Service Coverage Research Articles

Meal-on-wheel Service Facility Location Strategy for Longhua District in Shenzhen based on GIS

With the development of Shenzhen, aging population with needs of Meal-on-Wheel (MOW) service is increasing as well, especially Longhua District. This paper analyses the characteristics of the aging population in Longhua District, and evaluates the accessibility and living quality of current meals service location by applying Geographic Information System (GIS). It finds that the meal service system struggles from low demands and quality, highly depends on government subsidies, lacks of participation from social enterprises, and diversity in service levels. Based on the analysis, proper location strategy is made, and proper MOW service locations are allocated by GIS to extend the coverage of MOW services and suggestions are made properly to promote the improvement of the quality of catering services.

Factors Affecting the Performance of Health Workers in Nsiika Health Center IV, Buhweju District

Health systems can only function with health workers improving health service coverage and realizing that the right to the enjoyment of the highest attainable standard of health is dependent on their availability, accessibility, acceptability, and quality. This study assessed the factors affecting the performance of health workers in Nsiika Health Center IV in Buhweju district. A descriptive cross-sectional study employing the quantitative method of data collection was employed with a sample size of 36 health workers working at different departments of Niika Health Center IV. They were chosen by a convenient sampling technique. Collected data were analyzed using Statistical Package for Service Solutions (SPSS) version 22.0. Data were analyzed and presented as frequency and percentage in the form of tables, figures, and charts. Out of 36 participants, 18 (50.0%) were within the age bracket of 29-34 years, 22 (61.1%) were females, and 16 (44.5 %) of the participants reported good skills in assessing patients. 22 (61.1%) indicated that they are motivated working as a team, 17 (47.2%) of the participants said their workload is high, 19 (52.8%) of the participants said they have a moderate relationship with their fellow workers, 27 (75.0 %) said equipment can sometimes be missing. In conclusion, health workers’ performance was greatly affected by both individual-related factors, health facility-related factors, and environmental factors which include; inadequate allowances, poor salary increments, and poor staff development programs, crushing workload as well as receiving inadequate feedback from supervisors. Keywords: Performance, Health Workers, Buhweju District, Health Centre

Spatial Pattern, Quality Evaluation, and Implications of Preschool Education Facilities in New Urban Areas Using Multi-Source Data: A Case Study from Lingui New District in West China

Currently, China has entered the development stage of a “low birth rate” demographically. There is a huge contradiction between the unbalanced and inadequate distribution of preschool education facilities (PEFs) and the people’s expectations for “full and good education for children”. This study took the Lingui New District, a typical new urban area in West China as the research area, and through the introduction of POI big data and GIS analysis methods, supplemented by GeoDA Bivariate Moran index analyses, established a kindergarten spatial database. The study found that preschool education facilities have problems such as insufficient quantity, uneven quality, low service coverage, poor accessibility, etc. Therefore, it is suggested to increase the proportion of public affordable preschool education facilities including kindergartens and nurseries, optimize the spatial distribution of preschool education, and improve the accessibility of preschool services to promote affordable, safe, and high-quality development of preschool education and to provide reference suggestions for the revision of relevant standards and the adjustment of the layout of preschool education in undeveloped regions of China.

Health Operational Assistance Funds : Literature Review

Introduction: BOK funds are primarily intended for services at Puskesmas, reducing maternal mortality, reducing infant mortality and addressing malnutrition. The existence of BOK funds at Puskesmas is expected to have an impact on improving service coverage and programme effectiveness. However, the absorption of BOK funds is considered not optimal. Objective: This study aims to determine the factors that influence the implementation and absorption of BOK funds. Method: The research method is literature review by using the search engines Google Scholar, Crossref and Garuda Portal from 2014 to 2023. The papers to be reviewed were selected based on inclusion and exclusion criteria. 13 studies were found that fulfilled the criteria. Result: Delays in the disbursement of funds are an obstacle in the management of BOK which results in inefficiency and non-achievement of set targets. Limited human resources at Puskesmas and high workload or overlapping tasks are also an obstacle at Puskesmas including in the management of BOK. Competent human resources are needed in the management of BOK funds. Conclusion: Delays in fund disbursement and limited human resources hamper BOK management.

