1

Using “Conscious Capitalism” as a

Framework for Catholic Social Teaching in the Catholic

Business School: The Nestlé Case Revisited

Patricia A. Britton and Zaida L. Martínez

Introduction

In his encyclical Caritas in Veritate

1 Pope Benedict XVI explores the essential theme of

authentic human development achieved through love in truth. For Benedict, love and truth must

be linked at all levels and in all endeavors for humankind to resolve its critical issues. Benedict

XVI also addresses globalization and its potential for divisive and destructive impacts on

cultures and peoples. He agrees with his predecessors that globalization is neither good nor bad

in and of itself. However, he warns multinational corporations (MNCs) against the dangers of

sole reliance on profit in exchanged goods as they move money, products and jobs in and out of

developed and developing countries. He rejects the old “binary” approach of unfettered

enterprise vs. government structure and calls for the rise of new business entities and business

managers grounded in love in truth with a purpose both inclusive of and beyond profit. In his

view, business managers must see more than investors as stakeholders and include employees,

business partners and the communities in which businesses operate. Benedict XVI challenges

business leaders to operate with the view of solidarity and urges the pursuit of social good as a

business pursuit rather than as unsustainable charity.

The Catholic business school is uniquely positioned to answer Benedict’s call for new business

managers who can lead with integrity in a complex and interconnected global economy. In this

paper we review the business philosophy of conscious capitalism (CC) as a means for further

advancing the role of CST in the curriculum of mission-driven Catholic business schools. By

examining a difficult international issue involving the MNC Nestlé, we suggest that the

development of international conscious capitalists could address major social issues through the

lens of love in truth as defined by Benedict XVI. First, we describe the development of CC and

the rationale for using this business philosophy as a vehicle for introducing CST to students,

noting the potential distinctions and departures between CC and CST. Second, we demonstrate

how CC, informed by CST, could be taught and developed as a critical business approach for

MNCs engaged in globalization by using a current business case involving the inherent difficulty

of distributing Nestlé’s infant formula to poor mothers in South Africa. Third, we propose a

simple corporate plan for consideration by infant formula manufacturers to be adopted

incrementally using careful corporate processes based on CC and informed by CST principles.

Conscious Capitalism

In recent years, a number of business leaders have called for a greater inclusion of a higher

purpose, recognition of society, transparency, and integrity into the fabric of American business.

1 Pope Benedict XVI, “Caritas in Veritate” (2009). Available at: http//www.vatican.va.

2

Conscious capitalism (CC), an evolving business philosophy, has adopted these principles into

actual, sustained and successful practices. Initially its proponents described CC as having three

assumptions: (1) interconnectedness among individuals, businesses and the global society; (2)

wealth as a holistically understood state; and (3) a relevant time frame spanning multiple

generations. Interconnectedness refers to the idea that individuals are interested in the impact

they have on people inside and outside the company. Holistic wealth moves beyond mere

financial wealth and capital accumulation to incorporate the concept of a triple bottom line of

“people, plant and profits” and a multiple stakeholder approach. CC differs from the more

traditional concepts of corporate social responsibility (CSR) in that “it doesn’t depend upon

externalized corporate giving or ‘virtuous acts’ to create virtue or value in society.”2 Rather, CC

“generates virtue internally through aligning the purpose of the business, the practice of

capitalism, and interests of the various stakeholders.”3 Companies such as Whole Foods, Trader

Joe's, Panera Bread, and the Container Store have successfully embraced the CC concepts. In

general, however, CC companies are not MNCs; rather, they are smaller companies led by

charismatic and dedicated CEOs.

More recent writings of CC proponents expand on CC’s philosophy by emphasizing four

interconnected tenets: (1) a higher purpose, (2) stakeholder orientation, (3) conscious leadership,

and (4) conscious culture.4 Emphasis is placed on having a compelling purpose for existence

other than generating profits. As noted by Mackey, the CEO of Whole Foods and a major

proponent of CC, “[t]he single most important requirement for the creation of the highest levels

of trust and performance for any enterprise is to discover or rediscover the higher purpose of the

enterprise” which he views as “timeless ideals,” including having the “courage to do what is

right to change and improve the world.”5 Therefore, the CC purpose must be a sustaining goal

that excites and unites all stakeholders.

CC uses the acronym, “SPICE,” to highlight five key interdependent and interconnected

stakeholders – society, partners, investors, customers and employees. Society includes

communities, governments, nongovernmental organizations (NGOs), and other societal

institutions.6 Society is listed first on purpose to signify that “businesses must ensure that they

are on the ‘right’ side of society, i.e., that they have a positive net impact on the world.”7 The

role of a conscious leader is to guide the company in achieving its higher purpose; that is, “the

CEO and other senior leadership embody the higher purpose of the organization, rather than

seeking to maximize their own personal power and compensation.”8 Another acronym,

“TACTILE,” is used to capture a CC company’s culture which emphasizes the importance of

trust, authenticity, caring, transparency, integrity, learning, and empowerment. The acronym is

also used to suggest that “the cultures of these companies are very tangible to their stakeholders

as well as to outside observers; you can feel the difference when you walk into a conscious

2 Doug Rauch, “Conscious Capitalism: A Better Road Map,” California Management Review 53, no. 3 (2011), 92.

3 Ibid.

4 Rajendra S. Sisodia, “Conscious Capitalism: A Better Way to Win,” California Management Review 53, no. 3

(2011): 98-108. 5 John Mackey, “What Conscious Capitalism Really Is,” California Management Review 53, no. 3 (2011), 84.

6 Steve Frazee, “Catalyzing Conscious Capitalism (C3) Conference, Integral Leadership Review, 2009. Available at:

www.integralleadershipreview.com/asrchieves/2009-06-notes-frazee-php 7 Sisodia, op. cit., 99.

