Using Fairness Models to Improve Equity in Health Delivery Fleet Management

Abstract

Inefficiency and inequity are two challenges that plague humanitarian operations and health delivery in resource‐limited regions. Increasing capacity in humanitarian and health delivery supply chains is one option that has the potential to improve equity while maintaining efficiency. For example, the nonprofit organization Riders for Health has worked to increase capacity by providing reliable transportation to health workers in rural parts of sub‐Saharan Africa; with more motorcycle hours at their disposal, health workers can perform more outreach to outlying communities. We develop a model using a family of fairness function to quantify the efficiency and equity of health delivery as capacity is increased via development programs. We present optimal resource allocations under utilitarian, proportionally fair, and egalitarian objectives and extend the model to include dual modes of transport and diminishing returns of subsequent outreach visits. Finally, we demonstrate how to apply our model at a regional level to provide support for humanitarian decision makers such as Riders for Health. We use data from the baseline phase of our evaluation trial of Riders for Health in Zambia to quantify efficiency and equity for one real‐world scenario.

Asset supply networks in humanitarian operations: A combined empirical‐simulation approach

“…However, a substantial portion of humanitarian literature only considered either disaster response ( Barbarosoglu and Arda, 2004;Balcik et al, 2008;Campbell et al, 2008;Salmeron and Apte, 2010;Acimovic and Goentzel, 2016;Ferrer et al, 2018) or ROW development program supply (De Treville et al, 2006;McCoy and Lee, 2014). However, a substantial portion of humanitarian literature only considered either disaster response ( Barbarosoglu and Arda, 2004;Balcik et al, 2008;Campbell et al, 2008;Salmeron and Apte, 2010;Acimovic and Goentzel, 2016;Ferrer et al, 2018) or ROW development program supply (De Treville et al, 2006;McCoy and Lee, 2014).…”

“…This is the case when research analyzes either disasters and ROW jointly (Besiou et al, 2014;Stauffer et al, 2016) or disaster response in isolation (Balcik et al, 2008;Campbell et al, 2008;Salmeron and Apte, 2010;Ferrer et al, 2018) or development (ROW) program supply in isolation (De Treville et al, 2006;McCoy and Lee, 2014). This is the case when research analyzes either disasters and ROW jointly (Besiou et al, 2014;Stauffer et al, 2016) or disaster response in isolation (Balcik et al, 2008;Campbell et al, 2008;Salmeron and Apte, 2010;Ferrer et al, 2018) or development (ROW) program supply in isolation (De Treville et al, 2006;McCoy and Lee, 2014).…”

“…We remark that a majority of research within a humanitarian context assumes that disaster supply flows are independent of ROW flows. This is the case when research analyzes either disasters and ROW jointly (Besiou et al, 2014;Stauffer et al, 2016) or disaster response in isolation (Balcik et al, 2008;Campbell et al, 2008;Salmeron and Apte, 2010;Ferrer et al, 2018) or development (ROW) program supply in isolation (De Treville et al, 2006;McCoy and Lee, 2014). This assumption of independence indicates that large asset flows to support a mega disaster would not impact other asset flows within the IHO supply network.…”

Metro Meals on Wheels Treasure Valley Employs a Low-Cost Routing Tool to Improve Deliveries

“…It represents the second largest overhead expenditure (after staff) in most global humanitarian organizations (Disparte 2007). Vehicle fleet management is a key aspect of effective transportation management; and vehicle routing is a key aspect of effective fleet management in general (Crainic andLaporte 1997, Ghiani et al 2003) and in humanitarian operations per se (McCoy and Lee 2014). Last-mile costs can represent as much of one-third of transportation costs.…”

Decision support for long-range, community-based planning to mitigate against and recover from potential multiple disasters

“…Much of the current analytical work in disaster operations management tends to focus on the emergency of the disaster -the middle three phases of disaster operations management: preparedness, response, and short-term recovery (Salmeron & Apte, 2010;Holguin-Veras et al 2013;McCoy & Lee, 2014), and on the specific characteristics of a particular disaster event, or type of disaster, with which these phases are associated (Kappes, Keiler, von Elverfeldt, & Glade, 2012). It is important to recognize, however, that there are broader issues of safety that encompass the entire range of hazards that may pose a risk to a city (Pollett & Cummins, 2009;Basher, 2006).…”