Maximal covering location with partial coverage for second-level specialized health care services

The lack of access to Second-level Health Care Services (SHCS) in developing countries is primarily due to the scarcity of facilities and the limited investment of resources in the public sector. Access to these services directly relates to the distance the population travels to these facilities. In that sense, a maximal covering location problem can be helpful to maximize the impact of decisions related to the location of new SHCS. In this paper, we propose a model to guide the location of additional sites where second-level services can be installed in a network of public hospitals. The partial coverage and variable radius are considered in the problem to assess a large territory with different characteristics and population densities. The system is composed of multiple institutions that supply differentiated varying levels of coverage concerning their own demand and external demand. The objective of the problem is to improve the demand coverage in the system by locating new sites, since there are already sites offering different services. A case study in the Mexican public health system is conducted to assess four specialized SHCS. The obtained results evidence for the benefit of using optimization tools in the resource planning of SHCS.

The challenges and benefits of public health in smart cities from a 4 M perspective.

With the acceleration of urbanization, public health issues have become increasingly prominent in smart city construction, especially in the face of sudden public health crises. A deep research method for public health management based on a 4M perspective (human, machine, materials, methods) is proposed to effectively address these challenges. Methods: The method involves studying the impact of human factors such as population age, gender, and occupation on public health from a human perspective. It incorporates a machine perspective by constructing a public health prediction model using deep neural networks. Additionally, it analyzes resource allocation and process optimization in public health management from the materials and methods perspectives. The experiments demonstrate that the public health prediction model based on deep neural networks achieved a prediction accuracy of 98.6% and a recall rate of 97.5% on the test dataset. In terms of resource allocation and process optimization, reasonable adjustments and optimizations increased the coverage of public health services by 20% and decreased the response time to public health events by 30%. This research method has significant benefits for addressing the challenges of public health in smart cities. It can improve the efficiency and effectiveness of public health services, helping smart cities respond more quickly and accurately to potential large-scale public health events in the future. This approach holds important theoretical and practical significance.

Galor: Global view assisted localized fine-grained routing for LEO satellite networks

Low Earth Orbit (LEO) satellite networks have been expected to provide global coverage for Internet services with immediacy requirements. The dynamics of an LEO satellite network topology induce the challenges of achieving efficient content retrieval. This article takes an initial step toward achieving efficient content retrieval in LEO satellite networks from the routing perspective. We start with investigating the topology characteristics of LEO satellite networks in terms of the deterministic neighbor relation and the intermittent inter-satellite links. We then propose a Global view Assisted Localized fine-grained Routing (GALOR), which is an information-centric routing mechanism customized to LEO satellite networks. Specifically, GALOR disseminates the link state within a predefined range instead of the entire constellation, incurring less convergence time and control overhead. Therefore, GALOR can calculate the routing table (to guide interest forwarding) based on the local link state and the global neighbor relations. Moreover, GALOR improves the forwarding method of the information-centric routing by reconstructing a failed Pending Interest Table (PIT) entries in response to occasional link failures. Our packet-level experiments show that GALOR outperforms state-of-the-art mechanisms (up to 103.4%) in terms of average packet delivery ratio in content-sharing.

Examining fire service coverage and potential sites for fire station locations in Kathmandu, Nepal

In the densely populated Kathmandu Metropolitan City, inadequate fire service coverage poses a significant fire risk. With the demand for fire services increasing due to rapid growth in population and infrastructure development, the limited number of fire stations, insufficient human and physical resources, poor street connectivity, narrow streets, and delays in response to calls for emergency services have resulted in significant property loss, environmental impact, serious injuries, and even loss of life. Although a substantial body of research exists on understanding fire patterns and fire station site selection in developed countries, there is a noticeable lack of similar research in developing countries, which can be attributed to a lack of available data and interest. This study utilises ward-level urban fire incident data in Kathmandu from July 2019 to February 2023 to examine the spatial pattern of fire risk, fire service coverage and identify potential sites for fire stations. Results reveal a significantly higher fire rate in the central part of the city. Fire rescue service cannot reach most areas in Kathmandu within 5 min, with some areas exceeding 10 min response time. The findings from this study will enable fire agencies to enhance the operational efficiency of emergency response and help develop policies and programs related to fire risk prevention and mitigation. This includes targeted education and awareness campaigns and the allocation of finite fire service resources, such as the strategic placement of fire stations.

