Can UAV's augment transportation networks for HIV viral load samples when ground-based courier transportation is interrupted?
To answer this question, Parker is working on a team to determine realistic scenarios where UAVs can prevent interruption of testing HIV VL samples in Turkana, Kenya. The challenges faced by health providers in a large, rural county routinely cause their courier services interrupted. For patients living with HIV, viral load suppression is critical to living a healthy life and prevention of transmission of the virus; and suppression requires viral load testing at certain time points for a given individual. Delays faced by ground-based couriers of lab samples is one component that can further delay clinically-informed therapies. Our goal is to understand these delays, determine the situations in which UAVs could be the best solution, and then to model the transportation network in these scenarios, providing outcomes of estimated turnaround-time and cost per sample.
How long do women in Ethiopia have to travel to reach emergency obstetric and newborn services, and what impact do key interventions have on reducing travel time?
Through our partnership with Columbia University’s Averting Maternal Death and Disability program, Parker is working on a team with the Ethiopian Public Health Institute to create a GIS-based model of access to facility-based delivery services, and to the life-saving interventions required when complications arise (emergency obstetric and newborn care). The approach models women’s access to facilities offering any delivery services, basic emergency services, and comprehensive emergency services, providing nuanced information on the various pathways to care which sometimes include bypassing lower-level facilities. The models consider that women may walk or be carried on foot from their home until they reach a roadway, that at the roadway they will have access to motorized transportation, and that some women will need to be referred via ambulance to reach the nearest facility offering comprehensive emergency services. A base model of the current state provides actual total travel times, and improvement models explore solutions to decrease travel time, including adding ambulances to lower-level facilities, and upgrading key facilities to provide a higher level of service. Outcomes are compared between models, and will be shared with decision-makers for future planning needs.
What is the optimal network configuration for TB sputum sample referral for three regions of the Philippines, and how do the costs compare to the current system?
As part of the TB Innovations and Health Systems Strengthening project in the Philippines, Parker is supporting the program to identify the current system operations and costs, and model changes to the system so that turnaround time for samples is reduced, laboratory capacities are maximized, and is done so at reduced cost from the current, unorganized system. A representative sample of sites will be visited to determine their current system for sending samples, the labs they are sent to, the barriers they face, and the turnaround time of the samples. We will extrapolate these data to the nearly 2,000 facilities, then using the Network Analyst tools in ArcGIS, we will model which treatment facilities should send their samples to which laboratories by test type, such that laboratories are fully utilized and the delivery schedule is frequent enough to reduce delays reaching the labs. The results will be presented to the National TB Program as guidance for improving the TB sputum referral network.