A Mixed Integer Programming Model for a Complex Humanitarian Emergency Case

Complex humanitarian emergencies cause large number of internally displaced people and refugees. Huge percent of world’s refugees are hosted by developing countries. These countries are tackling with difficulties in meeting shelter, health and education requirements of refugees due to the development challenges. This study proposes a mixed integer programming model handling shelter, health and education requirements of refugees. It is expected to use this model for supporting decision making on capacity building activities and disaster recovery towards refugees in developing countries.

A New Tamper Evident Packaging Seal for Combating Counterfeit/Substandard Medical Products

The purpose of this study is to assess currently used or proposed methods for detecting counterfeit/substandard medical products, here called CSMP, to identify their shortcomings and to analyse if a new tamper evident packaging method using vacuum may resolve some of these shortcomings. With the new method, the product and a pressure sensor with a signalling means are placed in a gas proof bag which is vacuum sealed. If someone tries to open it, air gets in and the sensor registers the loss of vacuum and sends an alarm and/or memorizes a time stamp of the event to be read at future inspections. See Patent (2010), Patent (2016) and TamperSeal (2017).

The design/methodology/approach used comprehensive literature and patent studies combined with about 70 unstructured interviews were performed followed by construction of a multi-layer packaging security model. This framework together with the criteria found in the literature were applied to evaluate both current and the new methods. Finally, a cost-benefit analyses were performed on a real case.

Accelerated Shelf Life Studies and Micronutrient Stability of Food Aid Products: Implications for the Humanitarian Supply Chain

Accelerated shelf life/stability studies are a critical part of product research and development, now being included in the introduction of new/upgraded food aid products. Food aid products, in particular, can be exposed to conditions throughout the food aid supply chain (e.g., sustained exposure to high levels of heat and humidity) that can potentially affect or degrade products, including nutritional properties, taste, odor and packaging integrity and appearance. The presenters will share research from a study which determined vitamin and mineral stability and integrity of new products in the supply chain, as due diligence, for products developed through the Food Aid Quality Review (FAQR) Phase II food aid effectiveness trials.

Shelf life studies are crucial to verify the stability and integrity of food aid products. These findings highlight the role that intrinsic values of raw ingredients play in establishing FBF specifications. Advances in ingredients and micronutrient technology can have a significant impact on shelf life duration and organoleptic properties through the supply chain. Accelerated shelf life studies are industry standard for new product development and should be adopted as due diligence and become standard for all new or upgraded food aid products. Shelf life protocols and conditions should be harmonized among aid organizations working on product development for comparable data and results. Industry should be engaged in packaging material and ingredient form innovation to reduce degradation of Vitamin A and other biomarkers. This research was funded by the United States Agency for International Development’s (USAID) Office of Food for Peace (FFP) under USAID Contract AFP-C-00-09-00016-00 with the Friedman School of Nutrition Science and Policy for Phase II of the Food Aid Quality Review (FAQR). 

Assessing Stability and Performance of a Digitally Enabled Supply Chain: A Retrospective of a Pilot in Uttar Pradesh, India

Immunization supply chains in low resource settings do not always reach children with necessary vaccines. Digital information systems can enable real time visibility of inventory and improve vaccine availability. In 2014, a digital, mobile/webbased information system was implemented in two districts of Uttar Pradesh, India. The purpose of this poster presentation is to highlight improvements and stabilization of supply chain performance following introduction of the digital information system.

Cold Chain Equipment Support Package

Cold Chain Equipment Support package is aimed at assisting decision-makers at all supply chain levels to choose correct and reliable cold chain equipment for vaccine storage. Supporting countries in improving their cold chains to ensure that vaccines remain cold, safe and effective throughout the entire supply chain. Some older technologies have high operating costs and/or poor temperature control that can lead to vaccine wastage if vaccines are exposed to very high or freezing temperatures.  The Cold chain support package is intended to support countries when considering CCE procurement

Evolving Follower Networks and Information Diffusion on Social Media for Disaster Relief Organizations

Humanitarian organizations utilize social media platforms, such as Facebook and Twitter, to broadcast information to key stakeholders. For instance, organizations issue appeals for donations to donors and provide updates on goods and services for beneficiaries over social media. On social media, a user's posts are instantly transmitted to their connections, or followers, and this means that a user's set of followers represents her direct audience.Therefore, humanitarian organizations should aim to expand their follower networks to maximize the number of users that can be immediately reached and the diffusion of their posts.