A Scoping Review to Improve Universal Health Coverage for Pediatric Dental Services Policies

Background: Poor oral and dental health significantly affects public health, impacting over half the world’s population. Dental caries can undermine children’s academic success and career prospects. Social inequities result in unequal access to oral healthcare, particularly among populations with lower socioeconomic status (SES). National policies that improve access to oral health can reduce these disparities. Objectives: This study aims to compile policies implemented by various countries to achieve universal health coverage (UHC) for pediatric dental services. Methods: This scoping review was conducted according to Arksey and O’Malley’s framework and is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A systematic search was conducted on databases including Scopus, PubMed, Magiran, SID, Irandoc, Google Scholar, the WHO website, and the databases of Iran’s Ministry of Health. The search aimed to identify literature discussing governmental steps taken to achieve UHC for pediatric dental health, published between January 1, 2011, and December 31, 2022. The results were charted and presented in a table. Results: This review included 22 studies. Six themes were identified based on the roles played by key players in this field, including schools, government policy and support, community-oriented preventive plans, insurance support, parents’ awareness, and inequality in accessing dental services. Conclusions: A comprehensive policy that reduces barriers to access, increases utilization, and engages all stakeholders—including parents, schools, and community centers—can effectively achieve UHC for pediatric dental health.

High-resolution mapping of essential maternal and child health service coverage in Nigeria: a machine learning approach

BackgroundNational-level coverage estimates of maternal and child health (MCH) services mask district-level and community-level geographical inequities. The purpose of this study is to estimate grid-level coverage of essential MCH services...

Towards Sustainable Urban Mobility: Voronoi-Based Spatial Analysis of EV Charging Stations in Bangkok

This study leverages the efficacy of Voronoi diagram theory within a mixed-methods approach to thoroughly examine the spatial distribution, service coverage, and optimal locations for expanding electric vehicle (EV) charging infrastructure in Bangkok. Drawing on data from field surveys and public data providers, our analysis unfolds in four key stages. Firstly, we delve into the spatial distribution of charging stations, scrutinizing density, proximity to various road types, and land use through the lens of Voronoi diagrams. Secondly, the application of Voronoi diagrams informs the evaluation of service boundaries. Thirdly, utilizing this effective tool, we assess population density per parking slot or charging head to anticipate future EV adoption. Finally, the study introduces an approach to identify suitable locations for new charging stations through the application of overlapping Voronoi circles. Findings reveal a clustered distribution of charging stations along roads, particularly in the central business district, showcasing the efficiency of Voronoi diagrams in spatial analysis. Residential areas and urban commercial zones also host significant charging station concentrations. Notably, service coverage in inner Bangkok surpasses that of middle and outer areas, highlighting underserved regions. Prospective areas for new charging stations, identified through Voronoi analysis, include Bang Khae, Phra Khanong, Min Buri, and Huai Khwang. This research, rooted in the application of Voronoi diagram theory, offers vital insights for various stakeholders involved in urban infrastructure planning. By employing Voronoi diagrams within Geographic Information Systems (GIS), the study contributes to strategically placing charging stations, optimizing spatial understanding, and enhancing resource allocation. This GIS-based approach not only supports the rise of electric vehicles but also promotes sustainable urban development practices through the efficient utilization of spatial data and analysis techniques.

Evaluating alternatives to improve drinking water supply within a complex and uncertain human-environment system: case of the Port-au-Prince Metropolitan Region

ABSTRACT Improving decision making in urban water supply systems under a wide range of changing human-environmental scenarios represents a challenging issue, especially when there is a high level of uncertainty and the available information is limited or scarce. To address this concern, the present study applied a decision aiding process to evaluate long-term planning solutions for the Port-au Prince Metropolitan Region’s water supply in Haiti, which is recognized for having a low coverage of water services and great lack of monitoring data. The methodological framework assessed pre-specified alternatives to face uncertain future conditions, with the main emphasis of being aware of how these uncertainties can be framed in the water management practices. To discover the most robust management solutions, a tradeoff analysis and multi-objective optimization allowed to explore the performance of alternatives across many future states of the world and multiple criteria. The results highlighted that human factors associated with the increase of per-capita water use and population growth posed a greater risk on water supply coverage than climatic factors. In addition, the decision support can offer a comprehensive representation of potential supply/demand futures, and provides decision-makers with the opportunity to discuss a posteriori the most appropriate water supply solution under an extensive variety of information with severe uncertainty.

