MIT SLOAN SCHOOL OF MANAGEMENT
GLOBAL ENTREPRENEURSHIP LAB
G-Lab: Global Health Delivery 2009
Projects run September 2009-January 2010
Application for Prospective Hosts
This application questionnaire is divided into an initial check and two parts. Part One is about the project and
your organization, and Part Two addresses resources and logistics for the project.
To start, please review the Note to Prospective Hosts and complete the initial check.To answer the questions,
you’ll need to have a project in mind, even if tentative. We understand that the project itself is likely to evolve.
Please complete Part One as early as possible, but in any case by 24 July 2009. If needed, the G-Lab GHD
team will help refine proposals based on the Part One submissions. The earlier we get these, the better.
The entire application, Parts One and Two, is due no later than 21 August, 2009. An online application form is
expected to be available in early June via http://g-lab.mit.edu but the same applications are also
downloadable from http://globalhealth.mit.edu/glab-ghd/. Our email is glab.ghd@gmail.com. You may
also find more information at the G-Lab website, http://g-lab.mit.edu, which we expect to be updated by
early June. To learn more about last year’s experience, please visit http://globalhealth.mit.edu/glab-ghd/.
G-Lab GHD 09 Application Questionnaire
Initial check
1. In which country/countries is your site with which you would like us to work?
Kenya
Ghana
Rwanda
Uganda
Zambia
Malawi
Tanzania
South Africa
None of these
2. Do you deliver clinical care yourselves or work directly with doctors, nurses, or health
workers who deliver health care to patients?
Yes
No
3. Which broad area or areas does the project you have in mind relate to?
i. improving your processes and operations
ii. managing supplies and other logistics
iii. improving patient demand for or access to your services
iv. developing a new line of business or a new means of generating revenue
v. none of the above
vi. not sure
If your answer to questions 1 and 2 are “None of these” and “No”, we regret that your project does not fit with
G-Lab GHD, as it lies outside our focus this year. Please consider us for next year! On question 3, we are
looking for projects that fit in the categories we identified: if your proposed focus is very different, it is likely not
a good fit, either. If you are not sure, please complete Part One and ask us for feedback.
G-Lab GHD 2009-2010
1
G-Lab GHD 09 Application Questionnaire
Part One: The project and the organization
A. About your organization
1. What is the name of your organization?
2. Where would the project be located?
3. If you have a website, what is the address?
4. Please describe your organization’s mission and its main services or areas of
operation and give us a sense of your size (e.g. number of programs, number of
employees, patients served, or similar).
5. 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.
6. Does your organization have any connections to MIT or Harvard, including alumni
employees?
B. Hosting the project
1. Who is the contact person for this project? This should be the person whom the
G-Lab GHD team can contact to discuss the project.
a. name
b. title/role
c. work location(s)
d. email
e. phone number(s)
f. Skype id or any other contact information
2. Please list a secondary contact person in case the person listed above is not
available.
a. name
b. title/role
c. work location(s)
d. email
e. phone number(s)
f. Skype id or any other contact information
G-Lab GHD 2009-2010
2
3. Please confirm that contacts will be available to work with the G-Lab GHD team
this summer and also for frequent student contact and collaboration from
September 2009 to February 2010, including on-site in January.
4. If this form has been filled out by someone other than one of the above, please let
us know who you are.
C. Project focus
A faculty-supervised team of four students would work with you from MIT from October to
December 2009, then intensively at your organization for three weeks in January 2010.
1. What you would like a team of MIT MBA and other graduate students to do for your
organization? Briefly describe the key activities, identifying the components to be
completed in the autumn from MIT as well as the work on site.
2. What is the key deliverable that the team should provide to you at the conclusion of
their work with you in late January 2010?
3. In a sentence or two, what is your core problem, opportunity, or situation that this
project addresses?
4. How does this project improve the delivery of health services? Does it relate to
process improvement and supply chains; reaching and serving patients, including
via pricing, income generation, and marketing; or developing new lines of business
or organizational models to increase sustainability?
5. What training, skills and experience are most valuable for the team to bring to the
project? (Please note any language requirements.)
6. What preparation, research, or study can the team most usefully do at MIT from
September to December 2009, before they arrive at your organization?
D. Support and collaboration
1. 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.