Our research analyzes what mechanisms drive follower growth for organizations involved in disaster relief. We utilized the Twitter dataset from the 2016 Ecuador Earthquake to track the growth of Twitter follower bases for approximately 65 organizations involved with disaster relief during a two-week period that spanned one week before and one week after the earthquake. 

From Plan to Implementation: Lessons Learned from Niger’s Introduction of New Cold Chain Technology

Niger has made it a priority to update its cold chain equipment across the country in order to strengthen the Expanded Program on Immunization (EPI) and increase vaccine availability and coverage rates. With funding from Gavi, the Vaccine Alliance, through both Health Systems Strengthening (HSS) and the Cold Chain Equipment Optimization Platform (CCEOP), the country is procuring and installing more than 1,200 new refrigerators over the next five years. This presentation documents the planning process through installation and monitoring in order to provide lessons learned and guidance for other countries undertaking similar activities.

How Existing Infrastructure and Support Functions can Drive Efficiency in Healthcare and Humanitarian Logistics Operations

Supply Chain management strategies are extremely important in developing sustainable public health sector and humanitarian distribution structures which deliver quality product to the populations. Existing stakeholders’ infrastructures and support functions are paramount in ensuring that Public Health Supply Chain and Humanitarian Response can be both efficient and cost effective whilst benefit from agile solutions suitable for their evolving needs. In an environment where Supply chain costs contribute between 15 to 41% of the total landed cost pf products, leveraging existing infrastructure and having collaborative approach can result in `value creation up to 30%. On the one hand, leveraging existing logistics infrastructure enable the rapid but cost effective deployment of both temporary (for example for emergency response) and long term solutions (Public Health Strengthening). On the other hand, support functions in Supply Chain contribute meaningfully to costs. Support functions in supply chain including logistics (warehousing and distribution, procurement, and materials management), technology, quality health, environment, and safety (QHSE); human resources; and finance, can constitute anywhere between 10 and 45 percent of these operating expenses. This poster will highlight strategies of private sector stakeholders’ structures.

How UNICEF Supply Drives Research and Development

UNICEF procures over 5,000 supply items and in 2016, UNICEF procured approximately $3.6 billion worth of supplies and services for children in more than 190 countries- making UNICEF the largest procurer agent within the UN system. Over the years, UNICEF has honed expertise and processes to encourage research and development (R&D) of essential products for children and to influence markets to ensure they are accessible, affordable, appropriate, and produced by a competitive supply base.  

UNICEF Supply R&D projects are initiated when a product to address an unmet product need within programs or emergencies is required, but where the product does not exist in a procurable form on the market either because they are not developed or because the product has not been field trialled for UNICEF’s application. The poster outlines the different activities within the three main stages of the innovation process of need, R&D and scale.

Implementing an Emergency Transport Scheme in Rural Madagascar

The Community-Based Integrated Health Programme, known locally as MAHEFA, was a five-year USAID-funded programme led by JSI Research & Training Institute, Inc., and implemented in partnership with Transaid, The Manoff Group and 15 national NGOs. The overall aim of the programme was to reduce maternal, child, and new-born mortality and malnutrition rates through increasing the uptake of health-related community-based interventions and essential products. While transport has been widely recognised as a barrier to the provision of and access to health service in rural areas (46% - INSTAT, 2010), few community health programmes have integrated transport interventions as an enabler to support the provision of services. From its onset, MAHEFA’s core strategy included trialling innovative solutions to improve access to health care through emergency transport systems (ETS). This poster presents the implementation of ETS in Madagascar.

Improving Health Community Security through Citizen-led Advocacy: A case of Regular Assessments in Uganda's Health Facilities

Advocacy for Better Health (ABH) is a five-year USAID project aimed at improving the accessibility, availability, and quality of health services in 35 districts of Uganda. Implemented by PATH and Initiatives Inc, it engages communities in the planning and monitoring of health services and strengthens the capacity of local civil society organizations (CSOs) to represent citizen interests and conduct advocacy for health policies, budgets, and programs.

Under ABH, Health Facility Assessments (HFAs) are conducted regularly by community members to analyze; (1) the prevalence of absenteeism of service providers in the health centers, (2) the prevalence of stock out of essential drugs and commodities in the health centers, and (3) the consistency with Ministry of Health guidelines regarding opening and closing hours of the health facilities. This poster presents the activities, findings, results, and conclusions from this project.

