Multi-period location routing: An application to the planning of mobile clinic operations in Iraq

Abstract

Health service access and delivery are hampered during humanitarian crises due to disrupted health systems, damaged infrastructure, and healthcare worker shortages, this particularly in conflict zones. Mobile clinics are a strategy used to reach populations cut off from local health services, and organizations commonly rely on them during relief and recovery humanitarian efforts to deliver primary healthcare. In this study, we present a multiperiod location-routing problem (MLRP) with benefits for the tactical planning of mobile clinic deployment. Our set-packing formulation was developed and solved as part of a collaboration with Première Urgence Internationale (PUI). The proposed model aims to select communities to be served and design routes to be performed such that health benefits, measured by means of coverage and continuity of care functions, are maximized throughout the planning horizon. Results are presented for an application based on PUI’s operations in Iraq, including sensitivity analyses on the parameters used to model the healthcare benefits. Managerial insights on the impacts of organizational strategic and tactical decisions, such as the number of mobile clinics and the relative importance given to coverage and continuity of care, are presented.