Case

Caring Vision: Fighting Against FIIB Business Review

8(1) 17–24, 2019
2019 Fortune Institute of
Blindness in Bangladesh International Business
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DOI: 10.1177/2319714519831545
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Jashim Uddin Ahmed1

Sadeq Ahmed2
Asma Ahmed3
Mohammad Abdul Majid3

Abstract
Caring Vision Hospital (pseudo-name) started as a small charitable organization in Bangladesh which later turned to be a renowned
eye care institute. This eye care service model is dedicated towards providing proper eye care to both the affluent and underprivileged
patients through cross-subsidization measures. A key to the success of this concept is due to the good relationship between foreign
non-governmental organizations, philanthropists and renowned ophthalmologists who act as key stakeholders. The present case study
highlights the growth of Caring Vision. Moreover, the problems and future scopes shed light into the practical business world which
can be implemented across any organization.

Keywords
Bangladesh, eye care, cross-subsidization, cataract, blindness

A world in which nobody is needlessly visually impaired, overcome impaired vision—the Global Initiative, VISION
where those with unavoidable vision loss can achieve their full 2020: The Right to Sight. Vision 2020’s prime concerns are
potential and where there is universal access to comprehensive the cataract; trachoma; onchocerciasis; corneal blindness,
eye care services. refractive error and low vision (Pizzarello et al., 2004).
—Universal Eye Health: A Global Action Plan 2014–2019 These have been selected not only because of the major
issues but also due to its affordability and feasibility of
performing actions required to prevent and treat these
Blindness: Magnitude and medical conditions (Holden & Resnikoff, 2002).
There are about 285.405 million people in the worldwide
Prevalence
who are suffering from vision impairment. Out of them,
The World Health Organization (WHO) member states 39.365 million are blind and 246.024 million of them have
endorsed the new ‘Universal Eye Health: A Global Action impaired vision. According to an estimate by WHO (2012),
Plan 2014–2019’ in the 66th World Health Assembly to 4.24 per cent of the world population is visually impaired
strengthen eye health care and blindness prevention and 0.58 per cent are blind—BCVA (best corrected visual
programmes. The Global Action Plan (GAP) highlighted acuity) <3/60 in the better eye—and 3.65 per cent have low
the ‘need for generating evidence on the magnitude and vision—BCVA <6/18–3/60 in the better eye. Of the over
causes of visual impairment and eye care services and using 39 million, 6 million (15%) were from Africa, 2.7 million
it to advocate greater political and financial commitment by (7%) from Europe, 23 million (67%) from Asia, 3.2 million
Member States to eye health’ (WHO, 2013). (8%) from America and 5 million (12.5%) from the Eastern
Multiple organizations collaborated to eliminate Mediterranean (Aggarwal, 2015). Among them, 82 per
blindness due to injury, disease or congenital conditions and cent blind were over 50 years of age. In developed

1 Department of Management, School of Business & Economics, North South University, Bashundhara, Dhaka, Bangladesh.
2 School of Public Health, University of South Asia, Dhaka, Bangladesh.
3 InterResearch, Bashundhara, Dhaka, Bangladesh.

Corresponding author:
Jashim Uddin Ahmed, Department of Management, School of Business & Economics, North South University, Bashundhara, Dhaka 1229, Bangladesh.
E-mails: [email protected]; [email protected]
18 FIIB Business Review 8(1)

countries, the principal causes of blindness are age-related National Eye Care Plan 2005–2009 approved by the government
macular degeneration (AMD), glaucoma and diabetic 2005 followed by a groundbreaking event-creation of a post of line director
for National Eye Care
retinopathy. In the rest of the world, cataract1 (47%) is the
major cause. 2006 First operation plan (2007–2011) for National Eye Care
Additionally, the report also expressed that 12.049 formulated under HNPSP

million blind people and 78.482 million people with vision

impairment reside in the Southeast Asian region. This 2011 Second operation plan (2011–2016) for National Eye Care formulated
under HPNSDP
represents 30.60 per cent of world’s blind people and 35.89
per cent of world’s people with impaired vision. The
WHO’s 2010 data contained many key parameters that 2013 National blinding eye disease survey in Bangladeshi adults

form the base line data for the application of GAP to

universal eye health as laid down by the WHO Resolution
of 66.4 (WHO, 2013). 2014
Review of National Eye Care Plan 2005