8 Mackey, op. cit., 85.

3

business versus one that is purely driven by a profit motive and run just for the benefit of

shareholders.”9

In general, business scholars have viewed CC favorably; however, there are concerns about the

lack of details on key issues, such as how to address and assess the needs of different

stakeholders which oftentimes diverge. O’Toole and Vogel provide an example that highlights

this particular problem:

[W]hen a company lowers its costs by outsourcing production to developing

countries, what is good for its customers is not necessarily beneficial for its

employees, and when sales decline, firms often have no alternative but to lay-off

employees to the benefit of shareholders….Conscious Capitalism provides no

guide to help managers recognize, let alone manage, the kinds of painful trade-

offs all firms must periodically be prepared to make in order to survive.10

In response to this criticism CC proponents emphasize the interdependent and interconnected

nature of stakeholders, but acknowledge that CC companies cannot and do not try to treat all

stakeholders equally. For example, Rauch, the former President of Trader Joe’s, noted that the

company focuses primarily on its two most important stakeholders: customers and employees.11

An additional concern is that different CC proponents have diverging views concerning key

concepts. For example, Mackey, the founder of CC, believes that the role of a company is to

create value for stakeholders, which is the basis for “business virtue,” noting that the “ethical

foundation of business doesn’t necessarily mean that everything any particular business does is

always ethical, but only that voluntary exchange for mutual benefit is itself an ethical process.”12

Indeed, he does point out that some of these “voluntary exchanges” can have a negative impact

on society and the environment, which can lessen or even negate “the overall virtue of

business.”13

However, Thigpen notes that CC companies need to pursue ethical standards that

are more rigorous than what the law permits to be true to their guiding principles.14

It is also

important to note that some of the companies that are regarded as practicing the principles of CC

do not necessarily call themselves CC companies (e.g., Southwest Airlines, Patagonia).

CC and CST

Despite concerns about CC’s lack of specificity and diverging views of some of its major

proponents, its business principles merit further examination. CC is not based on a spiritual or

religious philosophy, but its principles share some common ground with several key points

raised in Caritas in Veritate (CV), particularly with regard to the purpose of a firm and its

relationship with stakeholders. For Benedict XVI, profit is not the primary corporate purpose,

9 Ibid.

10 James O’Toole and David Vogel, “Two and a Half Cheers for Conscious Capitalism,” California Management

Review 53, no. 3 (2011), 67. 11

Doug Rauch, “Conscious Capitalism: A Better Road Map,” California Management Review, 53, no. 3 (2011), 91-

97. 12

Mackey, op. cit., 86-87. 13

Ibid. 14

Peter Thigpen, “Can We Find Another Half a Cheer?,” California Management Review 53, no. 3 (2011), 118-123.

4

because “[o]nce profit becomes the exclusive goal, if it is produced by improper means and

without the common good as its ultimate end, it risks destroying wealth and creating poverty.”15

The common good in CST reflects a view of the person that is relational and therefore social;

[w]hat is good or objectively valuable for the person is tied up with what is good for others…not

set against, or apart from the good of others.”16

The hallmark of CC companies is that they

pursue a purpose other than profit as a primary goal. Although CC companies do not explicitly

address the common good as defined in CST, their pursuit of a higher purpose within an

interdependent stakeholder framework can lead to actions that contribute to the common good of

the communities in which they operate. The clothing company Patagonia exemplifies this

orientation in requiring that its suppliers in other countries comply with the high environmental

standards that the company sets for itself. The suppliers are willing to follow the standards set by

Patagonia because they know that their relationship with Patagonia is long term and

characterized by trust.17

As with CC, a stakeholder approach is suggested in CV. Specifically, Benedict XVI notes that

“there is…a growing conviction that business management cannot concern itself only with the

interest of the proprietors, but must also assume responsibility for all the other stakeholders who

contribute to the life of the business [italics in original].”18

Goodpaster, however, contends that

although a stakeholder approach is a step in the right direction, it is insufficient since it “accepts

at face value the interests and claims of various stakeholder groups independently—in isolation

from one another—without considering their deeper connections as part of the larger human

community.”19

He proposes the inclusion of comprehensive moral thinking as an important

component to corporate social responsibility (in addition to stockholder thinking and stakeholder

thinking), stressing that comprehensive moral thinking is critical for discerning whether the

goods that companies make are “truly good” and whether their services “truly serve.”20

According to Goodpaster, comprehensive moral thinking includes two important elements: (1)

attention to the potential for collaboration between companies and government or non-

governmental organizations, and (2) attention to the ideals of human dignity and just

community.21

Both of these elements are directly related to key CST principles and to the

emphasis that Benedict XVI places on collaborative resolutions to our world’s pressing

problems. Goodpaster’s example of a video game company demonstrates this point. The video

game company may not see itself as responsible for the negative consequences that video games

can have on youth and may point to other institutions, such as governments and families, as the

ones that need to address the problem. However, if the company recognizes and accepts that its

actions can contribute to the common good, it would seek collaborative relationships with

15

Pope Benedict XVI, CV, 21. 16 James Ball, Zaida Martinez, and Brian Toyne, "Catholic Social Teaching: Addressing Globalization in Catholic

Business Education," Journal of Catholic Higher Education 27, no.2 (2009), 72. 17

Rajendra S. Sisodia, David B. Wolfe, and Jagdish N. Sheth, Firms of Endearment: How World-class Companies

Profit from Passion and Purpose, Wharton School Publishing, 2007, 167. 18

Pope Benedict XVI, CV, 40. 19

Kenneth E. Goodpaster, “Goods That are Truly Good and Services that Truly Serve: Reflections on ‘Caritas in

Veritate’,” Journal of Business Ethics, 100 (2011), 13. 20

Ibid. 21

Ibid., 14.

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governments, communities, and other groups to address the negative consequences of its

products.22

Although CC places society first in its stakeholder approach, its view of collaboration focuses on

those stakeholders that directly impact their business, such as suppliers, rather than government

agencies and non-governmental organizations. As noted earlier, CC lacks specific guidelines for

addressing the needs of different stakeholders and the extent of responsibility of the company

towards specific stakeholders. Comprehensive moral thinking serves as both a challenge and a

path toward a deeper understanding of the purpose of a business and its relation to stakeholders.

CC companies would benefit from a reflection on the following point that Goodpaster makes:

Comprehensive moral thinking asks business leaders to discern opportunities for

collaboration and to respond affirmatively to invitations to collaborate. It invites

businesses to look at their roles not solely in insular economic terms, but also in

social or civic terms. Companies and industries…have stockholders and

stakeholders, to be sure, but they also have vocations to participate in realistic

ways with other institutions in building a better world, in fostering what Benedict

describes as authentic human development. [Italics in original]23

Benedict XVI, like his predecessors, reminds us that decent work enables people to address the

essential material dimension of development and also to grow in skill, self-understanding and

self expression. CC companies recognize the value of their employees and the importance of

treating all employees with respect and dignity. For example, the grocery company Wegman

pays above-average wages, offers affordable health insurance, and provides opportunities for

educational scholarships, even to part-time workers.24

Also, Mackey, the CEO of Whole Foods,

consistently urges CEOs to reject excessive compensation packages that far exceed the basic pay

of an average worker. He and others insist on profound respect for employees and urge higher

wage levels and better working conditions than those available from competing firms. Mackey

believes that lower turnover and higher employee morale benefits all stakeholders.25

Thus, while

he does not speak directly to the issue of human dignity, the concept of human dignity has not

been left wanting in his CC vision.