TEMPORARY REMOVAL: Drivers of Anemia Reduction among Women of Reproductive Age in Senegal: A Country Case Study

BackgroundIn Senegal, anemia prevalence among women of reproductive age (WRA) decreased from 59% in 2005 to 54% in 2017. However, determinants of reduction in disease burden under challenging public health conditions have not been studied. ObjectiveTo conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia reduction among WRA in Senegal between 2005 and 2017. MethodsStandard Exemplars in Global Health methodology was used for quantitative analyses using Senegal’s Demographic and Health Surveys. Qualitative analyses included a systematic literature review, program/policy analysis, and interviews with key stakeholders. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors. ResultsAmong non-pregnant women (NPW), mean hemoglobin (Hb) increased from 11.4 g/dL in 2005 to 11.7 g/dL in 2017 (p<0.0001), corresponding to a 5%-point decline in anemia prevalence (58% to 53%). However, inequities by geographical region, household wealth, women’s educational attainment, urban compared to rural residence, and antenatal care (ANC) during last pregnancy continue to persist. During this time period, several indirect nutrition programs were implemented, with stakeholders acknowledging the importance of these programs, but agreeing there needs to be more consistency, evaluation, and oversight for them to be effective. Our OBDA explained 59% of the observed change in mean Hb, with family planning (25%), malaria prevention programs (17%), use of iron and folic acid (IFA) during last pregnancy (17%), and improvement in women’s empowerment (12%) emerging as drivers of anemia decline, corroborating our qualitative and policy analyses. ConclusionsDespite a reduction in anemia prevalence, anemia remains a severe public health problem in Senegal. To protect the gains achieved to date, as well as accelerate reduction in WRA anemia burden, focused efforts to reduce gender and social disparities, and improve coverage of health services, such as family planning, IFA, and antimalarial programs, are needed.

Equity in HIV/AIDS services requires optimization of mainstreaming sectors in Ethiopia

BackgroundMainstreaming HIV and AIDS across sectors is crucial to close the disparities in service provision and coverage. However, evidence has shown that certain social groups are left behind in receiving HIV/AIDS services. The objective of this study was twofold: to understand the reasons behind the existing inequities and to explore challenges of equity in HIV/AIDS services in the Amhara region of Ethiopia.MethodsTwenty-two adults (aged 26–57 years) from eighteen sectors that are mainstreaming HIV and AIDS were purposefully selected until the point of saturation and participated in a semi-structured in-depth interview conducted between January 20 and February 17, 2023. Interviewees were asked to describe their mainstreaming experiences in equitable HIV/AIDS services, reflect on the challenges and barriers that impede equitable service provision, or explain the reasons behind the existence of inequity in HIV/AIDS services. The interviews were audio recorded, transcribed, translated, and iteratively analysed, with early analysis informing subsequent interviews. An inductive-reflexive thematic analysis was conducted, whereby themes and subthemes were identified, and the relationships between subthemes and patterns were critically reviewed.ResultsThe challenges to equitable HIV/AIDS service provision were grouped into eight thematic areas: (1) changing contexts that shifts public and government attention to emerging diseases, war and political instability, and poverty; (2) leadership-related, such as the lack of supervision and monitoring, not politicising HIV/AIDS (not providing political attention to HIV/AIDS) and weak intersectoral collaboration; (3) financial constraints due to a random budgeting and contract interruption with non-governmental organisations (NGOs); (4) lack of resources due to scarcity and unfair distribution; (5) inadequate skilled personnel due to inadequate numbers and lack of continuous professional and career development; (6) lack of equity-related evidence-based tools and guidelines; (7) inadequate understanding of equity due to lack of training and misunderstanding, and lack of access to equity-oriented tools and guidelines; and (8) cultural norms, values, and perceptions.ConclusionsThis study identified critical challenges faced in the equitable HIV/AIDS services provision. To achieve equity in HIV/AIDS services, mainstreaming sectors need to invest in mechanisms to sustain services in emergency situations; identify effective leaders to maintain collaboration, monitoring, and evaluation; institutionalise responsive budgeting and establish alternative funds to maintain non-governmental organisations initiatives; provide continuous up-to-date training and create a common evidence-sharing platform; implement proper recruitment, education, and professional development of HIV/AIDS focal persons; and promote and practice culturally safe care. It is, therefore, essential to optimise sectors that are mainstreaming HIV/AIDS and incorporate equity considerations in their strategic plans and working guidelines.

