Distribution of Medication Considering Information, Transshipment, and Clustering: Malaria in Malawi

Abstract

Malaria is a major health concern for many developing countries. Designing strategies for efficient distribution of malaria medications, such as Artemesinin Combination Therapies, is a key challenge in resource constrained countries. This paper develops a solution methodology that integrates strategic‐level and tactical‐level models to better manage pharmaceutical distribution through a three‐tier centralized health system, which is common to sub‐Saharan African countries. At the strategic level, we develop a two‐stage stochastic programming approach to address the problem of demand uncertainty. In the first stage, an initial round of shipments is sent before the malaria season to each local clinic from district hospitals, which receive medications from regional warehouses. After the malaria season begins, a recourse action is triggered to avoid shortages in the form of (i) lateral transshipment or (ii) delayed shipment. The optimal solutions developed by the strategic model identify small clinic clusters possessing exclusive transshipment policies. Therefore, we decompose the problem at the tactical level, solving each clinic cluster independently using a Markov decision process approach to determine optimal periodic transshipment policies. A case study of our proposed distribution system is performed for 290 facilities controlled by the Malawi Ministry of Health. Numerical analysis of Malawi's distribution system indicates that our proposed cluster‐based decomposition method could near optimally reduce shortage incidents. Moreover, such an approach is robust to challenges of developing countries such as slow paper‐based inventory review, uncertain transportation infrastructure, the need for equitable distribution, and seasonal and correlated demand associated with malaria transmission dynamics.

Impacts of epidemic outbreaks on supply chains: mapping a research agenda amid the COVID-19 pandemic through a structured literature review

“…Regarding the "Main Method/Theoretical Approach" reported by the papers, it should be recalled that most papers were related to optimization models, and therefore, they used different mathematical models and approaches. They included mixed integer programming (Liu and Zhang 2016;Büyüktahtakın et al 2018), linear programming (Dasaklis et al 2017), game theory (Shamsi et al 2018;Chick et al 2008), case study and simulation (Ivanov 2020a, b), case study and SIR model (Rachaniotis et al 2012), case study and stochastic programming/Markov (Parvin et al 2018), among others. Table 4 shows the distribution of papers by type of epidemic outbreak.…”

“…We found several tensions related to SC responses to past disruptions caused by epidemic outbreaks. From the theoretical perspective, we found that the OSCM literature has addressed the past disruptions caused by the epidemic outbreaks by employing mainly optimization approaches, especially in relation to resources allocation (Büyüktahtakın et al 2018;Liu and Zhang 2016;Parvin et al 2018;Rachaniotis et al 2012). Managers and practitioners need to continuously monitor SCs, as no stage of epidemics' impacts should be left unturned before any recovery plan is properly implemented and managed.…”

“…It should be noted that the OSCM literature has approached studies on different types of epidemic outbreaks, with various objectives. For instance, outbreaks of influenza (Mamani et al 2013), Ebola (Büyüktahtakın et al 2018), Cholera (Anparasan and Lejeune 2017) and malaria (Parvin et al 2018), among others, have been thoroughly studied. The majority of these papers have devoted particular attention to resource allocation, distribution of the medicaments, vaccines procurement policies, and emergency health response.…”

COVID-19 pandemic related supply chain studies: A systematic review

“…These articles broadly focus on two major areas: (1) allocating resources to increase supply chain capabilities during large-scale disruptions; and (2) redesigning logistics and supply chain networks to reduce vulnerability. In the first area, articles have highlighted resource shortages as a major obstacle during an epidemic ( Enayati and Özaltın, 2020 , Liu et al, 2020 , Parvin et al, 2018 , Rachaniotis et al, 2012 , Savachkin and Uribe, 2012 , Sun et al, 2014 ). Consequently, these studies offered various strategies for allocating minimal or further resources, such as controlling transportation costs and equitable policies ( Savachkin and Uribe, 2012 ); undertaking threshold policy for inventory balancing; optimal area-based trans-shipment policy and planning horizon ( Parvin et al, 2018 ); increasing capacity to manage disruptions ( Hessel, 2009 , Sun et al, 2014 ); implementing cost-sharing contracts ( Mamani et al, 2013 ) or coordinating contracts ( Chick et al, 2008 ); and appropriate capacity setting and the minimum budget ( Liu et al, 2020 ).…”

Location‐Routing with Conflicting Objectives: Coordinating eBeam Phytosanitary Treatment and Distribution of Mexican Import Commodities

“…, Parvin et al. ), though it may provide more conservative results because the occurrence probabilities are assumed to be the same for all possible sample paths, including outlier cases. Hence, in the objective function of Problem for one replication can be replaced by 1/ κ , so the objective based on a sample of κ scenarios is , where is the objective function for scenario ω and is a feasible solution that is chosen to maximize the objective value across the κ scenarios of a replication.…”