Although CC does not explicitly mention the spiritual dimension of a person, its values reflect a

move from a “having” society to a “being” society. In commenting about a shift in contemporary

societies, Sisodia, Wolfe, and Sheth, in their study of companies which apply CC principles, note

that:

Having societies are steeped in self-centeredness and materialism. Being societies

have an others-centered focus and are deeply vested in high ground moral

values….For a full century, the consumer economy has been grounded in a

22

Ibid. 23

Ibid. 24

Sisodia, Wolfe, and Sheth, op. cit., 68. 25

Ibid, 164-165.

6

materialistic having focus. That focus is now being diffused by rising desires for a

sense of meaning that cannot be drawn from material things.26

CC leaders understand and reflect this shift in the management of their companies and their

approach to stakeholders is relational and long-term oriented. In this regard, there is

commonality with the relational view of the person that is central in CST.

In CV, Benedict XVI emphasizes authentic human development to highlight the need for

viewing development in terms of its spiritual dimension as well as its economic or material

components.27

CC, in contrast, approaches human development from a psychological

perspective. Maslow’s hierarchy of needs—in particular, his conceptualization of self-

actualization—provides a framework for the underlying values of CC. Persons who exhibit the

characteristics of self-actualization “tend to be centered on solving problems outside of

themselves, rather than remaining ego-centered” and “convey strong feelings of respect,

empathy, care, love, and compassion for other people.”28

These characteristics are viewed as

desirable for CC leaders and reflect a worldview centered on “being” rather than “having.”29

For

example, Southwest Airlines views love as an essential component of the company’s workplace.

Kelleher, the co-founder of Southwest, in commenting about his business philosophy stated that:

“A company is much stronger if it is bound by love rather than by fear.”30

The company strives

to develop loving relationships with its stakeholders and builds its business model on this

principle.

Is CC spiritual? CC principles have commonalities with the spiritual leadership model developed

by Fry. Fry links the psychological concept of intrinsic motivation to spiritual values as a way of

developing an ethical approach to leadership. He defines spiritual leadership in terms of “values,

attitudes, and behaviors required to intrinsically motivate one’s self and others in order to have a

sense of spiritual survival through calling and membership.”31

According to Fry, this approach to

leadership is based on having a vision that gives members of the organization a sense of calling

(i.e., a sense that one’s life has meaning and can make a difference) and on developing an

organizational culture that is based on altruistic love (i.e., a culture based on care, concern, and

appreciation for oneself and others).32

A distinctive attribute of the spiritual leadership model is

that it links spiritual values with organizational outcomes, such as organizational productivity,

employee well-being, and corporate social responsibility. Although the view of love in CC

companies does not stem from the central idea in CV that God’s love is the origin of

everything,33

the leadership approach of CC companies tends to share some elements of spiritual

26

Ibid., 27. 27

Sandie Cornish, “Placing Integral Human Development at the Centre of Catholic Social Teaching,” The

Australasian Catholic Record, 86, no. 4, 450-456. 28

John Mackey and Don Beck, “The Upward Flow of Human Deelopment—Maps of the Terrain,” in Be the

Solution: How Entrepreneurs and Conscious Capitalists Can Solve All the World’s Problems, Michael Strong (ed.),

John Wiley & Sons, Inc., (2009), 282. 29

Ibid., 28. 30

Sisodia and Wolfe, op. cit., 156. 31

L.W. Fry,,“Toward a Theory of Spiritual Leadership,” The Leadership Quarterly, 14 (2003), 711. 32

Ibid. 33

Domènec Melé and Michael Naughton, “The Encyclical-Letter ‘Caritas in Veritate’: Ethical Challenges for

Business,” Journal of Business Ethics, 100 (2011), 2.

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leadership, particularly in their emphasis on positive interpersonal relationships, employee

commitment, and sense of community.34

As previously mentioned, CC sees society as the “ultimate stakeholder.” This point is

particularly relevant in relation to the role that MNCs play in the global economy and in societies

in different countries. The late Ryuzaburo Kaku, former president of Canon, made this role clear

in an essay he wrote for the Harvard Business Review:

Because multibillion-dollar corporations control vast resources around the globe,

employ millions of people, and create and own incredible wealth, they hold the

future of the planet in their hands. Although governments and individuals need to

do their part, they do not possess the same degree of wealth and power … If

corporations run their businesses with the sole aim of gaining more market share

or earning more profits, they may well lead the world into economic

environmental and social ruin … It is our obligation as business leaders to join

together to build a foundation for world peace and prosperity.35

Although a few MNCs are recognized as exhibiting some of the characteristics of CC, none has

fully embraced CC. However, their leaders’ decisions and actions have a major impact on

societies throughout the world. We suggest the use of case studies as a vehicle for introducing

the principles of CC to future business professionals of MNCs. This pedagogical approach

facilitates a discussion of the higher purpose and responsibilities of large corporations within an

international context. Also, this approach can facilitate the introduction of CST in relation to the

actions of an MNC, noting similarities and differences with CC and, more importantly, how CST

principles can serve to inform business decisions that impact the well being of people in different

societies. The Nestlé case provides one practical example for applying CC and CST to a specific

MNC and its infant formula distribution practices in South Africa.

Nestlé Case Revisited

Introduction

This case is about the ethical complexities of selling, donating and/or distributing powdered

infant formula intended for ultimate use by very poor mothers in South Africa. The case is

ethically complex because formula is both essential and risky for different members of the

intended group. The consequences of feeding failures are severe to those customers who lack the

resources or know-how to properly prepare, use and/or store the product. The feeding failures

threaten the lives and well being of recipients’ babies and of future babies yet to be. Although

the risk of failure is foreseeable and demonstrable, many of the mothers do not anticipate or

understand the risk. On the other hand, government officials, health authorities, medical

authorities, NGOs, concerned citizens and infant formula makers do. We believe that this is an

excellent teaching case for training the business student to integrate critical analysis at a number

34

CC companies are mentioned as one example of how the principles of spiritual leadership can be applied in

business in the article by Louis W. Fry and John W. Slocum Jr., “Maximizing the Triple Bottom Line through

Spiritual Leadership,” Organizational Dynamics, 37, no. 1 (2008), 86-96. 35

Quoted in: Sisodia, Wolfe, and Sheth, op. cit., 193.

8

of levels, including ethical decision-making, product distribution and CST. The purpose of this

case is to help the business student become a conscious capitalist who will maintain an

awareness of the difficult issues that he or she may encounter in the business world. The case

assumes that the formula maker, Nestlé SA (Pty) Ltd. (Nestlé) produces an excellent product that

meets all applicable standards, laws and codes relating to infant formula.

