Equitable Community Health Worker Deployment in sub-Saharan Africa: A Modeling Framework for Stochastic Health Progression
Name
reubenstein-rreubens-sm-orc-2023-thesis.pdf
Description
Thesis PDF
Size
9 MB
Format
Adobe PDF
Checksum (MD5)
8b3334408c4a3a824c6f205f669e2a8b
Author(s)
Reubenstein, Rebecca
Advisor(s)
Jónasson, Jónas Oddur
Date Issued
June 2023
Publisher
Massachusetts Institute of Technology
Abstract
Community health workers (CHWs) are increasingly important to healthcare delivery in many African countries. As CHW programs are being scaled up and integrated into national healthcare delivery systems, an important policy question is how to deploy CHWs to various localities, given their differences in disease burden and population density as well as the limited national resources for the program. We develop a modeling framework which jointly describes the health impact of a CHW program as a function of an area’s disease characteristics, operational environment, and CHW deployment density. Specifically, we use a continuous logistical model to capture the travel time constraints of CHWs and a novel continuous time stochastic model to describe individual health progression. We then demonstrate how our model can be used to inform policy decisions by formulating and solving an optimization problem for CHW deployment. Our numerical results demonstrate that we can prioritize equity in our deployment approach without incurring too high a price in terms of total country-wide utility.
MIT Department
Massachusetts Institute of Technology. Operations Research Center
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