, Stewart and Brosseau proposes possible and challenging paths, as well as the contention that it has become epistemologically and ethically desirable to describe organization poetically. Indeed, relatedness implies alternative forms of inquiry and writing, based on exposure and exploration, radical openness, affect and sensitivity, in evocative and reflexive writing.
3 citations
TL;DR: In this paper , the effects of donations on mitigating the negative effects of COVID-19 on vulnerable communities were modeled using the system dynamics method, and the results showed that increasing access to cleaning supplies in communities through donations can significantly reduce coronavirus transmission, particularly in high-density and low-resource areas, such as slums in urban settings.
Abstract: The governments' isolation measures to contain the transmission of COVID-19 imposed a dilemma for the people at the bottom of the pyramid. Since these people have very unreliable sources of income, a dilemma arises: they must either work under risky conditions or refrain from work and suffer from income cuts. Emergency donations of food and cleaning supplies in a pandemic context might be overlooked by government and civil society actors. This paper aims to model the effects of donations on mitigating the negative effects of COVID-19 on vulnerable communities. Applying the system dynamics method, we simulated the behaviour of the pandemic in Rio de Janeiro (Brazil) communities and the impacts that donations of food and cleaning supplies have in these settings. We administered surveys to the beneficiaries and local organisations responsible for the final distribution of donations to gather information from the field operations. The results show that increasing access to cleaning supplies in communities through donations can significantly reduce coronavirus transmission, particularly in high-density and low-resource areas, such as slums in urban settings. In addition, we also show that food donations can increase the vulnerable population's ability to afford necessities, alleviating the stress caused by the pandemic on this portion of the population. Therefore, this work helps decision-makers (such as government and non-governmental organisations) understand the impacts of donations on controlling outbreaks, especially under COVID-19 conditions, in a low-resource environment and, thus, aid these hard-to-reach populations in a pandemic setting.
1 citations
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TL;DR: This article provided a broad and multifaceted review of the received literature on business models in which the authors examined the business model concept through multiple subject-matter lenses and found that scholars do not agree on what a business model is and that the literature is developing largely in silos according to the phenomena of interest of the respective researchers.
3,850 citations
TL;DR: In this paper, a comparative analysis of commercial and social entrepreneurship using a prevailing analytical model from commercial entrepreneurship is presented, highlighting key similarities and differences between these two forms of entrepreneurship and presents a framework on how to approach the social entrepreneurial process more systematically and effectively.
Abstract: Entrepreneurship has been the engine propelling much of the growth of the business sector as well as a driving force behind the rapid expansion of the social sector. This article offers a comparative analysis of commercial and social entrepreneurship using a prevailing analytical model from commercial entrepreneurship. The analysis highlights key similarities and differences between these two forms of entrepreneurship and presents a framework on how to approach the social entrepreneurial process more systematically and effectively. We explore the implications of this analysis of social entrepreneurship for both practitioners and researchers.
2,628 citations
TL;DR: In this article, a new framework for understanding how the concepts of service exchange and value co-creation are affected by recognizing that they are embedded in social systems is presented, and the authors argue that value should be understood as value-in-social context and that value is a social construction.
Abstract: According to service-dominant logic (S-D logic), all providers are service providers, and service is the fundamental basis of exchange. Value is co-created with customers and assessed on the basis of value-in-context. However, the extensive literature on S-D logic could benefit from paying explicit attention to the fact that both service exchange and value co-creation are influenced by social forces. The aim of this study is to expand understanding of service exchange and value co-creation by complementing these central aspects of S-D logic with key concepts from social construction theories (social structures, social systems, roles, positions, interactions, and reproduction of social structures). The study develops and describes a new framework for understanding how the concepts of service exchange and value co-creation are affected by recognizing that they are embedded in social systems. The study contends that value should be understood as value-in-social-context and that value is a social construction. Value co-creation is shaped by social forces, is reproduced in social structures, and can be asymmetric for the actors involved. Service exchanges are dynamic, and actors learn and change their roles within dynamic service systems.
1,254 citations
Posted Content•
TL;DR: In this article, the authors uncover institutional voids as the source of market exclusion and identify two sets of activities: redefining market architecture and legitimizing new actors as critical for building "inclusive" markets.
Abstract: Much effort goes into building markets as a tool for economic and social development, often overlooking that in too many places social exclusion and poverty prevent many, especially women, from participating in and accessing markets. Building on data from rural Bangladesh and analyzing the work of a prominent intermediary organization, we uncover institutional voids as the source of market exclusion and identify two sets of activities – redefining market architecture and legitimating new actors – as critical for building ‘inclusive' markets. We expose voids as ‘analytical spaces' and illustrate how they result from conflict and contradiction among institutional ‘bits and pieces' from local political, community, and religious spheres. Our findings put forward a perspective on market building that highlights the ‘on the ground' dynamics and attends to the ‘institutions at play', to their consequences, and to a more diverse set of ‘inhabitants' of institutions.
739 citations
TL;DR: The bottom of the pyramid (BOP) proposition argues that large companies can make a fortune by selling to poor people and simultaneously help eradicate poverty as mentioned in this paper, but the market at the BOP is generally too small monetarily to be very profitable for most multinationals.
Abstract: The popular "bottom of the pyramid" (BOP) proposition argues that large companies can make a fortune by selling to poor people and simultaneously help eradicate poverty. While a few market opportunities do exist, the market at the BOP is generally too small monetarily to be very profitable for most multinationals. At the same time, the private sector can play a key role in poverty alleviation by viewing the poor as producers, and emphasize buying from them, rather than selling to them.
718 citations