Scaling up without selling out: Cases of Indian healthcare organizations for the underprivileged

Abstract

Social enterprises face an imperative to scale up their services in order to extend their reach to a larger number of beneficiaries. However, only a few social enterprises are able to successfully scale up and most of them remain restricted as a small localized initiative. One of the most important reasons for inability to scale up are the human resource challenges, which has two aspects (1) lack of availability of committed and skilled human resource and (2) a concern that scaling up may lead to dilution of organizational values and culture, due to which the organization may lose its focus on its vision. In spite of these constraints some organizations are able to successfully scale up without selling out on their values and culture. In this study, through an empirical investigation into scaled up social enterprises involved in delivering affordable health care services for the poorer section of the society, we attempt to explore how social enterprises scale up their services, expand their human resource base and yet maintain the values and culture that drive the organization. The study contributes to the social entrepreneurship literature by providing useful insights on addressing a unique trade off faced in scaling up, namely, to scale up their services and yet remain rooted to the organizational values and culture.