ISB Updates

Professor Sarang Deo part of a global team awarded by the Bill and Melinda Gates Foundation

Sarang Deo, Executive Director of the Max Institute of Healthcare Management and Associate Professor of Operations Management at the ISB was a part of the team that recently won a research award from none other than the Bill and Melinda Gates Foundation under the Grand Challenges Explorations - an initiative fostering innovation that can make an impact in solving key global health and development problems. Along with Sarang, the winning team comprised Jonas Jonasson, faculty at MIT Sloan School of Management, Kara Palamountain from Kellogg School of Management and an international NGO called Riders for Health based in Malawi.

The team conducted a study on optimising the use of Sample transportation (ST) systems at Malawi in Africa. The ST systems are an integral component of diagnostic networks in most countries of southern Africa-enabling physical transportation of samples (e.g., dried blood spots, plasma, or sputum samples) from health centres to laboratories as well as of results back to clinics.

Unorganized and ad-hoc ST systems have for long resulted in inordinate delays in diagnosis, which can seriously impact the health outcomes of patients. In recent years, some countries have responded by moving to more formal nationwide systems (through NGOs or MOHs) that operate on a predetermined schedule of courier visits to clinics and laboratories. However, this push system is likely to lead to high frequency of unnecessary trips — defined as couriers spending a day visiting clinics that have collected no new samples. The problem of unnecessary trips, is further confirmed by recent data from Malawi, showing that around 31% of clinics visited do not have samples to pass on to couriers and that about 5% of daily tours - a courier visiting multiple clinics according to the daily schedule - result in no samples being collected and no results being returned. On a yearly basis, these unnecessary tours translate to approximately 90,000km travelled during 2,000 courier-hours. Given that staffing and a fuel make up approximately 50% and 30% of operating budget respectively of the Sample Transporter’s budgets, unnecessary trips become a significant drain on resources.

First, the team proposed a novel ST pull system for courier-scheduling, which optimises courier routes every day based on real-time information about the number of samples of each type waiting to be transported at any given clinic. This would not only help minimise costs as well as turnaround times, but also avoid possible negative implications on public health through delayed or diminished treatment initiation. Second, the team proposed installing a low-cost system for communicating ST demand from clinics to district ST operators and integrating it with optimization software for scheduling routes on a daily basis using powerful analytics.

With diagnostics being a major component in treatment of most illnesses, the award winning model can be leveraged to expand low-cost yet effective access to healthcare facilities to a larger and underserved section of people in the country.