Here's how optimized courier routes could improve health outcomes in Africa
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Here's how optimized courier routes could improve health outcomes in Africa

The Bill & Melinda Gates Foundation awarded a $100,000 grant to develop the idea.

By Rebecca Linke  |  January 16, 2018

rainbow-transport-lead-2

A Riders for Health courier traveling between villages in Malawi.

Why It Matters

Transporting clinical samples in low-resource settings is hard. This new approach can improve operational efficiency and public health outcomes while reducing costs.

MIT Sloan assistant professor Jónas Oddur Jónasson will use a $100,000 grant to develop a more cost-effective and efficient system for transporting clinical samples in low-resource settings in Africa.

Jónasson received the 18-month Grand Challenges Explorations Grant from the Bill & Melinda Gates Foundation in November. The grant is for his project, Utawaleza – Rainbow Transport.

In Malawi, where Utawaleza will focus first, clinical samples are transported back and forth daily between a network of clinics and laboratories. The samples are drawn at the clinics, sent to the laboratories for testing and analysis, and the results are returned to the clinics. Jónasson said Malawi is one of the first countries to have an organized, systematic, transportation system for this process, with the Ministry of Health contracting sample transportation out to the nonprofit Riders for Health, led locally by Mphatso Kachule.

But the transportation system still deals with operational problems — 5 percent of trips couriers take are unnecessary, which increases costs for fuel and maintenance, among other things. This is rooted in two main issues: lack of information flow between clinics and sample transportation managers, and technology not being applied to optimize routes or minimize extraneous trips.

Jónasson, along with collaborators Sarang Deo, an associate professor at the Indian School of Business; Kara Palamountain, an associate professor at Northeastern University’s Kellogg School of Management; Daria Brauner, an MBAn student at MIT Sloan; and Kachule plan to address both problems with Utawaleza.

rainbow-transportJónas Oddur Jónasson shadowed a courier who was transporting clinical samples.

Regarding the issue of communication between clinics and transportation managers, they believe setting up a system of daily text messages that communicate the quantity and type of samples the clinic has to be transported will be sufficient. “The second component is to develop an optimization algorithm that transportation managers can run every day to optimize where they send their couriers,” Jónasson said. The algorithm will work by incorporating the number, type, and locations of samples that require transportation between health centers and diagnostic laboratories each day. Using this data, the algorithm will optimize courier routes with the goal of lowering costs and improving public health outcomes.

“This is an opportunity to directly link an operational decision, like where to send the couriers, to public health outcomes,” Jónasson said. “We are trying to take all this information and optimize for health impact. Imagine a clinic having five samples that need HIV testing for infants and one tuberculosis sample. Another clinic might have 10 tuberculosis samples. Ideally the algorithm would be able to use disease progression models to be able to prioritize different types of samples.”

Jónasson’s team is in the preliminary stages of its work on Utawaleza, which means “rainbow” to represent how a rainbow’s arch can connect an origin and a destination. They have gathered data, have some preliminary results, and will use the grant to start running a field trial as soon as the algorithm has been developed, to evaluate its impact.

While the trial for Utawaleza will take place only in Malawi, Jónasson said that this system could be applied anywhere in sub-Saharan Africa where diagnostic networks and sample transport systems exist.