Case Background

Aids and Babies in South Africa. South Africa leads the world in HIV infections.36

According to

the 2010 UNAIDS survey, the total number of people living with HIV continues to rise in sub-

Saharan Africa, including South Africa, although the death rate is on the decline due to antiviral

treatment. According to the World Health Organization (WHO), this region bears 68% of the

global total of AIDS infections with more women than men living with HIV.37

Specifically, 5.6

million South Africans were infected with HIV/AIDS in 2009.38

This is the highest number of

infected people of any country in the world. In 2010, approximately 310,000 South Africans died

of the infection. The disease is most prevalent among those aged 15 to 49. The infection rate

varies from 3.8% in the Western Cape to a high of 15.8% in KwaZulu-Natal.39

The disease strikes at the very young in South Africa. In 2009, 330,000 children under 15 were

infected with HIV. Mother-to child transmission is the second main infection route. Almost 30%

of South Africa’s postnatal mothers were HIV positive in 2009.40

In the absence of preventative

measures, 15 to 30% of infants will contract AIDS from their mothers. Breast feeding is a

primary means of HIV transmission.41

The mother-to-child-transmission (MTCT) rate of AIDS

in the low income levels of South Africa remain at 20-45% as compared to 2% in high income

levels of the country. Non infected orphans represent another set of very young AIDs victims. In

2009, there were 1.9 million AIDS orphans in South Africa who had lost one or both parents to

Aids. 42

South African authorities have grappled with feeding young AIDS orphans and with preventing

the further spread of AIDS. South African authorities commenced a prevention of mother-to-

child-transmission (PMTCT) program in 2001. The goal was to prevent HIV infection in the

infected mothers’ newborn children. The program included free formula, counseling, antiviral

therapy, and government monitoring.43

South Africans believed that using formula would

prevent the introduction of AIDS through infected breast milk. Although the program achieved

reductions in HIV transmission rates, infants continued to sicken and die from HIV and from

other illnesses.

36

UNAIDS/WHO. AIDS Epidemic Update. 2007. UNAIDS, Geneva Switzerland. 37

UNAIDS Report on the Global AIDS Epidemic 2010. Joint United Nations Programme on HIV/AIDS. Chapter 2. 38

Estimated as of 2009. South Africa. The World Factbook. United States Central Intelligence Agency.

https://www.cia-gov/library/publications/the-world-factbook/geos/sf.html 39

HIV and AIDS in South Africa. Avert Website. http://www.avert.org/aidssouthafrica.htm. 40

Ibid. 41

R. Ladzani, K. Peltzer, M.G. Mlambo, and K. Phaweni, “Infant-Feeding Practices and Associated Factors of HIV-

Mothers at Gert Sibande, South Africa,” Acta Paediatrica 100 (2011), 538-542. 42

K.M. Moland , M.M. de Paoli, D.W. Sellen, P. van Esterik, S.C. Leshabari, and A. Blystad, “Breast-Feeding and

HIV: Experiences from a Decade of Prevention of Postnatal HIV Transmission in Sub-Saharan Africa,”.

International Breast-feeding Journal 5 (2010), 10-16. 43

Supra, note 4.

9

Despite the fact that breast feeding is a leading pathway of AIDS transmission, formula feeding

itself presents risks of illness and death from infectious disease.44

Under some circumstances, the

risks of death or serious illness for a formula-fed infant can be as high as tenfold as compared

with an infant who had been exclusively or predominantly breastfed.45

The deaths result from

diarrhea, acute lower respiratory infections, and sepsis or meningitis. 46

Most deaths of HIV

infected children are caused by diarrhea and pneumonia.47

Teams from the US Center for

Disease Control found that a high percentage of hospitalized infants from African PMTCT

programs receiving formula demonstrated decreased mean length for age and other evidence of

decline in nutritional status.48

Mothers often diluted the formula, mixed it with non-boiled water,

or stored it improperly. What should have been a nutritious food source had become become a

source of infection, malnutrition or both.49

A South African team of medical and health authorities linked morbidity risk and illness in

formula fed babies to lack of (a) clean water (no water piped to home or yard), (b) fuel for

sterilizing formula (no gas, electricity, paraffin), (c) fridge (no means for storing formula), (d)

regular employment (secure financial status), and (e) declared status (means to obtain feeding

support). The “Good Start” study was done by comparing these conditions among young HIV

infected women in the PMTCT program in three areas of South Africa that differed widely in

demographics, HIV rates, child morbidity rates and general poverty. The women were counseled

on the risks of formula feeding and breastfeeding and the proper way to formula feed. Some of

the women chose to breastfeed and others chose to formula feed. The team concluded that 67.4%

of the mothers who chose to formula feed in the most poverty stricken of the three regions made

inappropriate feeding choices based on WHO’s guidelines for the use of replacement feeding –

acceptable, feasible, affordable, sustainable and safe (AFASS). Among other matters, the

researchers concluded that counselors were not using AFASS to guide the decision making of the

mothers.

The AFASS Guidelines:

Acceptable – will the mother’s family and elders accept and support her decision or will they pressure her

to start solid foods?50

Feasible – does the mother have adequate time, knowledge and skills to correctly prepare the formula and

feed the infant every three hours?

44

R.D. Black , S.S. Lawrence, and J. Bryce, “Where and Why Are 10 Million Children Dying Every Year,” Lancet

361 (2003), I 2226-34, and G. Jones, R.W. Steketee, R.E. Black, Z.A. Bhutta, and S.S. Morris, “Bellagio Child

Survival Study G, How Many Child Deaths Can We Prevent This Year?,” Lancet 362 (2003), 65-71 (9377). 45

R. Bahl, C. Frost, B.R. Kirkwood, K. Edmond , J. Martines, N. Bandari , and P. Arthur, “Infant Feeding Patterns

and Risks of Death and Hospitalization in the First Half of Infancy: Multicentre Cohort Study,” Bull World Health

Organ 83(2005): 418-25. PMID: 15976892. 46

Tanya Doherty , David Sanders, Ameena Goga, and Debra Jackson, “Implications of the New WHO Guidelines

on HIV and Infant Feeding for Child Survival in South Africa,” Bull World Health Organ 89, no.1 (2011), 62-67. 47

Ibid. 48

Ibid., 63. 49

Ibid. 50

Researchers have noted the importance of maternal elders in influencing the infant feeding decisions of young

mothers. Lena Kroeker and Alyx Beckwith, “Safe Infant Feeding in Lesotho the Era of HIV/AIDS,” Annals of

Anthropological Practice 35, no. 1 (2011), 50-66.