Bangladesh Context Figure 1. Milestones of National Eye Care in Bangladesh

Bangladesh has been economically and socially recognized Source: Authors, 2018.
as a developing country with a population of 159.453
million (July 2018 estimate). Moreover, the population Eye Care Service
density (1,045 people per square kilometre—five times
than that of any other ‘mega’ country [>100 million])— The eye care service is principally worried about the
also poses a challenge (CIA, 2018). The nation faces safeguarding of ocular health and rectification of eye
considerable barriers that prevent it from satisfactorily problems that can reduce vision capacity. The primary
meeting its rising health care needs, including eye care objective is to provide eye examinations to visually
(Ahmed et al., 2015). In middle- and low-income countries, impaired persons by providing prescriptions for spectacles,
cataracts are known to be the leading cause of blindness. as well as retailing these products, that is, lenses and
There is a twofold variation in the widespread presence of frames.
blindness between the richest and poorest divisions (Muhit Qualitatively speaking, the cataract surgical rate is
et al., 2016). Blindness in developing countries, as well as 1,475 per million (2014 data) with a cataract surgical
in Bangladesh, is most commonly found in backward and coverage of 32 per cent. In Bangladesh, on average 1,000
rural, often remote underdeveloped areas. Over 90 per cent eye doctors are present with a ratio of (1:162,494) for
of the population health care expenditure is out-of-pocket, 156.18 million people with an eye health epidemiology
and 10 per cent are supported from the non-governmental (blind) of about 1.6 per cent. The ratio of optometrists to
organizations2 (NGOs) and government sector (Das et al., technicians: (n = 1,200) 1:125,000 (Das et al., 2017).
2017). Optometrists, opticians and ophthalmologists are the
In Bangladesh, the number of blind people aged 30 and primary caregivers when it comes to eye care service.
above is 750,000; 85 per cent of them have become blind Optometrists measure eyesight, prescribe corrective lenses
due to cataract (Ahmed, 2018). A staggering 120,000 people and detect eye diseases. Opticians typically manufacture
are added each year to that figure. More than 6 million and dispense glasses and corrective lenses in a variety of
people in Bangladesh need vision correction by spectacles locations as prescribed by an optometrist or ophthalmologist.
or by any other means. Overall treatment of disorders and diseases of the eye is the
The Government of Bangladesh is one of the signatories to specialty of an ophthalmologist. Laser surgery can
the Global Initiative launched in 1999 known as Vision 2020. eliminate the need for glasses or contact lens and has
In 2005, National Eye Care (NEC) plan was set in motion consequently experienced a rise in demand driven by those
along with a different operational plan of Health Nutrition and who can afford it.
Population Sector Program (HNPSP) which was subsequently In Bangladesh, the eye care scenario seems worse when
consolidated in the new Health, Population, and Nutrition weighed down by the fact that 90 per cent of doctors and
Sector Development Program (HPNSDP) (Figure 1). paramedics are based in urban areas while 80 per cent of
The motive of the national plan was to build secondary care people suffering from vision impairment live in rural areas
and strengthen primary health care infrastructure to facilitate where the treatment facilities are extremely poor. Visual
operation of prevention and referral cases. The detailed impairment of children limits their participation in
proposal included a combination of public–private and NGOs opportunities for education and self-development. More
in partnership with achieving Vision 2020 goal (The than 90 per cent of blind children receive no schooling
International Agency for the Prevention of Blindness, 2014). at all.
Ahmed et al. 19

