Disaster response
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Abstract

The United Nations High Commissioner for Refugees (UNHCR) establishes and maintains refugee camps to meet the needs of 34.5 million people affected by disaster or war worldwide. Like other international humanitarian organizations, UNHCR maintains central stockpiles which supply these refugee operations. Management at UNHCR seeks to improve the timeliness and quality of its disaster response subject to its budget constraints. We develop an inventory model to analyze the interaction between a stockpile and a downstream refugee camp or relief operation. We consider two inventory decisions: first, how to partition a fixed budget between stockpiling and shipping costs in order to best meet the needs of beneficiaries; and second, given the shipping budget determined by the budget partition, how to ship relief items from the stockpile to a downstream relief operation in an efficient manner. We solve for the shipment policy using dynamic programming, then determine the optimal stockpile size given knowledge of the optimal shipment policy. The optimization balances a key tradeoff: a larger stockpile is costly to procure and maintain, but enhances a humanitarian organization’s ability to respond to relief operation demands. We provide insights into shipment strategies and stockpile size. We also develop a spreadsheet model to help humanitarian organizations in their operational decision-making, leading to improved response to beneficiaries. Humanitarian organizations must use their financial resources wisely to carry out their mandates, and models of this type can help them make the best use of their limited response resources.
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Publication Type
Journal Articles
Publication Date
Journal Publisher
OR Spectrum
Authors
Margaret L. Brandeau
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Purpose. Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. The authors examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models.

Methods. The authors reviewed a spectrum of published disaster response models addressing public health or health care delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. They developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making.

Results. The authors propose 6 recommendations for model construction and reporting, inspired by the most exemplary models: health sector disaster response models should address real-world problems, be designed for maximum usability by response planners, strike the appropriate balance between simplicity and complexity, include appropriate outcomes that extend beyond those considered in traditional cost-effectiveness analyses, and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models.

Conclusions. Quantitative models are critical tools for planning effective health sector responses to disasters. The proposed recommendations can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response.

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Publication Type
Policy Briefs
Publication Date
Journal Publisher
Medical Decision Making
Authors
Margaret L. Brandeau
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