Aftertaste Foundation (Aftertaste) was an organization that provided livelihood support to women living in the impoverished urban areas of Mumbai, India, who created sustainable handicrafts. Aftertaste was started in 2013 and initially employed three craftswomen. By 2021, the organization had expanded to two locations and had increased the number of craftswomen employed to 40. Aftertaste’s business model was focused on creating social impact by generating revenue through the sale of handcrafted items to corporate and retail buyers. For six years, Aftertaste was supported financially by the social impact organization Avanti Foundation. In September 2019, Aftertaste was registered as an independent entity. However, shortly after its transition, in March 2020, the foundation was confronted by the challenges of the COVID-19 pandemic. A nationwide order for temporary lockdowns soon forced Aftertaste to stop all in-person operations. When the country started reopening after pandemic lockdowns, Aftertaste’s owner struggled to maintain the financial sustainability of her organization. Surrounded by enduring pandemic uncertainty, she had to decide what strategy to pursue for the future of her organization. How could she overcome her venture’s losses and lead Aftertaste on a path of financially sustainable growth?

Aftertaste Foundation (Aftertaste) was an organization that provided livelihood support to women living in the impoverished urban areas of Mumbai, India, who created sustainable handicrafts. Aftertaste was started in 2013 and initially employed three craftswomen. By 2021, the organization had expanded to two locations and had increased the number of craftswomen employed to 40. Aftertaste's business model was focused on creating social impact by generating revenue through the sale of handcrafted items to corporate and retail buyers. For six years, Aftertaste was supported financially by the social impact organization Avanti Foundation. In September 2019, Aftertaste was registered as an independent entity. However, shortly after its transition, in March 2020, the foundation was confronted by the challenges of the COVID-19 pandemic. A nationwide order for temporary lockdowns soon forced Aftertaste to stop all in-person operations. When the country started reopening after pandemic lockdowns, Aftertaste's owner struggled to maintain the financial sustainability of her organization. Surrounded by enduring pandemic uncertainty, she had to decide what strategy to pursue for the future of her organization. How could she overcome her venture's losses and lead Aftertaste on a path of financially sustainable growth?

The case explores the promises and challenges of Public-Private Partnerships (PPPs) in the Indian Healthcare system. India has a high maternal mortality rate, poor doctor-to-patient ratio, rising C-section rates, absence of last-mile access to quality maternal healthcare. In this context, Dr. Fernandez, a veteran in maternal healthcare, believes that midwifery is a workable solution to these widespread problems. However, to have an impact both in terms of and financial sustainability, government support is essential. Dr. Fernandez thinks that a PPP may be the best way to create many well-trained and professional midwives in the country. However, given India's complex healthcare structure, it is not easy to get acceptance and commitment from all the states for government schemes. Problems such as frequent changes in the bureaucratic leadership often disrupt the implementation of schemes. Another challenge is the mindset of birthing mothers, the obstetric community, and family members who view the medicalization of birthing as acceptable. Dr. Fernandez has to overcome multiple challenges. She has to address obstetricians' pushback while changing birthing mothers' mindsets and continually motivate the midwives her team had trained. Regarding the PPP, she has to evolve a plan to fast-track the rollout of the PPP model, ensure that the complex PPP involving multiple stakeholders works effectively, she has to address the roadblocks to the implementation of the PPP initiative, and design mechanisms to monitor progress.

The case delineates the journey of L.V. Prasad Eye Institute (LVPEI), which evolved to become the biggest rural eyecare network, and it is amongst the most well-known eyecare providers in the world. Established in the year 1987 in the city of Hyderabad, India, LVPEI had been known internationally for its quality of eye care. As part of its vision, it treats half of its patients free of cost by adopting the cross-subsidization model. It developed the unique 'Pyramid Model' to serve the last mile population. The subject of Strategy and Innovation is riddled with paradoxes. A paradox is typically a pair of opposites, that have to be creatively reconciled, ensuring that both the opposites are simultaneously true. The case is set in the year 2018, and the key highlight of the case is to showcase how LVPEI has reconciled the hierarchy of paradoxes, i.e., strategy paradoxes, and innovation paradoxes during its 30 years journey and achieved excellence in eye care. The vital question of how LVPEI can sustain continued innovative excellence has emerged now. The senior management of LVPEI has to chart their way forward for the coming 30 years, reconciling the hierarchy of paradoxes. These paradoxes are elusively described in the case. Students would need to identify the paradoxes and think through LVPEI's journey ahead by reconciling them.

The case explores the journey of Fernandez Hospital (FH) and its evolution from a small maternity clinic to a tertiary-level hospital for women and children with a focus on accessible and high-quality healthcare in the areas of obstetrics and gynecology. Dr. Evita Fernandez, CEO of FH, was a vocal advocate of natural birth, contrary to the trend towards Caesarean section (C-section) deliveries seen in most hospitals across India. The case is set in the year 2014 and deliberates on the options that Dr. Fernandez had at different stages of FH's journey and the strategic decisions that she and her team made and implemented. It showcases the challenges FH faced in deciding what to do next while keeping its values intact. From studying the case, students will appreciate the need for organizations to develop a framework to help them analyze their current situation, establish priorities, identify opportunities, and make rational and well-informed decisions about the future. Dr. Fernandez had an expansive purpose of enabling safe deliveries in society at large. While an expansion of the existing hospitals may achieve this goal to the limited extent of enabling safe deliveries within her hospitals, it would not result in a much wider preference across the country for natural deliveries over C-section deliveries. The case ends with Dr. Fernandez and her team contemplating various options available to them.