Eye care programmes have primarily focused on the treat the poor. Even though facilities such as type of surgery
increasing numbers of cataract surgeries rather than the (SICS usually for poor and phacoemulsification usually for
quality of outcomes or patient satisfaction. In some clinics, affluent), type of surgical material (American IOL usually for
fewer fees attract more patients, leading to more net affluent and Indian IOL usually for poor), waiting area,
income. Rural, illiterate and underprivileged people are not waiting hour, air-conditioned wards and other facilities vary
completely mindful of the various interventions that can be according to patients’ preference and affordability, the hospital
accessed to return vision to the blind. People suffering ensures the same quality treatment for all levels of patients.
from eye diseases do not seek surgery because of different Mr Shamsuddin’s dream of eradicating avoidable
cultural, social (lack of attendant) and psychological blindness from Bangladesh has expanded outside the border
reasons (fear). The concept of comprehensive eye care of Dhaka with branches being established in Barisal,
(CEC) is to guarantee that recipients get a system of Jamalpur and Naogaon. The establishment of these ‘25-bed-
assistance that successfully prevents blindness, promotes capacity’ hospital branches was supported by Orbis
eye health and ensures provision of clinical services for International,4 and the goal of the branches is ‘Creating
treating the common and blinding eye diseases. Access to Eye Care Services for Rural People of Bangladesh’.
These branches provide treatments specially for ‘cataract
and refractive’ errors, which are the major reasons of
Background: Caring Vision Eye blindness in Bangladesh (Activity Report 2010–2012).
Hospital
In the late 1950s, Caring Vision Eye Hospital (referred to Strategies of Service and Cross-
as Caring Vision3) and Shamsuddin Institute of
Ophthalmology were established by industrialist and
subsidize Revenue Model
philanthropist late Mr Shamsuddin in Dhaka as a donation In order to achieve the goal of providing free-of-charge
for the welfare of the underprivileged community of quality eye care to those who cannot afford to pay, the
Bangladesh (Activity Report 2010–2012). Initiated as a Caring Vision Eye Institute and Hospital inevitably resorted
philanthropic dispensary, it was later transformed into a to extracting a surplus of funds by treating those who can
specialized eye hospital with the express intent of reducing afford to pay for their treatment—in other words, by
the number of unnecessary blindness among the deprived adopting the model of cross-subsidization. In order to do
people of the country. Since then, the hospital has been this, and to ensure that the operational model currently
providing the best and cost-effective eye treatment by being employed is sustainable, the solution is twofold:
allocating the most modern technology, best physicians, First, the model for general and poor patients must have
well-trained ophthalmologists and other support staff. It is low fees, small profit margin, economies of scale and high
the first and most equipped eye hospital of Bangladesh, and volume. Second, upscale facilities must be provided for
it has always been like a non-profit organization. Towards wealthier patients, so they can be charged a premium that
the end of 2011, the hospital was renamed as Caring Vision may be used to cross-subsidize the less fortunate patients,
Eye Institute and Hospital. The change emphasizes that it is and thus ensure sustainability. To establish this strategic
not just a hospital. It is also an institute where ophthalmic model, three groups of patients5 are self-selected to receive
trainings are provided to the ophthalmic nurses and treatment from the Caring Vision Eye Institute and Hospital
paramedics. The institution is offering postgraduate based on their financial ability to pay for the services:
fellowship programmes for the doctors who are interested
1. The established and affluent group, who will spend
to pursue their career in ophthalmology. Due to the lack of
premium sums to obtain premium facilities. This
proper government regulation of fellowship programmes,
group will, as a result, finance a significant part of
the proposed fellowship programme by Caring Vision is
the medical care required by poor patients.
yet to be established by legal authorization.
2. The ‘general patients’ from the aspirant and emerging
When Mr Shamsuddin established this hospital, his aim
middle groups who will get phenomenal treatment,
was to ensure quality eye care services to that economic
but who will pay only a modest amount that will be
section of the society which cannot afford quality treatment.
within their means. The large number of patients
Currently, this 50-year-old biggest ‘multidisciplinary’ eye
in this group enables the small margin charged to
hospital is providing quality treatment to all the socio-
be able to compensate for the expenses incurred in
economic sections of Bangladesh. This is because the new
running the hospital.
management committee recently realized that it is difficult to
3. The poor patients (bottom of the pyramid), who live
run such a large hospital and institute solely with donations
beneath the poverty line, and who cannot pay for
from individuals and organizations. Additional funding is
their services, will be treated without charge, and
required for branding of the hospital and institute as well.
will be presented with housing in modest facilities.
Therefore, cross-subsidization has been introduced to earn
However, they will be provided with the most up-to-
money from the affluent patients and then use the money to
date treatment with the finest equipment.
20 FIIB Business Review 8(1)