10

Affordable – does the mother and her family have the means to buy the equipment, supplies, and

replacement formula for the first six months of the baby’s life without affecting the health or nutrition of

other family members?

Sustainable – will this formula actually be prepared correctly day and night for six months without

interruption?

Safe – does the mother have access to clean water, fuel (electricity, gas or paraffin) and a fridge so that she

can prepare sterile formula and store it safely?51

The South African research team focused on the links among three of these criteria – water, fuel,

and HIV status disclosure at the infant’s third week. They concluded that the 67.4% of the HIV

mothers who chose to formula feed without the proper conditions experienced a three- month

mortality rate of three times that of the HIV mothers who chose to formula feed and did meet the

criteria. On the other hand, the mothers of babies who met the proper conditions for formula

feeding had the best outcome in terms of HIV survival.52

Among other things, the authors concluded that the benefits of providing free formula to prevent

postnatal AIDS transmission is more than offset by the increased mortality from diarrhea and

respiratory infections if the mother does not have the proper environmental conditions for

formula preparation and storage. The authors referenced studies finding contamination of milk

bottles with fecal bacteria in South African homes and clinics. The referenced study also found

over dilution of formula in 28% of clinics samples and 47% of home samples.53

The authors

concluded that the supply of formula through public health authorities was unreliable as were

nearly half of the sampled homes. This means that a large percentage of the children in sampled

homes were at risk of malnutrition or infection as a result of improper or non sterile formula

preparation or storage.

The authors concluded that the risk of infection and death from improper formula preparation

and storage is so severe that breastfeeding should be urged as the principal feeding choice for

HIV positive women in the first 6 months of a baby’s life until replacement feeding is

acceptable, feasible, affordable, sustainable and safe. They cited demographic studies indicating

that the majority of South Africans are not likely to meet the WHO AFASS criteria for formula

feeding. They recommended the curtailment of passing out free formula to those caretakers and

mothers who could meet the AFASS requirements and who otherwise clearly required formula.

They also urged that counseling of mothers focus, assess and reassess the mothers against the

measurable safety criteria – water, fuel and fridge.54

They made these recommendations with the

full understanding that babies will become infected with AIDs as a result of the breast feeding.

Based on the evidence from these and other studies, South African authorities met in 2009 to

review the latest evidence on postnatal transmission of HIV and to consider the new WHO

guidelines on HIV and infant feeding.55

WHO representatives attended the meeting and

51

http://motherchildnutrition.org/info/afass-principles.html 52

Tanya Doherty, Micky Chopra, and Mike Colvin, Counselling on Infant Feeding Choice; Some Practical Realities

from South Africa. Taken from Field Exchange Issue 29 (2006) http://fex.ennonline.net/29/counseling.aspx 53

Note 12 at page 63. 54

Doherty, Chopra, and Colvin. op. cit. 55

Meeting held on November 18, 2009 entitled “Breastfeeding in the Context of HIV: What Do We Know? What

Should We Do?” Website - Children’s Rights Centre www.CRC-sa.coza/pages/32460. downloaded May 26,

2012.

11

expressed concern about the link between child mortality and infant formula use among poor and

resource challenged mothers. Representatives from WHO called for the promotion of exclusive

breast-feeding. They acknowledged exceptions in the case of low birth weight babies, sick

babies, mothers who were unable to nurse, orphans, and unavailability of anti-retroviral drugs. In

2011, South African representatives from NGOs, health and medical authorities agreed to the

consensus position of breast feeding as the primary feeding option with implementation plans to

be developed.56

South Africa promotes breastfeeding and AFASS guidelines for HIV positive mothers (Infected

Moms) and non HIV positive mothers (Clear Moms). The PMTCT program with its free formula

and continued counseling was directed at Infected Moms. A Clear Mom may or may not receive

counseling in a maternity ward about the importance of breastfeeding, the AFASS criteria and/or

the risk of formula feeding if she does not have her baby in a “baby friendly” maternity ward or

hospital that does not accept sample formula and has implement specific steps to support

breastfeeding.57

In a non-baby friendly hospital, she might receive a bottle of free infant formula

in the maternity ward prior to release with no follow through to see if she has the resources or

know how to sustain formula feeding. She won’t give her baby Aids but, as described above, her

baby may face malnutrition, infection or death if she fails to follow through on proper formula

feeding. 58

Nestlé. Nestlé is the largest manufacturer of infant formula in the world claiming a 17% share of

the $27 billion market in 2010.59

The company is located in Vevey, Switzerland. Nestlé owns

major food and food-related brands including Gerber baby food, Nescafé coffee, Ralston Purina

pet food, Nestlé chocolate, Tasters Choice, Carnation, Alpo, Stouffer's, the Jenny Craig weight

reduction program, and 30% of the cosmetics group L'Oreal, among others. The company was

founded in 1905 after a merger between Anglo Swiss Condensed Milk Company and the original

infant cereal company founded by Henry Nestlé. It has approximately 328,000 employees with

461 factories in 83 countries around the world.60

In 2010 it reported $32.8 billion in revenues61

.

Nestlé is currently acquiring the Pfizer’s infant nutrition unit for $11.85 billion to give it a strong

position in emerging markets in Asia.62

It is likely to become the largest infant formula producer

in China selling to middle to high-end consumers.63

Nestlé SA (Pty) Ltd is the South African subsidiary of Nestlé. The company was incorporated in

1916 and is headquartered in Randburg, South Africa. Nestlé SA produces and sells a variety of

56

Website – Children’s Rights Centre www.CRC-sa.co.za/site/files/6592 / 57

The Baby Friendly Hospital Initiative. Website. UNICEF Home.

http://www.unicef.org/programme/breastfeeding/baby.htm 58

Doherty, Sanders, Goga, and Jackson, op. cit DOI: 10. 247/BLT. 10. 079798 59

Nestlé Wins Pfizer Auction. The Wall Street Journal, Corporate News, April 24, 2012, p B2. 60

Nestlé Website - Company Profile.

http://www.nestle.com/Common/NestléDocuments/Documents/Library/Documents/About_Us/Quick-Facta-2011-

EN.pdf 61

Website. DATAMONITOR ResearchStore. Nestlé SA.

http://www.datamonitor.com/store/Product/nestl_sa?productid=73C32CD1-213A-4E6B –95D2-40255DDFB362/ 62

Nestlé Website – Press Releases. Nestle to acquire Pfizer in strategic move to enhance its position in global infant

nutrition. http://www.nestle.com/Media/PressReleases/AllPressRelease.aspx?PageId=295 63

Dragon baby boom drive setup infant formula prices. China daily.com.cn website updated May 16, 2012.

http://www.chinadaily.com.cn/business/2012-05/16/content-1530690. htm/

12

food and food products in South Africa including infant formula. It is involved in social

programs of various types. In March 2012, the company entered into a research partnership with

the South African government aimed at promoting scientific development in South Africa. One

of the goals of the program is to “accelerate the development of products … at the right price for

consumers in emerging markets."64

South African researchers will have access to Nestlé's

research capabilities. Nestlé has engaged in efforts to purify water and to promote sustainable

farming practices at the micro level in South Africa. Nestlé works with programs providing

formula and financial support to AIDS orphans in South Africa.