Changing epidemic of tuberculosis amidst the COVID-19 pandemic in the Western Pacific Region: analysis of tuberculosis case notifications and treatment outcomes from 2015 to 2022

Coronavirus disease-2019 (COVID-19) pandemic has deeply impacted tuberculosis (TB) services globally. This study aims to assess the COVID-19 pandemic's impact on TB diagnosis and care and explore associated factors in the Western Pacific Region. We analysed TB case notifications and treatment outcomes for the Region and 14 selected countries and areas from 2015 to 2022. We further explored differences in reported cases from predicted cases by the UHC service coverage index and Human Development Index (HDI), and the relationship between the Stringency Index and TB case notifications during the pandemic. TB case notifications declined in 2020 (21%) and 2021 (23%) compared to predicted cases and partly recovered in 2022 (18%). The shortfalls in 2020 and 2021 were more prominent in priority countries with high TB burden, where the decrease in clinically diagnosed pulmonary cases and paediatric cases was particularly pronounced. In priority countries, TB case notifications have a positive relationship with UHC service coverage index and HDI in 2021 and an inverse relationship with Stringency Index during the pandemic. In contrast, treatment outcomes have not changed significantly due to the pandemic across countries in the Region. The COVID-19 pandemic has adversely impacted TB diagnosis and care in the Western Pacific Region, especially TB case detection. Stringent government policies against the pandemic, coupled with weak health systems and suboptimal socio-economic development, may have brought a more profound and prolonged impact in priority countries. The Korea Disease Control and Prevention Agency and the Japan Ministry of Health, Labour and Welfare.

Assessing the job preferences of senior medical students for mandatory service: a discrete choice experiment.

To investigate the job preferences of senior medical students for mandatory service as general practitioners using discrete choice experiment. Health workforce is directly associated with health service coverage and health outcomes. However, there is a global shortage of healthcare workers (HCWs) in rural areas. Discrete choice experiments can guide the policy and decision-makers to increase recruitment and retention of HCWs in remote and rural areas by determining their job preferences. The aim of this study is to investigate job preferences of senior medical students for mandatory service as general practitioners. This cross-sectional survey was conducted among 144 medical students. To estimate students' preferences for different levels of job attributes, a mixed logit model was utilised. Simulations of job uptake rates and willingness to pay (WTP) estimates were computed. All attributes had an impact on the job preferences of students with the following order of priority: salary, workload, proximity to family/friends, working environment, facility and developmental status. For a normal workload and a workplace closed to family/friends which were the most valued attributes after salary, WTPs were 2818.8 Turkish lira (TRY) ($398.7) and 2287.5 TRY ($323.6), respectively. The preference weights of various job characteristics were modified by gender, the presence of a HCW parent and willingness to perform mandatory service. To recruit young physicians where they are most needed, monetary incentives appear to be the most efficient intervention. Non-pecuniary job characteristics also affected job preferences. Packages of both monetary and non-monetary incentives tailored to individual characteristics would be the most efficient approach.

Inaccessible and Unaffordable? The State of Water and Sanitation Services in Nairobi, Kenya

As the limited water resources become increasingly stressed by factors such as rapid urbanization, population growth, and climate change, the need for sustainable urban water management is more important than in the past decades. A large part of the world’s population still lacks access to clean water and sanitation, making achieving Sustainable Development Goals a challenge. Water is an indispensable resource and plays an important role in ensuring the achievement of Sustainable Development Goals. Therefore, there is a need to prioritize research on the availability, affordability, and access of water resources to promote sustainable water resource management. In this study, we reviewed academic articles and published reports from various institutions and organizations to assess water sources, infrastructure, coverage, accessibility, and affordability of water and sanitation services in Nairobi County. The study identified Nairobi’s main water sources as municipal water, primarily from surface water and groundwater. However, the capacities of the water sources, treatment plants, and wastewater treatment plants were found to be insufficient, resulting in water shortages in most parts of the city.Most of the infrastructures were also found to be insufficient and old, contributing to water distribution inefficiencies, frequent leakages, and pipe bursts which hampers water reliability. The study suggests prioritizing the water and sanitation sector in government budgets to increase infrastructure development investments and funding. Appropriate wastewater treatment methods should also be adopted and implemented to enable wastewater to meet water consumption standards and be potentially integrated into supply systems.