Special attention should be given to the fact that the Caring Competitive Advantages
Vision Eye Institute and Hospital’s emphasis is to ensure
that all patients are given the same quality of treatment and Caring Vision Eye Institute and Hospital is a centre of
the only differentiating factors are the facilities offered. excellence for providing modern, efficient and cost-
One can see that this model depends on Caring Vision’s effective eye care by ensuring latest sight-saving medical
ability to surpass the expectations of affluent individuals and surgical techniques. Moreover, it has got the best
while simultaneously providing the poor patient with ophthalmic paramedics and nurses along with the best eye
compassionate care and respectful consideration. A model specialists. Since its establishment in 1960, Caring Vision
such as this requires not only the delivery of technically has persevered to meet the eye care needs of the country.
superior treatment but also the possession of facilities, Caring Vision Eye Institute and Hospital is proud of its
equipment and ambiance needed to ensure the comfort of competence regarding four standards of proficiency:
middle-upper class patients. In addition, it requires expertly service, cleanliness, patient handling and support services
trained doctors who are skilled specialists in their fields for both indoor and outdoor patients. Furthermore, it has a
and an exceptional management team present in the built-in medical and surgical follow-up regimen. The
hospital who will in the future be able to allow further Caring Vision Eye Institute and Hospital offers a broad
development and expansion of numbers. range of services (as shown in Table 1).

Table 1. Service Portfolio

Services Types
Outdoor department • All OPD rooms are equipped with slit-lamps and other instruments
(OPD) services • Availability of day-care services
• Availability of 24-hour emergency services
Fast-track services • Separate registration counters
• Separate air-conditioned waiting areas
• Availability of attendants for quick services
Counselling services • Separate counselling facility/room
• Professional counselling for patients
Accommodation services • Availability of clean cabins and wards
• Separate facilities for children
Surgery facilities • Availability of fully equipped modern operation theatres (OTs):
(a) Different OTs for different types of operations
• All types of advanced eye surgeries, such as:
(a) Cataract: Phacoemulsification
Small incision cataract surgery (SICS): Paediatric cataract surgery
(b) Keratoplasty (corneal grafting)
(c) Oculoplastic surgeries: Squint surgery, ptosis surgery and dacryocystorhinostomy
(d) Vitreoretina surgery: Retinal detachment surgery, vitrectomy surgery
(e) Laser: Retinal laser (panretinal photocoagulation), Yag laser and laser for glaucoma
Sub-specialty services • Cataract, cornea, glaucoma, retina, oculoplasty, paediatric ophthalmology, uvea, neuro
ophthalmology
• Low vision centre, contact lens clinic, refraction unit
Medical support services • Internal Medicine, Cardiology and Anaesthesia
Laboratory services • Microbiology, Biochemistry, Pathology, Serology and Histopathology
Support services • Pharmacy: Availability of full range of eye medicines
• Optic shop: Different types of frames (low cost/high cost), lenses and contact lenses
• Cafeteria: Fast food and soft drinks.
• Public awareness service
Welfare services • Assistance in registration and guidance
• Provision of food, medicine and clothing for patients, assistance in transportation
• Treatment and rehabilitation of destitute visually impaired patients
Source: Various internal documents (2018).
Ahmed et al. 21