In the 1970s Nestlé faced international censure and boycotts due to its marketing of infant

formula to poor mothers in underdeveloped countries.65

Nestlé and other formula makers

actively promoted the sale of infant formula in emerging markets. Young mothers were eager to

adopt modern Western ways of feeding their babies. Many poor mothers lacked the resources or

know how to continue properly feeding their babies once they could no longer breast feed. A

number of babies sickened and died. In response to international demand, WHO and UNICEF

established the International Code of Marketing of Breast-Milk Substitutes (the Code)66

to limit

the marketing of infant formula. Nestlé ultimately adopted the Code and currently audits

allegations of noncompliance.

The Case

On April 30, 2011, Father Edward Tsatsaert, a Catholic priest, was arrested for the possession

and sale of tins of “stolen” baby formula at a Catholic mission in the Queenstown area of the

Eastern Cape of South Africa.67

The formula was Nestlé Nan Pelargon and the product tins were

labeled “not for resale” by agreement between the Government of South Africa and Nestlé SA

(the "restricted formula"). The government had purchased the infant formula for free distribution

under the PMTCT program. Police and Eastern Cape health officials had acted on a tip that the

restricted formula would be delivered to the Catholic mission. They purchased a can of milk

from the church before the arrest. After the arrest, they found more than 1400 tins of Nestlé baby

formula in the back of the church all of which were marked "not for resale".68

Two other

Catholic priests were arrested for selling restricted formula at Catholic missions in nearby

Cofimvaba and Dutywa. Health officials confiscated 30 trucks containing restricted formula all

of which were headed to six Catholic missions.69

The health authorities expressed anger and

dismay upon learning that the source of the formula was Nestlé itself.

64

SouthAfrica.info Website. Nestlé, South Africa partner in science. March 9, 2012

www.southafrica.info/about/acience/nestle-090312.htm/ 65

S. Prakash Sethi and James E. Post, “Public Consequences of Private Action: The Marketing of Infant Formula in

Less Developed Countries,” California Management Review 21, no. 4 (1979), 35 – 48. 66

International Code of Marketing of Breast-milk Substitutes. 1981. World Health Organization. Geneva,

Switzerland. 67

Baby formula seized at ECape Mission, May 3, 2011; Sunday Times Live website;

http://www.timeslive.co.za/local/article1048894.ece/Baby-formula-seized-at-ECape-mission

Cops arrest ECape priest, April 30, 2011 Iafrica.com website; http://news.iafrica.com/sa/724865.html 68

Priest held for baby milk "scam". IOL news website. April 29, 2011.http://iol.co.za/news/crime-courts/priest-help-

for-baby-milk-scam-1.1062839 69

South African priest arrested for stealing baby milk. CATH News USA Website, May 4, 2011,

http://www.cathnewsusa.com/2011/05/south-african-priest-arrested-for-stealing-baby-formula/

13

Health authorities claimed violation of the agreement. Church authorities were apparently

surprised that feeding hungry babies could be treated as a crime. Within days, Nestlé and the

health authorities resolved the issues, and the priests were exonerated.70

Evidently, Nestlé had

treated sales to the missions as sales to orphanages under the Nestlé Orphans and Vulnerable

Children Assistance Program (NOVCAP). This program had been started in 2008 in partnership

with the South African Departments of Social Development and Health.71

Nestlé had designed

NOVCAP to assist orphans and vulnerable children. Under NOVCAP, participating NGOs

assumed responsibility for the further distribution of Nestlé infant formula to caretakers. The

NGOs counseled and monitored caretakers. As part of the settlement with the government health

officials, Nestlé agreed to reevaluate the status of the missions and supply them with unrestricted

formula in “retail packs.” The government agreed that Nestlé could continue to provide restricted

formula to state approved institutions and NOVCAP orphanages “to assist authorities with

traceability.72

This statement suggests that the formula sold from the missions will not be traced.

When the first priest was arrested, the newspaper article described a frightened woman who had

come to the Catholic mission from an outlying village to obtain formula.73

Authorities did not

arrest her but they took the milk she had just purchased. Her first name was Nontsapho. We don't

know anything else about her except that she made a trip for nothing. We presume that she was a

non-infected or Clear Mom. If she'd been infected, she could have obtained formula through the

PMTCT program. If she was the caretaker of an orphan, she could have obtained formula

through the NOVCAP program. We don't know if she got her money back and we don't know if

it was enough to buy formula at a regular store. Perhaps she was not the mother but was a sister,

aunt, grandmother or friend. We can presume that she represented the needs of a baby. For

purposes of this case, we will treat Nontsapho as a Clear Mom.

As far as we know from newspaper reports, the resolution reached between the health authorities

and Nestlé's did not require that the missions counsel with their customers or direct them to

NGOs or government health representatives for further monitoring or evaluation. It did not ask

them to distinguish between Clear Moms and Infected Moms. In fact there may be no programs

available for Clear Moms like Nontsapho. But we know that if Nontsapho does not meet the

AFASS criteria, her baby faces a substantial risk of malnutrition, illness or death from infectious

disease. As we have previously seen, that risk may vary from 10% to 40% or higher depending

on the circumstances. The risks increase with poverty, lack of education and lack of physical

resources.

The Case Issues

The Nestlé case presents an opportunity to analyze the situation of distinct low income South

African infant formula customers who may seek to purchase infant formula. The student will be

70

Nestlé apologizes as priest cleared. Website. Dispatch online blogs.

http://www.blogs.dispatch.co.za/repzone/2011/05/13/nestle-apologises-as-priests-cleared/ 71

Presentation to Nestlé South African Region Portfolio Committee on Social Development; November 17, 2009;

http://www.pmg.org.za/files/docs/091117nestle.pdf 72

Joint position statement by Nestlé South Africa and Eastern Cape Department of Health. South African

Government Information. 12 may 2011. Source: Eastern Cape Health.

http://www.info.gov.za/speech/DynamicAction?pageid=461&sid=18308&tid=33253/ 73

Supra, note 33.

