Operational Innovations to Improve Malawi’s HIV Sample Transportation Network

Abstract

The African nation of Malawi, like other sub-Saharan countries, provides diagnostic testing to its citizens through a centralized laboratory network. Diagnostic samples are collected from patients at remote, point-of-care health facilities and diagnostic tests are performed at centralized laboratories. Sample transportation (ST) systems within these networks are crucial for timely disease diagnosis and treatment. In this thesis, I present my research regarding two operational innovations to improve the ST system, and, consequently, the diagnostic network in Malawi. I first present a report documenting the development, implementation, and testing of a novel, mobile phone-based data collection system which vastly improves the accuracy and visibility of patient sample volumes and locations across the diagnostic network. By making this logistics information available and accessible to ST system administrators, ST systems can become more flexible, limit wasted capacity, and improve the quality of care. Second, I document my work towards understanding how different strategies for deploying point-of-care (POC) diagnostic testing devices influences the performance of the network as a whole. I find allocating POC devices to facilities with the highest sample volumes can cut the average time required for a patient to receive their test results after providing a sample by 60%, from over a month to less than two weeks.