Applying operations research to health planning: locating health centres in Zambia

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Abstract
Accessibility to health care facilities, particularly in rural areas with dispersed populations, is a major concern of primary health care policies. The physical accessibility of rural health care facilities is often assessed in terms of their location relative to those who will use them. However, the final choice of location for a facility will often depend on a trade-off between many criteria including not only its physical accessibility for the users, but also its costs to the provider, its political value to local leaders, etc. In this paper a technique will be presented which can help health policy-makers and planners in deciding on the optimum location for rural health facilities by taking into account the different criteria of these various interest groups. The technique is intended to help in a prospective evaluation of alternative feasible locations; it is therefore appropriate for operations research. Two examples are taken from Zambia to illustrate how the approach could be used in choosing the most suitable location for upgrading a rural health centre in a district.

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