14

asked to assume that he or she has been recently transferred to a product position within Nestlé

SA and has learned about the child morbidity statistics. He or she is a Catholic business school

graduate who wants to do well in the company while being true to his or her beliefs. The

assignment is to analyze the issues, to make an informed recommendation to management and to

outline a needs assessment plan (which the student will learn how to do in class). An outline of

the needs assessment plan is attached (see Appendix A).

Customers #1 and #2 are “restricted” customers. Customers #3 through #6 are retail customers

who will theoretically buy through the Missions.

1. Customer #1 is an identified Infected Mom who falls within the PMTCT program and

meets AFASS criteria. Her new infant is HIV negative. She can obtain formula through a

government program in which her infant’s feeding progress will be monitored.

2. Customer #2 is an identified Infected Mom who falls within the PMTCT program and

does not meet critical AFASS criteria. Her new infant is HIV negative. Due to poor

counseling and administration at the local health office or NGO, she may receive infant

formula although her baby will be at substantial risk if she formula feeds.

3. Customer #3 is a Clear Mom mother who needs formula because she stopped breast

feeding. Her body no longer produces breast milk. She doesn’t have AIDS, has not been

on chemotherapy or other toxic treatment and her decision to stop feeding was not the

result of a physical inability. She does not meet AFASS criteria. Without further

intervention, her progress will not be monitored.

4. Customer #4 is a Clear Mom who needs formula because she stopped breast feeding. Her

body no longer produces breast milk. She doesn't have AIDS, has not been on

chemotherapy or other toxic treatment and her decision to stop feeding was not the result

of a physical inability. She does meet AFASS criteria. Without further intervention, her

progress will not be monitored.

5. Customer #5 is a Clear Mom who is still breast-feeding but is thinking about switching to

formula because she is tired and discouraged and having some problems with breast

feeding. We do not know whether she meets the AFASS criteria. She does not have

AIDS or any other illness that would prevent her from breast-feeding. If she abandons

breast feeding, and commences purchase of formula from the missions, her child's

progress will not be monitored by the South African health authorities.

Case Analysis

Customers #5 is about to quit breast feeding and may not meet AFASS criteria. Her children

will be at risk. The concern is immediate because the decision is irreversible at a certain point.

These customers may simply need some support and advice to get her back on track. Nestlé

would not normally interact with Customer #5. However Nestlé does have the ability to identify

major poverty-centered sales points like the missions. What steps, if any, could Nestlé take at the

major poverty centered sales points and distribution channels?

15

Could it use its organizational skills to match these sales points with NGOs who do have

expertise in counseling mothers with breast-feeding issues?

Could it work with health authorities and experts in developing simple registration and

follow through policies for people who purchase at the sites?

Could it engage volunteer teams from its employee and distributor base to work with

NGOs at registration and follow through with Customer #5?

If Customer #5 does abandon breast feeding, could her information be retained for

possible follow through. Could Nestlé make this a community effort?

What other departments might you involve?

With Customer #5, the goal would be to continue breast-feeding. The issues with Customer #3

are more difficult. This Clear Mom needs Nestlé formula to feed her baby but her feeding will

probably fail.

Can Nestlé wire their homes or provide them with natural gas? No,

Could Customer #3 be provided with paraffin for heating water?

Could certain villages the identified so that volunteers might evaluate clean water

solutions?

Is Customer #3’s breast-feeding problem a social one? Is the problem the local tribal

leaders or elders?

Perhaps the first step is to gather the questions and then to use resources to think about

solutions..

Could a volunteer employee team work with one village?

Customer #4 has been distinguished from Customer #3 by the use of good questioning. This

customer needs formula for her baby. She is a Clear Mom who has a good chance of successfully

feeding her child according to the AFASS criteria.

Might her situation change later due to a loss of job or illness?

Should she be monitored at a different level as she returns to the Missions?

Customer #1 and Customer #2 are being monitored by the government although Customer #2

appears to be falling through the cracks. This may be due to poor local administration of the

program.

Is Nestlé acting as a product supplier in this program or is it utilizing its administrative

ability in the program?

Hypothetically, if the business student were a manager of a local Nestlé facility in the

same physical area, would he or she recommend becoming involved with NGOs, health

authorities and government in monitoring these programs?

Based on the Nestlé case analysis, five decision pathways have been identified. Are there others?

What action could or should Nestlé take, if any? Who are the stakeholders in this case? Are

future generations a stakeholder? Are the babies a stakeholder? Are the local communities a

stakeholder? Can investors win if other stakeholders become more advantaged? What are the

considerations in balancing stakeholder interests? What are the risks and rewards to stakeholders

under each of the following decision pathways?

16

a. No Change - supply to missions with retail packs, and to the NGOs and government

pursuant to existing agreements with no oversight of the “retain packs”.

b. Option (a) but participate in oversight/governance in Customer #1 and Customer #2

programs74

c. Option (b) and form alliances with NGOs to develop community plans for monitoring

formula feeding in targeted areas of extreme poverty

d. Withdrawal from distribution in areas of extreme poverty in which customers are

unlikely to meet AFASS criteria.

e. In areas described in (d), limit distribution to NGOs and government health

authorities for redistribution and monitoring under AFASS criteria.

f. In areas described in (d), limit distribution to those components of the Nestlé

distribution chain who agree to strict protocols. Product would be treated like a

controlled substance - careful records, locked storage, documentation of counseling

support, etc.

g. Utilize a Proposed Community Needs Assessment (attached) with other stakeholders

in affected communities to address needs.

Application of Principles

In all of the hypothetical situations, we discussed Nestlé. We did so because it is the major MNC

in South Africa with an interest in infant formula and nutrition. However, the discussion applies

to any of the infant formula manufacturers. We believe that the larger MNCs have a unique

ability to identify and implement discrete actions not readily available to the government or

NGO sectors. Our approach emphasizes team work and cooperation across the sectors. The

problems encountered by these customers are not about improper marketing. The problems arise

from the some customers’ inability to properly use the products. Simple withdrawal of infant

formula will not resolve the issue because many Clear Moms depend on the product. The issue is

supplying formula to those Clear Moms who require it while blocking access to those Clear

Moms who should not start using it.

A number of mothers successfully use Nestlé formula to feed happy, thriving babies. What

business model allows a company to justify voluntarily limiting distribution based on the

inaction and mistakes of some customers? The answer is that for some customers this product is

not safe. Principles of CST aid us in this analysis.

