Wearing the MBA Hat: Propelling Access to Clubfoot Treatment Across Africa

Smridhi Khanna and Prasad Nallusamy

MiracleFeet’s partnership with INSEAD started in 2021 when MBA students gathered for the 10th Master Strategy Day - a competition to create a strategy for MiracleFeet to expand clubfoot treatment in middle-income countries. Since then, the partnership has continued through a follow-on field-based course in INSEAD’s MBA programme called Business as a Force for Good Practicum or BFG. This year, course culminated in a trip to The Gambia. 

Pursuing an MBA from INSEAD, the business school of the world, means studying with students of 65+ nationalities, spending hours brainstorming solutions to difficult problems, and exploring the world together. However, of all the experiences we had in the last 10 months, traveling to The Gambia, the smallest country in Africa that many of us knew very little about, to work with MiracleFeet, clearly stood out.

When we traveled to The Gambia in October, along with 22 of our MBA classmates, we were tasked with creating pragmatic solutions for six of MiracleFeet’s African partners to help further their work with hospitals, government agencies, and other local partners to deliver clubfoot treatment to families searching for care. 

Accounting for the level of support MiracleFeet provides and the unique challenges facing each partner, we were divided into six groups, each assigned a specific country to research and help create solutions to overcome the challenges of the countries (The Gambia, Madagascar, Nigeria, Morocco, and Sudan). 

Challenges included: increasing patient access to clubfoot treatment, increasing awareness of the condition in rural and semi-urban areas, ensuring adequate number of trained providers, and building partnerships with local organisations and governments to unlock funding and increase systematic support for clubfoot treatment.

Our experience can be divided into three phases:

1.    Preparation (before the visit)

The project's first phase included a presentation by MiracleFeet giving a broad overview of clubfoot, MiracleFeet’s operating model in each of the six countries, and the overall challenges. We were then put in touch with MiracleFeet’s local partners to learn more about the country-specific challenges. 

Using the financial reports provided to us and conversations with partners, most of the groups initially identified setting up new clinics and unlocking funding support from government and local NGOs as the key tasks.

2.    On-ground experience (during the visit) 

With our ideas in mind and excitement to solve these challenges building, we embarked on a five-day trip to The Gambia. The first two days were dedicated to visiting clubfoot clinics and spending time with patients and families in their homes to gather as much on-ground data about clubfoot treatment and parents’ experience with it. 

We saw clubfoot clinics that utilised government hospital rooms and had very basic equipment - sometimes only a fan and a table. Some parents had to be contacted multiple times to encourage them to bring their children in for treatment. 

However, seeing patients’ homes and hearing from them personally was eye-opening; it revealed how people lived in very humble settings with large families and had limited access to jobs, education, and money. Some parents had six children, all of whom relied on one working member of the family for food. 

Travelling for a weekly clubfoot treatment appointment often meant utilising multiple modes of transportation to reach the clinic - many kilometres and many hours away. It also meant forgoing a day’s wages and spending already limited resources on transportation.  

While visiting the families, we also saw how social stigma hindered them from visiting treatment centres (opting instead for local healers) thereby urging us to design solutions to address these specific challenges.


3.    Co-creating solutions with local partners (during the visit)

Following the clinic and family visits, we teamed up with the local partners to develop solutions that would add value to their operations. 

We applied design-thinking principles to reframe our initial questions and be more patient-centric. 

For instance, from our initial problem statement of examining how we could increase enrolments in the clinics, we pivoted to exploring ideas for how to improve the patient’s journey from remote areas and complete treatment. 

Unlike before the trip where we anticipated the lack of funding and government support as the main bottlenecks, our solutions focused instead on making treatment more accessible to families through mobile vans, building basic dorms around clinics to assuage the travel burden on families, and spreading awareness of clubfoot treatment through local stakeholders and decision-makers such as partnerships with spiritual healers, church communities, schools, and vaccination centres.

A key part of our programme was the partnership with local MiracleFeet partners who not only collaborated on solutions with us, but also went a step further discussing implementation timelines, how to tackle key on-ground challenges, and how to measure the success of our recommendations. 

Their knowledge and experience working in a local context helped us re-think some recommendations and helped us learn our biggest lesson: even a well thought-through strategy will fail if the social realities and local contexts do not support it. 

Our experience in The Gambia was intriguing, insightful, and humbling. 

It made us even more passionate about using our time, education, and skills to support causes close to our hearts.

We are hopeful that our collaborations with continue and grow, and that our contributions to helping increase access to clubfoot will help ensure more children receive the care they deserve.

INSEAD is grateful to Aaro Eide (MBA’91J) and Georg Madersbacher (MBA’90D) for their generous support. This programme is organised and supported by the INSEAD Healthcare Management Initiative.