MIT SLOAN SCHOOL OF MANAGEMENT
GLOBALHEALTH LAB
Initial application for prospective partners
GlobalHealth Lab student projects 2012-13
Note: Projects will run from early February to late April 2013, with student collaboration
beginning in late 2012 or early 2013
Thank you for your interest in GlobalHealth Lab, an MIT class that pairs teams of students with
enterprises on the front lines of health care delivery in resource-limited settings to address their
pressing organizational and business needs. This application questionnaire will help us understand
your needs and assess if your project is a good fit for us. The application is divided into an initial
check and two parts: Part One is about the project and your organization, and Part Two, which
comes later, addresses resources and logistics for the project.
Please make note of key milestones for this year’s projects:
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Turn in Initial check and Part One during October. They are due by November 2, 2012 the
latest. The earlier we get these, the better.
We’ll give you some quick feedback, and for projects that will fit well, Part Two is due no
later than November 23, 2012.
Students will be matched with projects by December 14, 2012.
Matched projects will be taken up in our GlobalHealth Lab course which runs at MIT from
February-April, 2013 (we ask student teams to make initial contact with hosts in December
to prepare to start in February).
The two-week onsite intensive work takes place when the MIT students come to your
organization, around March 16-30, 2013.
The Initial Check and Part One are below. After you have submitted these, if your project looks to be
a good fit for our class, we will contact you with a request to submit Part Two. You may also find
more information about how the course works and see sample projects
http://globalhealth.mit.edu/past-projects. Our email is global.health.lab@mit.edu.
To start, please complete the initial check below. If you have any questions, it will be useful to
review our Note to Prospective Hosts, available from us or online at http://globalhealth.mit.edu/labpartner. To complete the questionnaire, you’ll need to have a project in mind, even if tentative. We
understand that the project itself is likely to evolve. Please don’t hesitate to contact us with
questions.
GlobalHealth Lab 2012-2013 Partner Application Part One
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Initial check: Is the project a good fit with GlobalHealth Lab?
Our goal is to enable leading organizations to deliver more or better healthcare to those in greatest
need. We are grateful for your interest in partnering with us on student projects. As you complete
this initial set of screening questions to assess potential fit, please keep your key needs in mind.
What aspects of your organization’s operations, strategy, or marketing create your biggest
challenges or opportunities?
1. In which country is the site with which you would like us to work? (See note below)
[ ] Kenya
[ ] Uganda
[ ] South Africa [ ] India ________________state
[ ] Ghana
[ ] Tanzania [ ] Zambia
[ ]Bangladesh [ ] Mozambique
[ ] Other _________________________ you must specify
2. Do you deliver clinical care yourselves or work directly with doctors, nurses, or health
workers who deliver health care in resource-constrained settings?
[ ] Yes [ ] No
3. Are more than a third of your patients or beneficiaries low-income?
[ ] Yes [ ] No
4. Which broad area or areas does the project you have in mind relate to? For more information, see
http://globalhealth.mit.edu/lab-focus-areas.
[ ] Operations
[ ] Strategy and leadership
[ ] Technology decisions
[ ] Demand and marketing
[ ] Finance and revenue [ ] Not sure
[ ] None of the above
5. Will it be feasible for you to work with our team October - December to develop the project?
[ ] Yes [ ] No
6. Will it be feasible for you to work with students remotely December - January, intensively
February - mid March, and in April?
[ ] Yes [ ] No
7. Will it be feasible for you to work with students and possibly faculty on site March 16-30?
[ ] Yes [ ] No
8. Will you be able to help organize trip logistics (for instance, finding lodging) and help offset
costs to some extent (to be discussed)?
[ ] Yes to both
[ ] Yes to logistics, no help with any costs
[ ] No to both
Now, if you selected the last answer to most of the questions above, you are probably not a
good fit for GlobalHealth Lab this year; please keep us in mind for future efforts. If your selected
answers are not the last items, please proceed. If you are not sure, please complete Part One and
ask us for feedback.
GlobalHealth Lab 2012-2013 Partner Application Part One
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GlobalHealth Lab Project host application
Part One: The project and the organization
A. About your organization
A1.
What is the name of your organization?
A2.
Where would the project be located (city or area)?
A3.
If you have a website, what is the address?
A4.
Please describe in one sentence each of the following:
 your organization’s mission
A5.

its age and history

its main services, programs, or areas of operation

its size (e.g. number of patients per month, number of employees and locations)

is it for profit, nonprofit, or a hybrid
How does your organization fund its operations (from operations/commercial finance,
grants, self-funding, etc.)? At your option, please include the names of any large donors.
B. Project contact
B1.
B2.
B3.
Who is the primary contact person for this project? This would be the person whom the Lab
team and MIT students can contact to discuss the project.
 Name:
 Title/role:
 Time zone:
 E-mail:
 Phone number(s):
 Skype id:
Please confirm that this contact will be available to work with the Lab team this fall and for
frequent student contact and collaboration for the duration of the project.
If this form has been filled out by someone other than one of the above, please let us know
your name, role, and email.
GlobalHealth Lab 2012-2013 Partner Application Part One
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C. Problem Focus
C1.
From your organization’s perspective, what problem, opportunity, or situation would you
like to address?
C2.
How would your addressing this problem, opportunity or situation help deliver more or
better healthcare to the people in greatest need?
D. Activities and Deliverables
A faculty-supervised team of four students would work with you from MIT, first contacting you in
December 2012. The team would work intensively February-April and spend two weeks at your
organization from March 16-30, 2013.
D1.
What is the key deliverable that the team should provide to your organization at the
conclusion of their work in April 2013?
D2.
What do you anticipate the team of students would do over the course of their work before
and on site? Please list the specific tasks that would enable them to complete the key
deliverable.
D3.
How would you categorize this project? (Operations, Demand and marketing, Finance and
revenue, Strategy and leadership, or Technology adoption)? For more information, see
http://globalhealth.mit.edu/lab-focus-areas.
E. Support and collaboration
E1.
Participation of senior leadership is crucial to project success. With which of your senior
staff do you expect the team will work closely?
E2.
How much time will each of them be able to spend in person with the team during their site
visit March 16-30?
E3.
What financial support can you offer for the students’ air travel, local travel, board, and
lodging? We’ll ask for more details later, but for now an estimate of the total amount you
could contribute would be helpful for our planning. To give you an idea, past hosts have
typically covered local travel, board, lodging, and some percentage of air travel.
GlobalHealth Lab 2012-2013 Partner Application Part One
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E4.
Does your organization have any connections your organization has with MIT, Harvard, or
other collaborators in North America? Will any member of your organization be in the
Boston area in the next few months? This will not affect your eligibility.
E5.
How did you hear about GlobalHealth Lab?
Thank you very much!
GlobalHealth Lab 2012-2013 Partner Application Part One
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