Integrated UNICEF emergency response during 2014-2015 Ebola virus outbreak in West Africa: Successes, challenges and lessons learned

This poster is a compliment to the model "Ebola Community Care Center" that may be toured during the conference. See tour time slots on website for details and you may sign up in person on Day 1 of the event:

For 70 years, supplies have been central to UNICEF’s emergency response. Supply Division (SD) is UNICEF’s global headquarters for procurement and logistics and has a critical role in coordinating with humanitarian partners and governments to ensure that life-saving supplies are efficiently mobilized and delivered to affected communities. The complexity and scale of the 2014 Ebola virus disease (EVD) outbreak was like no other in UNICEF’s experience. Bringing EVD under control required a rapid response on a global scale as well as intensive commitment at a community level.  UNICEF Supply Division’s work complemented UNICEF’s programme focus on community and household level interventions, for example, raising awareness about the EVD and encouraging preventive actions such as handwashing and avoiding physical contact with infected people. This outreach was complemented by the large-scale supply of basic hygiene and sanitation such as soap and chlorine.  In five intensive months, UNICEF delivered 5,500 tonnes in emergency supplies, by air and by sea to the three Ebola-affected countries.

When epidemiological evidence confirmed that breaking EVD transmission required isolating people showing EVD symptoms and caring for the sick where outbreaks occurred, UNICEF worked with communities to design and establish temporary Community Care Centres (CCEs) which could be rapidly set up and to treat and provide palliative care. In all, UNICEF worked with governments and communities to construct 51 CCCs in Guinea, Liberia and Sierra Leone. Family support and community leadership were critical to the success of CCCs.

Equipping CCCs with adequate protective personal equipment (PPEs) and training personnel to use these safely, were also essential. Supply Division facilitated the dialogue between humanitarian agencies and industry worked to develop, standardize and scale up production of Ebola resistant protective equipment used front-line workers and burial teams. Brand new supply chains were established to meet soaring demand for protective masks, gloves and coveralls and other PPEs. 2014’s EVD supply response experience generated important lessons that are helping to strengthen preparedness for future health emergencies.  

Leveraging Citizen Empowerment in Advocating Health Commodity Security: The Advocacy for Better Health Story in Uganda

The Advocacy for Better Health is a five-year funded by the United States Agency for International Development (USAID) with a goal to improve the quality, accessibility, and availability of health and other social services. The project aims to enhance the capacity of citizens and Civil Society Organizations (CSOs) to carry out effective advocacy for increased investment and accountability by decision-makers so as to improve the quality and availability of essential health and social services in 35 target districts in Uganda.

Leveraging Supply to Gain Better Results for Programmes

Safe Injection Equipment (SIE) , including Auto Disable Syringes and Safety boxes, play a crucial role in immunization activities, reducing the risk of transmission of blood borne diseases through reuse of syringes and needle stick injuries. UNICEF, in supporting immunization activities globally, plays a key role in the procurement of SIEs alongside Vaccines, procuring on behalf of UNICEF Programs, Gavi, The Vaccine Alliance and Procurement Services Partners (Governments) for approximately 100 countries annually. The value of SIE procurement is small in comparison to Vaccines, but has large programmatic impact if not delivered in time. Given the above, UNICEF considers SIE strategic supplies and has actively engaged within SIE procurement and supply - including changing the tendering approach and business processes - to obtain better results for children.

Locating Roadside Clinics in Sub-Saharan Africa

Providing African truck drivers with adequate access to healthcare is an effective way to reduce the burden and the spread of HIV and other infectious diseases. Therefore, NGO North Star Alliance builds a network of healthcare facilities along major African trucking routes. Expanding this network presents complex optimization problems. In this poster presentation, we consider the problem to select locations for new facilities and to choose for each of these facilities whether or not to add a given optional health service to the standard health service package. The latter is to enable centralization of expensive health services.  The objectives are to maximize the truck driver patient volume at these facilities and to improve continuity of access. The latter entails ensuring that the density of the network is sufficient safeguard effective service delivery. We describe how we relate decisions to objectives and discuss how our model and its implementation in a decision support tool enable better decisions.

Managing UNICEF Supply Chain for Distribution of Mosquito Nets

Use of Long Lasting Insecticidal Nets (LLINs) remains a key UNICEF-supported malaria prevention strategy.  UNICEF is one of the leading procurers of LLINs for children and families. In 2015, UNICEF procured 22.3 million LLINs that were distributed across 30 countries.  UNICEF key procurement objective is ensuring un-interrupted and sustainable supply of affordable LLINs of assured quality.  UNICEF nets supports the distribution of nets through routine systems and also contributes to mass campaigns –this includes strengthening countries’ supply and logistics. This poster is showing an example of a supply chain strengthening and optimization model using the 2014 mass campaign in Ivory Coast.    