Caring Vision Eye Institute and Hospital is not only an eye The new OT suite encompasses more than 15,000
hospital, but it is also an institution to train the eye square feet and comprises 10 new operation theatres. Each
specialists and ophthalmic paramedics, along with a theatre is equipped with 17 operation tables. Moreover, the
specialty eye care. For the doctors who want to pursue their complex accommodates a pre-operative waiting area, post-
career as ophthalmologists, the institution offers courses operative recovery areas, an operation theatre store and a
such as Diploma in Ophthalmology, postgraduate degree central sterilization department consisting of the most
course like Fellow of College of Physicians & Surgeons, modern autoclaves and sterilizing equipment. A new
Part-2 course in ophthalmology and so on. Moreover, the anaesthetic and monitoring machine with a central gas
Caring Vision Eye Institute and Hospital has signed a supply is also incorporated in the new operation suite to
memorandum of understanding with India’s LV Prasad Eye meet or exceed international standards.
Institute and Aravind Eye Care System. Caring Vision
sponsored doctors’ education as per the institution’s policy.
Along with the doctors, ophthalmic paramedics such as Underprivileged Patients
nurses, optometrists and ophthalmic paramedics can also For the rural people who are financially insolvent and
visit these two institutions for doing relevant courses. incapable of travelling, Caring Vision hospitals have
The institute also offers courses for outside ophthal- arranged an alternative to reach to them with support from
mologists who are working for different eye hospitals and Orbis International, establishing three branch hospitals,
NGOs. These courses are as follows: one each at Barisal, Jamalpur and Naogaon under the
1. Basic eye care medical officers banner: ‘Creating Access to Eye Care Services for Rural
2. Primary eye care training for physicians People’. Each hospital has a 25-bed capacity. The branch
3. Orientation programme for postgraduate doctors hospitals were established to make eye care increasingly
in all sub-specialties. accessible to the poor and underserved rural population
The institute also offers courses for ophthalmic paramedics and to provide services aimed specially at addressing the
in Bangladesh. Other eye hospitals are also sending their issues of cataract and refractive errors, which are two of
nurses, ophthalmic paramedics and optometrists for the leading causes of blindness.
ophthalmic training. The courses offered are ophthalmic Specifically, objectives of the branch hospitals include
training for nurses and assistant nurses, ophthalmic OT and making quality, cost-effective and sustainable eye care
sterility maintenance. services available in these areas. In addition to these branch
Other training programmes are Ophthalmic Pathology hospitals, Caring Vision hospitals established vision
and Microbiology Training, Low Vision Training Programme, centres in those villages which have no access to ophthalmic
Optical Dispensing Training Course, Diploma in Ophthalmic care. These vision centres are equipped with basic eye-
Techniques, Refraction Training Programme. Other than testing equipment and a trained technician. The first branch
these training programmes, four more new programmes are hospital was launched at Jamalpur in 2008, followed by the
also going to be started which are as follows: branch hospital at Barisal in 2009, and finally the third one
at Naogaon in 2011.
•• Fundus photography, fundus fluorescein angiog- The hospitals are staffed by doctors trained in Dhaka,
raphy, optical coherence tomography and observa- and they are performing thousands of cataract surgeries
tion for B-scan and laser each year, along with other ocular surgeries. The patients-
•• Ocular prosthesis, contact lens basic screening programmes identify cataract patients in the
•• Biometry and auto-refractometer refraction community and at camps, and these cataract patients are
•• Applanation tonometry procedure, visual field test then referred to the local branch hospital for surgery. Since
the project area are poverty-stricken, many surgeries (up to
30% of patients) are performed either free of charge or at a
Affluent Patients subsidized rate (65%). However, a certain percentage of
To achieve the objectives of Caring Vision, the facilities patients pay for their surgeries.
need to be improved and contemporized, with special Since the first branch hospital was opened in May 2008,
attention paid to those areas where the more affluent a total of 272,924 outpatients have been seen and 11,991
patients are served. The process is currently underway, for surgeries have been performed up to December 2011 in the
example, by providing a new section for private patients. three branch hospitals. Six vision centres have been
The new examination area for private patients has 15 established in six upazilas (sub-districts) in partnership
examination rooms and a separate private waiting area. In with local NGOs. These refractionists are trained at the
December 2011, a 9-room, 11-bed private ward was hospital in Dhaka. They see patients in the vision centres
opened. Each room is carefully decorated and provides the and in the screening camps, do refraction, dispense glasses,
patients with superior accommodation. All rooms are refer patients to the hospital for further treatment as needed
air-conditioned and nicely furnished. and promote eye health education.
22 FIIB Business Review 8(1)

