Primary Health Care Center (PHCC) Location-Allocation with Multi-Objective Modelling: A Case Study in Idleb, Syria
Abstract
:1. Introduction
2. Materials and Methods
2.1. Methodology
2.2. Building the Model
- Laboratory service,
- Blood grouping service,
- Vaccination,
- Solar power,
- Basement,
- Internet service.
- Each demand node can be served as an entire unit from a PHCC or not served at all (0 or 1 without any fraction).
- Amount of each demand and its location are fixed.
- Paths throughout the updated built road networks are accessible and there is no broken or closed street.
- Variable costs for each allocated group of people at each location are related to the amount of people allocated in the PHCC irrespective of the PHCC’s location. It means that the cost of allocating a person to a certain PHCC is the same cost of allocating him/her to another PHCC in another location.
2.3. Weighted Goal Programming (WGP)
2.4. Analytic Hierarchy Process (AHP) for Identifying Criteria Weights in WGP
2.5. Weighted Goal Programming Formulation
3. Case Study and Results
3.1. Case Study
- Demands at nodes;
- Availability factors of candidate PHCCs (solar power, basement, internet service, laboratory service, blood grouping service and vaccination);
- Coverage distance;
- Fixed cost of locating a PHCC at candidate locations;
- Capacity of each candidate location;
- Cash for work amount at each candidate location.
- Regarding the RHS of our first objective, the target value of allocated people, we have set our target value as 1,852,440 following data collection since we aim to allocate all people in the case study area.
- Among candidate PHCCs; 31 have laboratory service, 33 have blood grouping service, 60 have vaccination, 18 have solar power, 36 have basement and 65 have internet service. Through the process in Figure 3, we determined these objective’s target values as: 30, 30, 30, 18, 30 and 30, respectively.
- According to the results obtained by AHP and depicted with Table 3; for every objective function(n); values are set as: 45, 0, 5, 5, 5, 5, 5, 9 and 9. values are set as: 0, 14, 0, 0, 0, 0, 0, 0 and 0. Here, goals though 1 to 9 correspond to: allocated people objective, total cost objective, cash for work, solar power, basement, internet service, laboratory service, blood grouping service and vaccination, respectively.
- Total cost budget and cash for work target values are determined as USD 1,000,000 and USD 100,000 via the process in Figure 3.
3.2. Results
3.3. Sensitivity Analysis
4. Discussion
- PHCCs or health care facilities can be assessed with more criteria such as the availability of running water and availability of electricity in hours.
- Criteria such as education, access to food and water can also be handled alongside the criteria/objectives addressed in this study.
- In future studies, labor factors (doctors, nurses, technicians and guards) and medical resources (beds, drugs, etc.) can be included in the model.
- Sensitivity analyses can be performed by changing multiple parameters simultaneously.
- Other regions of Syria can also be added into the relevant area, which can make the paper more comprehensive.
- A web-based tool can be designed incorporating the mathematical model and GIS and adapted to various similar problems.
- A dynamic model might be proposed to deal with the high degree of uncertainty regarding such problems.
- The problem can be handled by different techniques such as heuristic, meta-heuristic methods, hybrid models and social simulations.
- A conflict risk assessment can be applied to investigate the connection between the risk of armed conflict/ongoing crisis and a set of indicators such as education, infrastructure and access to health care facilities and food.
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Parameter | Meaning |
---|---|
I | Set of demand nodes; i ϵ I |
J | Set of candidate locations; j ϵ J |
N | Set of targeted goals; n ϵ N |
Demand at node i | |
Fixed cost of locating a PHCC at site j | |
Running cost of each person at site j (constant number) | |
Capacity of each candidate location j | |
Amount of cash for work in each candidate location j | |
TC | Transportation cost for a distance of 1 km (constant number) |
Distance between node i and location j (acquired via constructing a GIS roads network dataset) | |
(covering matrix) | |
Penalty of not achieving the objective related to deviation | |
Penalty of not achieving the objective related to deviation | |
Right hand sides of targeted goal n according to goal programming | |
Positive deviational variable—amount of an overachieved targeted goal n | |
Negative deviational variable—amount of an underachieved targeted goal n |
Intensity of Importance | Definition | Explanation |
---|---|---|
1 | Equal importance | Two elements are equally important |
3 | Moderate importance | Experience and judgment slightly favor one element over another |
5 | Strong importance | Experience and judgment strongly favor one element over another |
7 | Very strong importance | One element is favored very strongly over another |
9 | Extreme importance | One element is absolutely more important over another |
2, 4 ,6, 8 | Intermediate values | When compromise is needed |
Objectives | Weights |
---|---|
P1 | 44.7% |
P2 | 14.4% |
P3 | 4.7% |
P4 | 4.7% |
P5 | 4.7% |
P6 | 4.7% |
P7 | 4.7% |
P8 | 8.7% |
P9 | 8.7% |
N | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
---|---|---|---|---|---|---|---|---|---|
0.58 | 0.9 | 1.12 | 1.24 | 1.32 | 1.41 | 1.45 | 1.49 | 1.51 |
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Miç, P.; Koyuncu, M.; Hallak, J. Primary Health Care Center (PHCC) Location-Allocation with Multi-Objective Modelling: A Case Study in Idleb, Syria. Int. J. Environ. Res. Public Health 2019, 16, 811. https://doi.org/10.3390/ijerph16050811
Miç P, Koyuncu M, Hallak J. Primary Health Care Center (PHCC) Location-Allocation with Multi-Objective Modelling: A Case Study in Idleb, Syria. International Journal of Environmental Research and Public Health. 2019; 16(5):811. https://doi.org/10.3390/ijerph16050811
Chicago/Turabian StyleMiç, Pınar, Melik Koyuncu, and Jamil Hallak. 2019. "Primary Health Care Center (PHCC) Location-Allocation with Multi-Objective Modelling: A Case Study in Idleb, Syria" International Journal of Environmental Research and Public Health 16, no. 5: 811. https://doi.org/10.3390/ijerph16050811