Application of operations research to healthcare industry in developing countries. Case study : optimization of the location of primary health care centers in Tunisia

Abstract

It has been agreed that over the last 50 years, the awareness of using Operations Research (OR) techniques in developing countries - where lack of resources is the norm - has increased and became more significant. One sign of this, is the emergence of several initiatives to promote OR in such countries. However, despite this rise in awareness, the use of OR is still very low compared to the “developed” countries due to the presence of many obstacles such as the lack of OR experts, insufficient technological and financial resources, scarcity of accurate data…

The objective of this paper is to first, conduct a literature review on the use of Operations Research in developing countries, more specifically in Healthcare industry. The focus is on the models used for locating facilities mainly for Public Healthcare Services. In a second step, the goal is to apply an OR approach in a chosen developing country namely Tunisia to assess the effectiveness of the current locations of Primary Health Care Centers across the country, use a mathematical model to find optimal sites for locating such facilities in a specific region and finally generate viable alternatives for action that decision makers (as the Tunisian Government) can consider for future facilities’ allocations. The objective of the implemented model is to maximize the number of people served by the located facilities within a maximal specified coverage distance/time. The results confirmed the initial hypothesis of the absence of optimality in the current locations. The model helped presenting new optimal location sites depending on the percentage of covered demand, a decision that the government needs to take. In fact, deciding the number of facilities to build depends not only on the number of people served but also on the budget available and the cost of constructing a center. Therefore, the presented results can help the Tunisian Government in taking more effective decisions and trading off between satisfying more patients or being cost-effective.