Sustainability and Inclusiveness in a Competitive Market: A Study of Faith-Based Hospitals in India

Authors

DOI:

https://doi.org/10.15566/cjgh.v7i2.321

Keywords:

Faith-based Hospitals, Indian Mission Hospitals, Sustainability, Inclusive Healthcare, Not-for-profit Hospitals

Abstract

Introduction: The Christian Healthcare Network is the largest faith-based healthcare network in India, functioning, most often, in the hard-to-reach and underdeveloped areas.  It is facing serious challenges such as being forced to comply with the recent changes in government regulations, policies, and globalized market situations.  Such changes in the social and financial environment are driving hospitals to adopt newer strategies to remain sustainable.  Some of the mission hospitals are compromising their mission goals for which they were founded.  If financial viability becomes the goal, social responsibility to the community and the true meaning of mission gets distorted.  Their mission must remain the primary belief system, which legitimizes the structural arrangements and ideology of business.  Mission and business must go hand-in-hand.

Methods: An embedded case study method was used to purposively study 16 selected cases of Christian faith-based hospitals (FBHs) pan India with the objective to understand the nature of services employed, the role played by FBHs in India in different contexts, their challenges in the changing business environment, and how successful they were in remaining both sustainable and inclusive at the same time.

Results: The study found that despite the variation in the services and infrastructure of mission hospitals across India, these facilities have had an on-going commitment and a long-standing operation with regard to population health.  In their different settings, they are either the only service provider or the referral centre for the public facilities and the trusted choice of the middle- and lower-middle class population.  The least sustainable and inclusive among them seem to have deviated from their founding objectives due to market changes, but more than a quarter of them were successful in remaining inclusive and sustainable.  In pursuit of competitive advantages, some of them remained sustainable by dropping their inclusiveness, while a few ended up in existential crisis because of their adhesiveness to inclusivism.  The challenges of attracting professionals, generating funds for development, and operating within the ethical boundaries set by the church are well addressed by the models which are sustainable and inclusive.

Conclusion: In the context of drastic changes in both internal and external environments, some of the FBHs lost their business, some lost their mission and a few got corporatized. But a few remain successful in terms of inclusiveness and sustainability by innovative strategies.

Author Biography

John Varghese Thekkekara, St.John's Medical College, Bangalore

MHA, MPhil, PhD, Department of Hospital Administration

References

Cherian A, Mathew A, Tomy T, Priya J, Mercy.T, Santosh M, et al. Potential of non-state players for universal health coverage, in India infrastructure report. 2013/14, IDFC Foundation, Orient Long Swan. Available from: http://www.idfc.com/pdf/report/2013-14/IIR-2013-14.pdf

Narayan T, Johney J, Tomy P. A golden harvest: a dream come true. (The CHAI golden Jubilee evaluation study). Secunderabad: CHAI; 1993.

Wolff M. No margin, no mission: challenge to institutional ethics. [cited 2017 August 2]Bus Prof Ethics J. 1993;12(2):39-50. Available from: http://www.jstor.org/stable/27800908

Burns LR. India’s healthcare industry: innovation in delivery, financing, and manufacturing. Cambridge University Press. 2014.610. Available from: https://www.semanticscholar.org/paper/India%27s-Healthcare-Industry%3A-Innovation-in-and-Burns/8fd934cee2a571952aeb90db0e752cf446d273eb

Mahal A, Anil V, Srinivas T. Diffusion of diagnostic medical devices and policy implications for India. Int J Tech Assess Health Care. 2006;22:2,184–90. Available from: https://www.researchgate.net/publication/7208607_Diffusion_of_diagnostic_medical_devices_and_policy_implications_for_India

Rout SK, Kriti SS, Sandeep M. Utilization of health care services in public and private healthcare in India: causes and determinants. Int J Health Care Man. 2019. http://dx.doi.org/10.1080/20479700.2019.1665882

Baru R. Missionaries in medical care. Econ Polit Weekly, 1999;34(9):521-4.

Chakravarthi I. The emerging ‘health care industry’ in India: a public health perspective. Soc Change. 2013;43(2):165-76. https://doi.org/10.1177/0049085713493041

Yin RK. Case study research: design and methods (3rd ed). New Delhi: Sage Publications; 2003.

Gillham B. Case study research methods. Real World Research. London. 2000;58. Available from: https://dspace.utamu.ac.ug/bitstream/123456789/138/1/%5BBill_Gillham%5D_Case_Study_Research_Methods_(Real_W(BookFi.org).pdf

Narayan T, Johney J. Finding of the policy delphi method of research. Community Health Cell, Bangalore.1994;56.

White KR, Tiang-Hong.C, Roberto D. Catholic hospital services for vulnerable populations: are system values sufficient determinants?. Health Care Man Rev. 2010;35(2),175-86. http://dx.doi.org/10.1097/HMR.0b013e3181cafa20

O’Rourke K. Catholic hospitals and Catholic identity. Christ Bioet. 2001;7(1).5-28.

Parappally J. Redefining Christian mission to religions. In: Manjaly T, Kuriakose P, Peter H, editors. In the service of mission — studies in honour of Archbishop Thomas Menamparampil. Shillong: Oriens Publications; 2006.

Gentry WM. Debt, investment and endowment accumulation: the case of not-for-profit hospitals. J Health Econ. 2002 Sep 1;21(5):845-72. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12349885

Coye MJ, Kell J. How hospitals confront new technology. Health Affairs. 2006 Jan;25(1):163-73. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19787843

Mahal A, Karan AK. Diffusion of medical technology: medical devices in India. Expert Rev Med Devices. 2009 Mar 1;6(2):197-205. http://dx.doi.org/10.1586/17434440.6.2.197

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Published

2020-06-30

How to Cite

Thekkekara, J. V. (2020). Sustainability and Inclusiveness in a Competitive Market: A Study of Faith-Based Hospitals in India. Christian Journal for Global Health, 7(2), 7–18. https://doi.org/10.15566/cjgh.v7i2.321