Modelling rural healthcare supply chain in India using system dynamics

Indian healthcare supply chain seems to be diverse depending upon the healthcare facilities and population. The present work entirely focuses on the supply of Iron Folic Acid tabs in state government owned rural healthcare systems. Brief introduction about system dynamic has been given in this paper. A survey has been conducted related to the supply chain of folic acid tabs from state drug stores to patients via women's hospital, community health centre (CHC), primary health centres, and sub centres in District Haridwar, Uttarakhand, India. Modeling and simulation of entire supply chain has been performed using system dynamics technique. Causal loop diagram (CLD) has been constructed which displays the supply chain process at various stages throughout the entire system. The factors such as frequency of patients, and order frequency has been considered while constructing the causal loop diagram. The CLD has been translated into stock-flow diagram (SFD) for the entire supply chain on Stella (R) platform and simulation has been run for a period of one year (Jan to Dec). It has been noticed that there is a huge shortage (stock out) of folic acid tabs at women's hospital, CHC, PHCs, and sub centres because of large delivery time. The present research may assist the government policy makers to take necessary decisions for improving the sustainability of the rural healthcare supply chain by reducing stock out of the medicine. (C) 2014 The Authors. Published by Elsevier Ltd.