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Preventive Care Resource Allocation in Developing Countries: Can Rational Planning Techniques Help in Allocating Vaccinators in Dera Ismail Khan District of Pakistan?

Preventive care service delivery faces immense challenges when it comes to the level of coverage. Within this context, the case of child immunization is presented by applying operations management tools. This paper explores the application of integer programming techniques to support the Expanded Programme of Immunization (EPI) service in the Dera Ismail Khan District of Pakistan. The main concern here is equitable service delivery to decentralized localities based on two criteria: (1) achieving the highest possible level of vaccination among the target population; and 2) ensuring equality among geographically scattered populations, especially in rural dwellings. For this purpose two integer programming models have been applied on the basis of (1) sub-dividing health district into localities and allocating vaccinators to visit and vaccinate children within their administrative boundaries, and (2) within the localized planning system allowing vaccinators to visit and vaccinate children across the administrative boundaries subject to savings in travel time. Both models show interesting results in terms of need satisfaction and travel-time savings with a minimum level of deviation from equity. The solutions provide a trade-off between alternative organizational tactics, and the argument is made that rational planning methods applied interactively can contribute to the delivery of an immunization service that is equitable and cost effective.