Our business transactions contribute to justice. This is a justice in which all people,

including future generations, share in the bounty of God’s creation. In particular, by the

way we conduct international business, we assist the poor in providing for themselves.75

Infants at risk of malnutrition or death because their mothers assumed a product risk may be

deprived of the full ability to learn and to share in God’s creation.

74

The WHO and South African Health initiatives invite participation by all sectors. 75

John Kohls and Sandra L. Christensen, “The Business Responsibility for Wealth Distribution in a Globalized

Political- Economy Merging Moral Economics and Catholic Social Teaching,” Journal of Business Ethics, 35

(2002), 223-234, 230.

17

Ronald Hoverstadt addresses this problem in his article Catholic Social Teaching and Market

Practices in the Global Economy.

Once access is guaranteed, products should be safe to buy, use and dispose of. A constant

theme throughout CST is respect for life: your life and the lives of others. Therefore, the

safe acquisition, use and disposal of goods and services is of primary importance.76

Sustainable development assists in the analysis. Sustainable development is development in a

manner that will not negatively impact future generations. Traditionally, sustainable

development applies to resource and agricultural development. However, the distribution of

powdered formula to low income South Africans who do not meet AFASS criteria creates loss of

human milk for young infants, significant risk of illness, malnutrition and death in the infant

population and negative impact on the ability of an underdeveloped country to develop. A

wayward tin in a high poverty area of South Africa potentially recreates the cycle of another

mom who may abandon breast feeding without resources and with severe consequences.

Our budding student product manager might argue to his or her management that the compelling

danger to the community, babies, and future generation stakeholders justifies corporate action

under CC as framed by CST. The student could further suggest that CC offers the optimal set of

tools for an MNC like Nestlé to use in approaching this set of complex ethical issues. Nestlé’s

alignment with its mission statement at the senior corporate level – “Good Food, Good Life”

could allow it to invest in the lives of infants who will survive to be nourished by its baby food

and other products. Thriving infants translate into thriving customers. Alignment with its goal as

a principal driving theme for aligning all corporate activities would cause the company to seek to

prevent deaths associated with its admittedly good food. A thriving South Africa ultimately

supports a thriving company.

The CC framework can be used to integrate ethics, social responsibility and sustainable practices

into core business strategies that will serve the needs of the community stakeholder as well as the

other stakeholders in the firm. CC calls for the inclusion of a higher purpose, recognition of

society, transparency, and integrity into the mission and values of a corporation.77

Unlike CSR,

this is not a program or an add-on.78

Thus, any charitable or community action is driven by and

aligned with its primary purpose and an interdependent view of stakeholders.

In analyzing the Nestlé case, we would ask our students to consider whether the unnecessary

death of children and loss of future generations is grave and should be avoided, if at all possible.

We would discuss Aquinas and the primary principle of natural law that “good” ought to be

pursued in human endeavors.79

This is a fundamental basis for CST. We would review Pope

John Paul II’s encyclical Centesimus Annus80

and his discussion of the fact that a business firm

exists not just to make a profit but to serve as a "community of persons" who form a group at the

service of the community. Consistent throughout CST is the "dignity of the human person." We

76

R. Hoverstadt, “The Social Teaching and Marketing Practices in the Global Economy,” Interbeing 2, no. 2

(2008), 19-30 at 26. 77

Kirk O. Hanson , “The Long History of Conscious Capitalism,” California Management Review 53, no. 3 (2011),

77-82. 78

Sisodia, op. cit. 79

Supra, n. 73. 80

Pope John Paul II , “Centesimus Annus”, United States Catholic Conference, Washington, D.C., 1991

18

would emphasize solidarity among all persons within and without the organization and the

relationship that we have to the children who will be lost by inaction of the MNC. We would

also emphasize a key teaching of Caritas in Veritate: what is good or objectively valuable is what

is good for others, and the common good can be achieved through collaboration. Comprehensive

moral thinking, as described by Goodpaster, can serve to guide the actions that the company

takes to address this critical issue.

Conclusions

The use of problems such as those related to Nestlé, can help our students think proactively

about human dignity, solidarity and subsidiarity – the pillars of CST using real world business

models and leaders. The principles of Caritas in Veritate and CC are linked in that the babies are

stakeholders in the company as are their mothers, and the company must therefore consider their

needs in its actions.

Through an analysis of a complex case such as Nestlé’s, we seek to develop business students

who are more conscious when they leave our classroom than they were when they came in.

Conscious awareness implies a connection with all of life. Being conscious means

acting with more intention, having greater self-regulating behavior, and

demonstrating a deeper awareness of the causes and consequences of actions.81

Finally, we hope to help students become future business leaders grounded in love in truth.

Patricia A. Britton is an adjunct professor of accounting at St. Mary's University in San

Antonio, Texas and a retired Vice President of Law, Public Affairs and Government Affairs. Her

current research interests include corporate best practice, sustainable development and

globalization.

Zaida L. Martinez is a professor of international business and a Marianist Educational

Associate at St. Mary's University in San Antonio, Texas. Her current research interests focus on

the impact of globalization on business education, and the role of Catholic social teaching in

international business education.

81

Katherine Pavlovich (2010). “Educating for Conscious Awareness,” Journal of Management, Spirituality &

Religion, 7/3 (193-208,193).

19

Appendix A

Proposed Community Needs Analysis Tool

A. High Risk Area

1. Identify the areas of highest risk for infant mortality and link to data on formula

distribution

2. match the areas with highest mortality and highest distribution

3. choose one area as a way of developing this model

4. determine all principals and stakeholders within the area

a. distributors

b. retail establishments (if any)

c. hospitals

d. maternity wards

e. doctors offices

f. orphanages

g. missions

h. transportation companies

i. wholesalers of any kind

j. partnering NGOs

k. contracting government authorities

l. key company managers and employees

5. create a stakeholder team

6. establish preliminary goals for

a. reduction of infant mortality linked to infant formula

i. utilize existing research and data

ii. invite participation by leading health authorities

b. increase of breast feeding

7. perform a community needs assessment with community members including

a. Faith leaders

b. NGOs

c. health/medical representatives

d. government leaders

e. tribal/community leaders

f. representative community members

g. involve your team members

i. employees

ii. employee families

iii. distributors

iv. vendors

v. customers

1. retail

2. wholesale

20

vi. investors

8. prepare a draft community action plan to address issues

9. issues may vary from place to place

a. water

b. power

c. remoteness

d. expense

e. black-market sales

f. education will

g. needs of the local hospital and/or maternity ward

10. develop community action plan for each of the six customers in the high risk area

B. Other low-income areas of South Africa

1. proactively support baby friendly initiative at hospitals and maternity wards serving the

poor

2. work with distributors and major customers to identify likely points of concentrated

contact with very poor customers