G-Lab GHD 2009-2010
3
2. With which of your senior staff do you expect the team will work closely?
3. How much time will each of them be able to spend in person with the team during
January 2010?
4. Will you or another member of your organization be in the Boston area between
now and next spring?
5. Please list any collaborators in North America or elsewhere that we could contact
to learn more about your work.
6. We intend to present a list of organizations we’re working with as we share
information on G-Lab GHD with our students, alumni, and others. Please indicate if
you wish to be excluded.
7. How did you hear about G-Lab GHD?
Thank you very much!
G-Lab GHD 2009-2010
4
G-Lab GHD 09 Application Questionnaire
Part Two: Resources and logistics
Review
Please review your earlier responses to Part One, sections A to D. Feel free to make edits,
and add a note here to indicate where the substantial changes are and to make any other
comments.
E. Your personnel and materials
1. Whom should the students contact for help in arranging travel, confirming lodging
and other logistical details? If this person is already detailed as a project contact,
no need to repeat all details.
a. name
b. title/role
c. work location(s)
d. email
e. phone number(s)
f. Skype id or any other contact information
2. Please list data and any other materials that you will prepare or make available to
enable the student team’s work from late September on (e.g. data sets to gather,
introductions to make, past reports to assemble). This may be a draft list for now.
F. Assistance and Expenses
1. Please confirm that you will assist the student team by answering their travel
questions regarding their January on-site work and arrange accommodations that
are convenient and safe.
2. For each of the following, please indicate whether you intend to provide funding,
and if so, how much (in US$ or by percentage). For example, you might note next
to “Lodging” the following: “Yes, 100%” or “Yes, up to US$1,000 per student”. Note
that each team is four students.
i.
Lodging
ii.
Local transport: Commuting to work
iii.
Food
iv.
Local transportation for project-related research, meetings, etc.
v.
Transport (plus lodging if needed) for project work outside the local area.
G-Lab GHD 2009-2010
5
G. Accommodations and Conditions
It is critical that students know what to expect: where they will stay, what they will have
access to, and how they will work and live in January. Please answer all of the following,
providing detail as appropriate. NOTE: Your answers will be copied directly into the
material the students use to select their projects.
Primary Lodging
i.
Housing type (hotel, guest house, apartments, etc.)
ii.
Number of rooms (the four students likely includes both men and women)
iii.
Access to drinkable water
iv.
Access to showers, toilets, and running water
v.
Access to electricity
vi.
Access to Internet
vii.
Access to transportation
viii.
How far is the accommodation from the site where the students will work?
ix.
Access to food (restaurants, cafeteria, kitchen in the apartment, etc.)
x.
Safety
Back-up Lodging (in case the Primary Lodging is not available)
i.
Housing type (hotel, guest house, apartments, etc.)
ii.
Number of rooms (the four students likely includes both men and women)
iii.
Access to drinkable water
iv.
Access to showers, toilets, and running water
v.
Access to electricity
vi.
Access to Internet
vii.
Access to transportation
viii.
How far is the accommodation from the site where the students will work?
ix.
Access to food (restaurants, cafeteria, kitchen in the apartment, etc.)
x.
Safety
Working conditions at your site
1. Your usual working hours and days
2. Office/building type (hospital, clinic, office building, converted home, etc.)
G-Lab GHD 2009-2010
6
3. Working space available to the student team (dedicated office, conference room,
etc.)
4. Access to drinkable water
5. Access to electricity
6. Access to Internet
7. Access to a printer, if needed.
8. Land-line telephone
9. Access to transportation
10. Access to food (staff kitchenette, restaurants, cafeteria, etc.)
11. Safety
Photographs
If you can send us a picture or two of the working space and accomodations, that would
be very helpful.
H. Other
1. We appreciate any additional background on the country or region, its people and
culture; your organization’s history and development; information about specific
health care or medical aspects of the project; press articles, training materials,
white papers, or any other information you believe is important for the teams to
understand your organization, the project, and the opportunity. You may share
documents, web links, or materials in any other format. Please note here if you
have or intend to send us these additional materials.
2. What do you want to make sure the students are aware of as they make plans for
this project? Please give us any descriptive information, cautionary notes, etc.
3. Your name. Could you please tell us who has completed this form?
Thank you very much!
G-Lab GHD 2009-2010
7