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Preventive care service delivery faces immense challenges when it comes tothe level of coverage. Within this context, the case of child immunization ispresented by applying operations management tools. This paper explores theapplication of integer programming techniques to support the Expanded Programmeof Immunization (EPI) service in the Dera Ismail Khan District of Pakistan. Themain concern here is equitable service delivery to decentralized localitiesbased on two criteria: (1) achieving the highest possible level of vaccinationamong the target population; and 2) ensuring equality among geographicallyscattered populations, especially in rural dwellings. For this purpose twointeger programming models have been applied on the basis of (1) sub-dividinghealth district into localities and allocating vaccinators to visit andvaccinate children within their administrative boundaries, and (2) within thelocalized planning system allowing vaccinators to visit and vaccinate childrenacross the administrative boundaries subject to savings in travel time. Bothmodels show interesting results in terms of need satisfaction and travel-timesavings with a minimum level of deviation from equity. The solutions provide atrade-off between alternative organizational tactics, and the argument is madethat rational planning methods applied interactively can contribute to thedelivery of an immunization service that is equitable and cost effective.

Preventive Care Resource Allocation in Developing Countries: Can  Rational Planning Techniques Help in Allocating Vaccinators in Dera Ismail  Khan District of Pakistan?