Setbacks and Challenges all social classes. The former will always want to differentiate
them and may want to be among patients with their similar
Caring Vision is located in one of the most crowded places stature. They would be willing to pay more to get the
in Dhaka city. Patients travelling with private vehicles will preferential treatment. As a result, the institution may lose
find it difficult to find a parking spot when they visit the out on a big portion of the population. Many patients have
eye hospital. complained about the duration of time that they need to wait
As it relies completely on donations, it is possible that in the waiting room. Although the specialists keep the
the eye care equipment cannot be upgraded as often as patients busy by asking them to fill out forms, getting the
needed, especially when compared to private hospitals. basic eye checked and tested before a consultation, it usually
This also applies to outdated software, and ineffective takes hours before the patients are finally finished with their
software might lead to system glitches, disrupting the appointment. Being a non-profit hospital, they are unable to
transparency of a non-profit organization. Software focus on the appearance of the facility. The servicescape or
glitches will likely cause a lot of time being lost which also the physical environment has a lasting impact on the minds
has a financial implication. It is also safe to assume that of whoever is in vicinity. As there is a long waiting time
their staff are underpaid and not compensated before the patient can finally consult a doctor, the waiting
proportionately to the service they provide. Dissatisfied rooms need to be equipped with multiple fans, adequate
workers might not provide adequate or the qualitative comfortable chairs and clean drinking water. If possible,
service that patients expect to get there. newspapers, magazines and a small television should be
There are some challenges for the eye hospital. These allocated to keep the patients waiting time comfortable and
being: more than 700 employees in the hospital, and yet, stress-free. Some patients have had to stand due to the over-
there are less than 10 employees handling the functions capacity of patients and due to the unavailability of seating
related to human resources, with no significant teamwork arrangements in the waiting room.
among them. There is a lack of proper planning; therefore,
the salary structure remains a questionable topic, and, as a
result, employee dissatisfaction arises. Needless to say, Moving Forward
there is no scope of quantitative evaluation and feedback. Caring Vision is facing pressure when it comes to funding
For example, security personnel earn almost the same as due to the cross-subsidization effect which divides the total
pharmacists who possess higher qualifications and skills. cost over the total number of patients. However, with its
This is another key problem to note: the building being humble mission, Caring Vision is recruiting expert nurses
almost 50 years old lacking modern facilitation such as a and other paramedics, and is providing them with
proper alarm system, proper ventilation, limited ophthalmic training to ensure the smooth functioning of
washrooms, etc. The building is built in such a way that the hospital. These trained nurses and ophthalmic
there are many empty spaces which are not being utilized. paramedics are required to sign a bond that they are going
The misconceptions in people’s mind about the eye hospital to serve Caring Vision for three years. These strategies are
stand as a major challenge for the hospital in terms of its not enough to ensure excellent ophthalmic services for the
image. A section of the people views the hospital as a increasing patients of Bangladesh. Hospital service is
government institution with inadequate services. On the highly discriminative because of emergency patients which
other hand, there are people who think that it is a corporate results to refusal and rescheduling of non-resident patients.
hospital that no longer provides the noble and charitable This quality versus quantity dilemma is reduced by some
services to the underprivileged segment of the society. strategies by Dr David Richardson, who worked as the
From Saturdays to Wednesdays, it closes by 7:30 pm and CEO of the Caring Vision Eye Institute and Hospital. In
on Thursdays it stays open until 1:30 pm. The working future, renovation activities will be done with the help of
population may find obtaining an appointment difficult as profits earned from the private OPD and some with the
they can only opt for Saturdays. As that is the only day of the help of donations from different individuals and
weekend that the hospital is open, it is possible that patients organizations. Moreover, currently the institution offers
have to wait for weeks to even get an appointment. Some more courses for doctors and ophthalmic nurses and
patients will choose to visit a different eye hospital altogether. paramedics along with fellowship programmes.
This will lead to the loss of two revenue streams: (a) the In order to effectively prevent and control avoidable
current patients who choose to go to a different eye clinic blindness and improve the overall eye care industry in
due to the limited time and (b) the prospective patients who Bangladesh, the following strategic directions are being
are turned away from the negative word of mouth by the taken. Improved accessible and affordable services are to
current patients. However, no such problems arise in a crisis be provided; quality of surgeries will be improved through
situation as their emergency service is open for 24 hours. ongoing monitoring according to standard protocol. School
The eye hospital may not reach the expectations of the screening programmes will be set up to diagnose children
established and affluent population. These patients will also with eye issues. Public awareness will be raised to facilitate
have a difficulty visiting an eye clinic that caters to people of early detection and establish preventive measures. Various
Ahmed et al. 23

