Deployment of rural health facilities in a developing country

This study describes the problem of finding suitable sites for additional health facilities in a rural area in Bangladesh. The objective is to improve the accessibility of people to the health care system given the existing set of facilities. As is frequently the case in developing countries, activities designed to develop and improve differing sectors of the infrastructure are poorly integrated and ill-coordinated. As a result, decision-makers may make independent and individual decisions about locating new service facilities. Often, as has been the case in Bangladesh, these decisions are taken at a relatively low level, by officers of local government or by elected leaders in a region, or by a combination of these. In the absence of any formal analysis and generation of alternatives, the final decision may be made on political or pragmatic considerations. As a result the decisions are often far from optimal. Ultimately, better health care will enhance many sectors of a regional economy, and so the decision about where to invest in new or better resources is important for reasons over and above that of providing health care for the population. In this paper, the role of location-allocation modelling in developing countries is considered, and the specific Bangladeshi problem is considered as a maximal covering location problem which is solved by an efficient heuristic method.