Planning for Successful Emerging Disease Response

Zoonotic diseases confront societies and institutions with global health challenges of major import- over 70% of emerging infectious diseases originate from an animal source. Recent zoonotic outbreaks such as the Ebola outbreak in West Africa and the rising count of human infection by avian influenza in China highlight the necessity of community-level disease response capabilities in both high- and low-resource settings. Leveraging institutional assets with specialist training in zoonotic disease, emergency management, public health, and logistics and supply chain management, LMI has developed a process to facilitate the development of these key capabilities with stakeholders from the national, regional, state, and local levels. 

Quantitatively Measuring Supply Chain Visibility: Application of a Novel Approach – along the Pharmaceutical Supply Chain

As a key motivation to explore approaches to improve supply chain performance, SCV measures can tell where to put the focus. SCV is rated as the most important measure for supply chain performance both by business leaders and researchers. In a wide perspective, authors define SCV as the ability of a focal company and related actors within a supply chain to capture, share, integrate, and create intelligence from key information, or making that information ready for monitoring, controlling, changing or decision making purposes.GS1 define SCV as “the awareness of, and control over, specific information related to product orders and physical shipments, including transport and logistics activities, and the statuses and events and milestones that occur prior to and in-transit”. Therefore, being able to efficiently measure and know the status of this influential aspect-SCV-in a given pharmaceutical supply chain has a significant value for benchmarking or improvement purposes. 

R&D of Zika Virus (ZIKV) Point of Care Diagnostics

A number of global post-Ebola assessments have highlighted the need for collective preparations to be made to ensure that the world is ready and able to respond to future health emergencies. Much of this attention has focused on the International Health Regulations (IHR) and the WHO, which has established a new internal structure for outbreaks and emergencies. It is against this backdrop that UNICEF developed the Health Emergencies Preparedness Initiative (HEPI) in 2015, focusing on strengthening and systematizing UNICEF’s role in the prevention, preparedness, response and early recovery phases of global health emergencies. A key strategic area of HEPI is R&D, to identify missing products and gaps to be able to respond in the event of an outbreak.

On February 1st, 2016 WHO declared the ZIKV and its suspected link to birth defects as a Public Health Emergency of International Concern. The global health community recognized the importance of a collaborated and quick response with Zika, from witnessing the spread and devastating impact of the Ebola Virus Disease (EVD) outbreak in 2015. The UNICEF Supply HEPI R&D Team therefore worked with partners and industry to transform today’s under-supplied Zika market, which at the time offered no point of care (POC) or diagnostic test.

Selecting a Location for Rehabilitative Shelters for Human Trafficking Survivors among States in the USA: A Decision Analytic Approach

Rehabilitative shelters are an important component of protection and prosecution efforts of anti-human trafficking efforts. While survivors of human trafficking exist in every U.S. State, only roughly 2/3 of the 50 states currently provide dedicated rehabilitative shelters. Furthermore, the demand for such shelters exceeds the current capacity, even in states that have rehabilitative shelters. Shelters entail a large investment, typically from the non-profit sector. In addition to safe housing, many shelters are also linked to a network of services such as medical treatment, psycho-social care, education, life-skills training, and legal advocacy that aids in a holistic approach to rehabilitation. Yet, significant disparity exists between states with regard to the legislative environment to combat trafficking and provide auxiliary services to rehabilitate survivors.

This project develops a decision analytic approach to evaluate the impact of opening a rehabilitative shelter dedicated to trafficking victims at the U.S. state level. Using concepts from health and social welfare economics, we develop a budget allocation problem that maximizes societal value. We quantify the societal value as a combination of dollar converted disability-adjusted life years (DALY)s averted and labor productivity gained, adjusted by state legislative environment, less construction and operating costs.

Socioeconomic Disparities in Existence of Multi-morbidity among Middle and Old Age Individuals.

Multimorbidity can be defined as simultaneous occurrence of two or more chronic diseases in an individual without defining a primary disease. Multimorbidity is a major cause of mortality among old age individuals. It is predicted that by 2020 non-communicable diseases will account for 80% of the global burden of disease, causing seven out of every ten deaths in developing countries.

Solutions for Efficient and Effective Cold Chains

Fridge-tag 3 ® is a wireless temperature monitoring system for cold chain equipment (CCE). Fridge-tag 3 ® transmits data and provides real-time temperature alerts through audio alarms and SMS (text messages). Technical features include: sim card slot for local or international sim card use; rechargeable battery with long life and operation; various antenna, external digital sensor (long cable integrateable in fridges); upload through GPRS and SMS; transmits data even during power outage.

