Download this Paper Open PDF in Browser

Improving HIV Early Infant Diagnosis Supply Chains in Sub-Saharan Africa: Models and Application to Mozambique

50 Pages Posted: 19 Oct 2014 Last revised: 3 Sep 2015

Sarang Deo

Indian School of Business (ISB)

Jérémie Gallien

London Business School

Jónas Jónasson

London Business School

Date Written: July 2, 2015

Abstract

Early diagnosis of HIV among infants born to HIV infected mothers is critical because roughly 50% of untreated infected infants die before the age of two years. Yet most countries in sub-Saharan Africa experience significant delays in diagnosis due to operational inefficiencies in early infant diagnosis (EID) networks. We develop a two-part modeling framework relying on optimization and simulation to generate operational improvements in the assignment of clinics to laboratories and the allocation of capacity across laboratories, and evaluate the associated impact on the number of infants initiating treatment. Applying our methodology to EID program data from Mozambique, we validate our simulation model and estimate that optimally re-assigning clinics to labs would decrease the average sample turnaround time (TAT) by 11% and increase the number of infected infants starting treatment by about 4\% relative to the current system. Further, consolidating all diagnostic capacity in one centralized lab would decrease average TATs by an estimated 22% and increase the number of infected infants initiating treatment by 7%. Our sensitivity analysis suggests that the consolidation of capacity in a single location would remain near-optimal across a wide range of laboratory utilization levels in Mozambique. However, this full consolidation solution is dominated by configurations with two or more labs for EID networks with average transportation times larger than those currently observed in Mozambique by at least 15%.

Keywords: Facility location; queueing networks; supply chain optimization; HIV prevention; early infant diagnosis

Suggested Citation

Deo, Sarang and Gallien, Jérémie and Jónasson, Jónas, Improving HIV Early Infant Diagnosis Supply Chains in Sub-Saharan Africa: Models and Application to Mozambique (July 2, 2015). Available at SSRN: https://ssrn.com/abstract=2511549 or http://dx.doi.org/10.2139/ssrn.2511549

Sarang Deo (Contact Author)

Indian School of Business (ISB) ( email )

Hyderabad, Gachibowli 500 032
India

HOME PAGE: http://www.isb.edu/faculty-research/faculty/directory/deo-sarang

Jérémie Gallien

London Business School ( email )

Sussex Place
Regent's Park
London, London NW1 4SA
United Kingdom

HOME PAGE: http://faculty.london.edu/jgallien/

Jónas Jónasson

London Business School ( email )

Sussex Place
Regent's Park
London, London NW1 4SA
United Kingdom

Paper statistics

Downloads
464
rank
52,006
Abstract Views
1,979