programmes are being undertaken to address the restoration middle, with income from USD 251 to USD 400; established,
of the vision of the underprivileged blind people. The with income from USD 401 to USD 650; and affluent, with
community centred rehabilitation and inclusive education income of more than USD 650 (BCG, 2015). In a developing
services will be integrated with the CEC programmes. country like Bangladesh, 7 per cent of the population, approxi-
mately 11 million people, are ‘middle and affluent consumers’
Finally, impact studies will be organized and carried out to
(MAC)—who are viewed as confident, with an expectation of
determine the sustainability of CEC programmes.
seeing their incomes increase positively in coming years. Two
One major concern is that the people of Bangladesh particular income segments established and affluent comprise
who are financially solvent are travelling to neighbouring the MAC population of the country, because they have attained
countries for better treatment. Caring Vision’s target is to the purchasing power to buy a broad variety of consumer goods
provide quality eye treatment to the affluent socio- and service. Besides, they have acquired the MAC purchasing
economic section of Bangladesh. As a result, the quality traits, such as buying goods and services that offer convenience
team is working very hard to ensure the desired quality in and luxury in addition to basic necessities (BCG, 2015).
each department. To ensure quality, Caring Vision’s target
is to achieve the standard of Joint Commission International References
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325,000 eye care personnel and provided medical and optical
Eye Care and IAPB, SEA.
treatment to more than 23.3 million people in 92 countries.
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5 Bangladeshi people are divided into five basic income groups:
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bottom of the pyramid, which refers to five-member house-
———. (2013). Universal eye health: A global action plan
holds subsisting on incomes of less than USD150 a month;
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aspirant, with income from USD 151 to USD 250; emerging
24 FIIB Business Review 8(1)

About the Authors

Jashim Uddin Ahmed, PhD is a Professor and Chairman of the Department of Management and Acting
Dean of School of Business & Economics, North South University, Bangladesh. He is the founder of
InterResearch, a leading research organization in Bangladesh. He has been awarded his PhD in
Management Sciences from the University of Manchester Institute of Science and Technology (UMIST,
currently known as The University of Manchester), UK. He has achieved Master degrees both in
Marketing and Management from the University of Northumbria, UK. He also studied in the University
of Reading and the University of Lincolnshire and Humberside (currently known as University of
Lincoln), UK. His research interests lie broadly within social innovation, strategic management and
contemporary issues in business. He has published over 100 research articles and case studies in reputed
journals. An expert on Asian and Emerging Markets business case writing, Prof. Ahmed's extensive
cases exceed 50 in number and cover diversified industries and sectors. His works published in
International Journal of Logistics Management, Vision - The Journal of Business Perspective, South
Asian Journal of Business and Management Cases, Global Business Review, Higher Education for the
Future, Research in Education, Decision, Business Perspectives and Research, SAGE Business Cases,
International Journal of Consumer Studies, Journal of Strategic Contracting and Negotiation, Journal
of Developing Societies, Journal of Global Entrepreneurship Research, Society and Business Review,
Australasian Journal of Information Systems, and Asian Case Research Journal. Currently, he is
Advisory Editorial Member of South Asian Journal of Business and Management Cases also Editorial
and Reviewer Board member of Business Perspectives and Research. He can be reached at jashim.
[email protected]; [email protected]

Sadeq Ahmed is an Assistant Professor of Ophthalmology, School of Public Health, University of South
Asia, Dhaka. He is a Fellow and Member of Bangladesh College of Physicians and Surgeons. He
received Diploma in Ophthalmology from Dhaka University. He became medical graduate from Dhaka
Medical College. He completed Fellowship in Neuro-ophthalmology from National Institute of
Ophthalmology & Hospital, Bangladesh. He is serving as Neuro-ophthalmologist in Vision Eye Hospital,
Dhaka. His research interests are in the fields of ophthalmic patient management, ophthalmic
microsurgery and medical education. He is co-author in a published article in the journal “Ophthalmology”.
He can be reached at [email protected]

Asma Ahmed is a freelance strategic planner in Bangladesh. Her Master’s degree and Bachelor’s degree
are from National University of Bangladesh. Her research interests are in the area of social innovation,
intellectual and human capita, higher education and strategic management. Currently, she is a senior
research associate with InterResearch, Dhaka, Bangladesh. She can be reached at ahmed.interresearch@
hotmail.com

Mohammad Abdul Majid is a professional digital marketer working as a strategic planner in

Bangladesh. He is currently pursuing his MBA in Marketing from University of Dhaka. He graduated
from North South University in 2015. His research interest includes product planning, brand management,
advertising and education. Currently, he is a research associate in InterResearch, Dhaka, Bangladesh.
He can be reached at [email protected]