Strengthening Supply Chain: Challenges and Solutions

Humanitarian organisations play an important role in the running of many nations irrespective of those nations? economic state, (poor nations and rich nations). For instance Hurricane Katrina affected even the United States of America even though its GDP is high. (16.77 trillion in 2013; World Bank) whereas a developing country like Zimbabwe had a GDP of 13.49 billion during the same period. When disaster strikes, these states need aid which if often brought through the hands of humanitarian organisations. These organisations are usually faced with a host of challenges when extending their humanitarian aid among these challenges are; the scale of the task at hand, lack of coordination which may spill into duplication of efforts among these organisations, lack of infrastructure, health issues and poor communication. 

The purpose of this poster is to highlight challenges faced by a few selected nongovernmental organisation in Zimbabwe such as Care International, Unicef, and Oxfam.

Stronger Supply Chains Through Shared Investment & Shared Benefit: OpenLMIS Version 3

OpenLMIS is a state-of-the-art, open source, web-enabled electronic logistics management information system (LMIS) purpose-built to manage and strengthen data collection and visibility in health commodity supply chains. The OpenLMIS initiative incorporates a community-focused approach to develop open source and customizable LMIS systems specifically designed for low-resource settings. The initiative provides an environment where software modules and datasets from newly developed code and existing systems are made available in a public repository.

Supply Chain Considerations for New Product Introduction: The Challenge of Matching Supply with Demand

A new 3-month injectable contraceptive product, DMPA-SC (Depot medroxyprogesterone acetate subcutaneous), also known as Sayana® Press1 , is being introduced through family planning (FP) programs around the world. FP program managers face the challenging task of aligning supply with anticipated demand as they move from product introduction to subsequent integration. To estimate commodity needs, program managers and others must make assumptions about future use of DMPA-SC and the possible impact that its introduction will have on the use of other products (including other injectables), in the absence of country-specific, historical data on which to base these assumptions. Countries risk overstocks and expiries if actual demand falls short of forecasts; shortages and stockouts can occur if demand for the new product far surpasses forecasts. In this poster, JSI will summarize key messages from forthcoming guidance on estimating DMPA-SC commodity needs in this uncertain context, including considerations and recommendations.

Task Shifting in Health Supply Chain Management in Developing Countries: What are we Doing Right or Wrong?

The majority of low-income countries continue to experience a critical crisis in human resources for health. Severe shortage of pharmaceutical workforce, especially in remote rural settings, is affecting equitable access to essential medicines and other health commodities. Inevitably, this translates to poor health indicators and outcomes. Relevant publications were identified from websites of organizations working in the study area and contacts working in the field. Task shifting is being used as stop-gap measure rather than a fully fledged policy shift. No formalized/systematic shift of tasks - change of job descriptions, formal training and orientation, incentives etc. are currently in use in multiple organizations. An absence or lack of conducive policy, legal, regulatory frameworks and enabling environment currently hampers proper implementation of task shifting in health supply chain management.

The INACEWS System: An Innovative Approach to Avoid Contraceptive Stockouts in Indonesia

Indonesia's National Population and Family Planning Board (BKKBN) has been working with several partners to improve the contraceptive supply chain management (SCM) system. We are addressing the issue of high stock out rates within the country that impacts contraceptive availability. Together with John Snow, Inc. (JSI) and the "My Choice" Project, we are piloting several SCM system strengthening interventions in selected districts within the My Choice Project provinces to improve the inventory management system and have developed a mobile-based supportive supervision tool.

Vision 90-90-90: Surmounting the Logistic Hurdles to Viral Load Scale up - The Nigerian Experience

By December 2015, an estimated 3,217,885 persons were living with HIV/AIDS while 853,992 persons were on ART in Nigeria. To improve the prospects of attaining the UNAIDS 90-90-90 goals, the country in December 2016 aligned with the WHO Test and Treat All Strategy. This ambitious target entails 90% of 3,217,885 persons tested, 2,042,104 on ART and 2,606,486 persons achieve viral suppression within 5 years. The last component of this target requires rapid unprecedented nationwide expansion of access to Viral load testing. An estimated 617,947 tests, which translates to 79% jump in AMC of Viral load kits between May 2016 and September 2017, was needed in 2017 to keep the country on track to achieve adequate viral load coverage. This poster examines the outcome of collaboration with donors amidst multiple supply chain challenges, to maintain commodity security at testing sites. 

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The Health & Humanitarian Conference series is organized each year by the Center for Health & Humanitarian Systems (CHHS) at Georgia Tech in partnership with INSEAD, MIT, and Northeastern University, with generous support from corporate and other organizational sponsors.

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