Redesigning Sample Transportation in Malawi Through Improved Data Sharing and Daily Route Optimization

Problem Definition: Healthcare systems in resource-limited settings rely on diagnostic networks in which medical samples (e.g. blood, sputum) and results need to be transported between geographically dispersed healthcare facilities and centralized laboratories. Due to lack of updated information, existing sample transportation (ST) systems typically operate fixed schedules which do not account for demand variability.Academic / Practical Relevance: We present an innovative approach for timely collection of information on transportation demand (samples and results) using low-cost technology based on feature phones and integrate it with a novel version of the Dynamic Multi-Period Vehicle Routing Problem to generate daily routes in response to this updated information.Methodology: We design the Optimized Sample Transportation (OST) system which comprises two components: a novel data sharing platform to monitor incoming sample volumes at healthcare facilities, and a comprehensive optimization model that generates daily transportation schedules in response to current demand at each facility. We implement OST in collaboration with Riders For Health, who operate the national ST system in Malawi.Results: Based on analysis of over 20,000 samples and results transported during July-October 2019, we show that the implementation of OST routes reduced average ST delays by approximately 25%. In addition, the proportion of unnecessary trips by ST couriers decreased by 55%. Managerial Implications: Results from our implementation demonstrate the practical feasibility of our novel approach for improving centralized ST operations in Malawi and its broader applicability to other resource-limited settings, particularly in sub-Saharan Africa