Worksheet No. A 1 Question Decision Legacy What are the key ‘decisions’ the company has made since its inception? What was the situation when these decisions were made? Answer To cater to the healthcare requirements of rural population by hiring local women as Sahayikas Situation – Problem Positive outcomes I. Increasing population in rural India presents huge opportunity for providing healthcare II. The importance of women in the lives of people in rural India Negative outcomes i. ii. 3 What are the causes of these outcomes? Failure of other medical options and prevalence of quacks Abysmal healthcare conditions in rural India

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Outcome: Importance of women Causes: Women directly responsible for health of children and can transfer best practices from generation to generation Outcome: Poor healthcare in rural India Causes: Prevalence of quacks as the only source of medical help in rural areas and lack of trust in other practices among people Problem: Low demand below the breakeven point making the program unsustainable Cause Lack of trust in modern medicine and lack of awareness among people in terms of ill effects of steroids Criteria Low number of patients and repeat patients  Awareness about the program as well as the ill effects of steroid injections   Trust and reliability of Piramal e-swasthya Confidence of people in Piramal workers Increasing awareness about the program as well as the ill effects of steroid injections Improving the trust and reliability of Piramal eswasthya Improving confidence of people in Piramal workers

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Key problem? Key causes that have caused the problem?

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What might have been the ‘criteria’ used to make these ‘key decisions’ in the past?

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Write the criteria as a standard vis-à-vis with which the decision ‘options’ can be evaluated?

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What were the other decision options available when the key decision/option was chosen?

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Make sahayika compensation linked to number of patients treated to provide incentives to reach out more Increase marketing specifically targeted at increasing awareness about Piramal and ill effects of steroid use Scrap the project completely Tie up with local institutions to increase awareness Target places frequented by rural population and key products used by them

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8 What were the ‘Action Points’ that were implemented to give effect to the ‘key decision option’?   

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In retrospect do you think the ‘key decision’ was right? Did it solve the problem by addressing the right cause?

Enighten people about the projects process and assure them that Piramal thinks about their well being Yes, the key decision would most suitably attack the basic problems that Piramal is facing

No. B 1

Question Current Situation What is the difference in the situation today compared to earlier periods? Can you list ‘outcomes’ – positive or negative – that define the situation today?

Answer Positive outcomes: a. A positive business plan backed by resources to help increase the healthcare condition in rural India Negative outcomes: b. Low awareness and lack of trust among people regarding the program

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What is the situation now? What are the main problems being faced today?

Situation – Women as sahayikas Positive outcomes a. Major influencers on lives of their children and family Negative outcomes b. Lack of trust in someone from their own village as a medical practioner Outcome: Women being major influencers Causes: Women are primariraly responsible for the healthcare needs of themselves and their families and can transfer the same from generation to generation

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What are the causes of these outcomes?

Outcome: Lack of trust among the villagers Causes: Lack of awareness regarding modern medicine and also lack of knowledge regarding the ill effects of steroid use. Problem: Lack of awareness and trust Cause: Low exposure to ill effects of steroid use and lack of knowledge among rural population Criteria: Awareness, Trust and reliability, Confidence in Piramal  Make sahayika compensation linked to number of patients treated to provide incentives to reach out more  Increase marketing specifically targeted at increasing awareness about Piramal and ill effects of steroid use Scrap the project completely

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Key problem? Key causes that have caused the problem?

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What are the decision options available that can help solve the problem?

 6 Which ‘criteria’ can be derived from the key ‘causes’ that have caused the ‘key problem’? Are the criteria mapped to the causes? Write the criteria as a standard vis-à-vis with which the decision ‘options’ can be evaluated?

Confidence in Piramal as a healthcare solution

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Yes     Increasing awareness about the program as well as the ill effects of steroid injections Improving the trust and reliability of Piramal eswasthya. Improving confidence of people in Piramal workers Lack of trust in the time taking medicine prescribed by Piramal as opposed to quick acting steroid injections Being referred to government institutions most of the time increasing lack of confidence and trust in the Piramal practices and authority

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Evidence needed to apply the criteria

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Drop or adjust any of the criteria? Risks associated with the recommendation?

No   Building trust is a long drawn process and can take time Risk of effectiveness of a targeted marketing campaign challenging the core beliefs of the people Tie up with local institutions to increase awareness

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What is the actionable content of the recommended decision

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option?

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Target places frequented by rural population and key products used by them

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Goal statement of the action plan Conclusion

Enlighten people about the projects process and assure them that Piramal thinks about their well being Building trust, loyalty and associativity with increasing awareness and proper knowledge Would require a collaborative effort among all the stake holders as building trust and loyalty is not an easy task and would go a long way in to creating better healthcare scenario for rural India.