Inequity Assessment in Healthcare Transportation and Logistics at Low Resource Settings

A drug stock-out is defined as an event that a drug-outlet or group of outlets of any type (drug shop/pharmacy/clinic), which is licensed or unlicensed, which serve(s) a specific community, are out of stock of a drug that is in demand in that community.

Although drug stock-outs are very common, their magnitude is largely undocumented in global health because of a lack of transparent demand data and inventory recording mechanisms. Drug stock-outs can increase the number of uncomplicated infections turning resistant, prescription of inappropriate drug alternatives, prolonged or severe illnesses due to inability to continue drug regimen, frustration of health care workers, and even death.

Low-resource communities with heavy disease burden often lack the infrastructure to improve the sparse drug availability. Given that existing supply chain research focuses on drug distribution based on equality to maximize profits, we seek to develop new research methodologies which characterize medical supplies needs based on equity of actual demands.

Dynamic factors such as the demographics, disease burden, drug availability and socio-economic indicators play a part in creating effective drug distribution models. Our measurement scale will assess inequity in pharmaceutical supply chains which incorporate these factors. This project will identify drug demands and the corresponding supply chain management strategy. We will apply an integer programming model and a heuristic approach to assess and reinvent distribution models to reduce inequity in low resource communities.

PhD Candidate Biplab Bhattacharya, in collaboration with colleagues from Engineering and Applied Sciences and Epidemiology and Environmental Health, are writing two papers: the first paper develops the measurement scale, called the Stock-out Severity Index, to assess pharmaceutical supply chain inequities; the second paper uses this measure in a drug delivery strategy that involves the routing of mobile pharmacies.