Situation analysis on the integration of refractive error services provided by optometrists into the national health services in Kenya

IntroductionEven though the burden of uncorrected refractive error could potentially be addressed through innovative and cost-effective approaches, integration of the services into the National Health Services (NHS) is desirable. However, minimal information exists on the current situation warranting the need for evidence about the integration of refractive error service provided by optometrists into the national health services in Kenya.MethodsA situation analysis of the Kenyan refractive error services provided by optometrists within the NHS was undertaken based on access to service delivery, service coverage, and human resource. A strengths, weaknesses, opportunities, and threats analysis was undertaken based on the existent evidence to identify the core factors that could potentially facilitate or hinder the integration of refractive error services provided by optometrists within the National Health Services. The proportion of optometrists to be integrated in the NHS was estimated based on the minimum ratios recommended by the World Health Organization.ResultsA section of tertiary and secondary healthcare facilities in Kenya have specific services to address refractive errors within the NHS with most facilities lacking such services. Treatment of refractive error occurs at the level of eye care general services. There are 11,547 health facilities offering primary care services in Kenya. However, none of them offers refractive error services and only a section of facilities offering county health referral services provides eye care services which is limited to refraction without provision of spectacles. The existing workforce comprises of ophthalmologists, optometrists and ophthalmic clinical officers, together with nurses and other general paramedical assistants. Optometrists, ophthalmologists and ophthalmic clinical officers are allowed to undertake refraction. However, optometrists majorly practices in the private sector. Centralization of eye care services in urban areas, weak referral systems, and a shortage in the workforce per population was observed.ConclusionsThe Kenyan NHS should advocate for primary care and reorient the current hospital-based delivery approach for refractive error services. This is attributed to the fact that provision of refractive error services at primary care remains effective and efficient and could translate to early detection of other ocular conditions. The existing human resources in the eye health ecosystem in Kenya should maximize their efforts towards addressing uncorrected refractive error and optometrists should be integrated into the NHS.

Location optimization of emergency medical services: Considering joint service coverage of ambulances and emergency centers

Emergency Medical Services (EMS) play an essential role in saving lives and improving health outcomes by offering immediate medical care to individuals who experience sudden illnesses or injuries. A complete EMS journey consists of two related trips: one from an EMS station to a scene (Trip 1), and the other from a scene to a definitive care location (Trip 2), where the service is coordinately provided by two types of facilities: EMS stations/ambulances and emergency centers (e.g., trauma centers or stroke centers) that are often affiliated with general hospitals. Current work on EMS location optimization considers only one trip (Trip 1 or Trip 2) which ignores the coordination between EMS stations and emergency centers, or the overall trip alone that overlooks the response time requirement. This paper proposed a spatial optimization model, the maximal coverage location problem based on joint coverage (MCLP-JC), for siting EMS stations and emergency centers simultaneously with a consideration of the two related trips. An empirical study of stroke center planning in Wuhan, China, is implemented to compare the proposed approach with the maximal coverage location problem based on overall coverage (MCLP-OC). The results demonstrate that the MCLP-JC can ensure more people being able to receive the first care from an ambulance within the response time requirement, which is critical to subsequent treatment at emergency centers and the odds of survival. The findings from the two scenarios regarding service relocation and expansion offer insights for future health facility planning.

Crowd-Starting a Shared (Shuttle) Service With Customer Suggestions

Digital platforms have improved the efficiency and quality of smart city operations by soliciting more customer inputs, for example, in the form of suggestions. One innovative option in urban transportation is the shared shuttle service, which lies between traditional public transportation and ride-hailing services. Platforms that offer these services can gather customer suggestions in a “crowd-starting” manner, which provides valuable insights into customer needs. However, this also presents a challenge in balancing service coverage and quality to meet customer needs implied by their suggestions. To address this issue, we introduce an optimization framework designed to maximize expected profit by leveraging customer response models which characterize how customers will respond to different service attributes and how their suggestions inform these responses. When estimating these response models, we present methods involving isotonic penalty and shrinkage tailored for handling small datasets. To demonstrate the practical implications, we apply our model to a shared shuttle service case study and discuss practical considerations, such as the value of information, the effectiveness of our estimation approaches, and the benefits of involving customers in the service design process.