Doctoral Degrees (Industrial Engineering)
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Browsing Doctoral Degrees (Industrial Engineering) by browse.metadata.advisor "Bam, Louzanne"
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- ItemThe development of a policy analysis logic model to support public medicine availability initiatives in the context of VAN(Stellenbosch : Stellenbosch University, 2020-03) Kleynhans, Emma; Van Eeden, Joubert; De Kock, Imke; Bam, Louzanne; Llewellyn, Thomas Edward; Stellenbosch University. Faculty of Industrial Engineering. Dept. of Industrial Engineering.ENGLISH ABSTRACT: The Visibility and Analytics Network (VAN) aims to improve public sector medicine availability from a supply chain perspective. The Bill and Melinda Gates Foundation (with inputs from multiple global health organisations and funders) developed a VAN Blueprint, using proven private sector operating models that aim to guide sub-Saharan African (SSA) countries to subsequently customise a VAN Operating Model specific to their context and country’s needs. People, processes, technology and policy must be organised and aligned from a national level to the facilities level in order to achieve the VAN defined goals and objectives. However, at an aggregated level, there is a lack of understanding of the enabling and limiting effect of country-specific policies on such an initiative; including how policy decisions and strategies can be better aligned to accommodate the VAN. This research study develops a policy analysis logic model (named PoliVAN) that aims to assist actors (i.e. government authorities, policymakers and VAN role players) with making insightful policy and legislation decisions to enable the implementation and operationalisation of their country’s VAN Operating Model. The proposed PoliVAN logic model underwent a complete evaluation strategy (verification and validation) with subject matter experts, over four progressive stages: (i) theoretical verification of the inherent theory; (ii) validation of the relevance and contextual appropriateness of the PoliVAN logic model through subject matter expert engagement; (iii) application of the PoliVAN logic model to two South African case studies; and (iv) a transferability validation, through engagement with SSA country VAN representatives. The application of the PoliVAN logic model—demonstrated through the outcomes of the case studies—yielded information, insights and decision support that contribute towards making informed policy reform decisions and strategies to successfully support the implementation and operationalisation of a VAN Operating Model. This study then further investigates the transferability of the PoliVAN logic model and the possibility for it to be utilised in an SSA country context. An amalgamation of the context-specific changes required to apply the PoliVAN logic model, gained through the application of the South African case studies, were discussed with SSA country VAN representatives. Through this engagement, insights were gained on the PoliVAN transferability and the context-specific notions. Furthermore, this study concluded with the necessary prerequisites to implement a PoliVAN logic model. In light of the aforementioned discussion, the PoliVAN has significantly contributed towards the gap highlighted in the VAN Blueprint regarding policy insights to assist countries with the implementation and operationalisation of their VAN Operating Model. The PoliVAN encompasses the necessary best-practices tools and guides the relevant actors on how to make informed policy decisions that consequently contribute towards the successful implementation and operationalisation of a country’s VAN Operating Model. The success of a VAN hinges on the enabling environment of policies and legislation and this study provides the necessary guidance, in the form of the PoliVAN logic model, on how to identify, analyse and develop policy-specific strategies that supports a country’s VAN, and subsequently support the medicine availability initiative for SSA countries in need of this approach.
- ItemSelecting incentive interventions to encourage pharmaceutical research and development for neglected diseases: A decision-support framework(Stellenbosch : Stellenbosch University, 2021-12) Hanekom, Nicola; Bam, Louzanne; De Kock, Imke; Vandaele, Nico Johan; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.ENGLISH ABSTRACT: Neglected diseases are diseases for which adequate drug treatment is lacking or not commonly available to sufferers of the disease. The diseases mostly affect people living in developing countries with more than one billion people globally affected by some of the ‘most neglected diseases’, known as neglected tropical diseases. Central to understanding the phenomenon of neglected diseases is the concept of market attractiveness, which refers to perceived market potential. As the multinational drug industry is highly competitive, it delivers drugs based on economic market forces. From the perspective of both public- and private investors, the market for neglected diseases is not sufficiently attractive to attain the necessary resources to effectively address such diseases. Noteworthy effort has been devoted to encouraging pharmaceutical organizations, non-profit organizations, and governments to engage in the research and development (R&D) for neglected diseases. Incentive interventions are a method used to promote these research efforts. Incentives aim to mitigate the challenges of completing drug R&D, by providing some kind of benefit or reward. A significant number of incentive interventions has been proposed and/or implemented for improving neglected disease research. Given the number of incentive strategies and types that exist, difficulty occurs in selecting an incentive intervention that is appropriate for encouraging R&D for the specific pharmaceutical landscape, the stakeholders that are involved, and the health care system context. This research proposes a decision-support framework that intends to assist any governmental, private or public entity aiming to encourage investment in the R&D of drugs for a disease that is currently experiencing neglect, with the selection of an appropriate incentive intervention. This is done by investigating literature on the goals and outcomes of health care systems, completing a pharmaceutical R&D market analysis, systematically reviewing literature on diseases that are perceived as being neglected and or attractive to pharmaceutical organizations, and investigating existing incentive interventions. The decision-support framework outcome provides a shortlisted set of recommended solutions (incentivising interventions) based on (i) the current pharmaceutical research and development system being addressed; (ii) the needs, abilities, and limitations of the enabling organization or body; the (iii) needs and objectives of the innovating organizations and the end-users (both the consumers and the procurers of drugs); and (iv) the abilities of the incentivizing interventions to address the priority improvement areas of the scenario under investigation. Through a verification and validation process involving subject matter experts and the application of three retrospective case studies, the decision-support framework is deemed a comprehensive and valuable contribution to assist in the selection of an appropriate set of incentive-based interventions. The framework thus contributes towards effective and efficient resource allocation in the context of the global neglected diseases R&D sphere.
- ItemTiered-facility vehicle routing problem with global cross-docking(Stellenbosch : Stellenbosch University, 2018-03) Smith, Anthony; Van Vuuren, J. H.; Bam, Louzanne; Toth, P.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.ENGLISH ABSTRACT: The service delivery of public healthcare is severely threatened due to insu cient resources. A current South African public healthcare organisation responsible for processing pathological specimens makes use of a public transportation network containing laboratories of multiple tiers corresponding to different processing capabilities in its business model. The effective transportation of specimens between facilities in this network may potentially lead to significant financial cost savings. The quest to establish a mathematical model for the transportation of specimens in this transportation network has led to the formulation of a novel variant of the celebrated vehicle routing problem (VRP) in the operations research literature, called the tiered-facility vehicle routing problem with global cross-docking (TVRPGC). This tri-objective combinatorial optimisation problem calls for the efficient route scheduling of a vehicle eet tasked with the transportation of pathological specimens. The objectives of the model are to minimise the total distance covered by the fleet (so as to save on transportation variable costs), to minimise the number of vehicles required for specimen collection (so as to save on transportation fixed costs), and to minimise the travel time of the vehicle which spends the longest time on the road (so as to ensure specimen integrity and balance driver workload). The model constraints take into account maximum driver autonomy (a constraint on the time a vehicle may spend on the road), specimen collection demand, permissible workloads at the various facilities in the network of processing laboratories, and requirements in terms of which laboratories are capable of processing the various specimens. Crucially, the model also allows for the novel feature of local hand-over of specimens at facilities between vehicles. The aforementioned model is validated, and exact and approximate solution techniques are developed for the model and implemented on a computer. These techniques draw inspiration from a thorough study of the prototype VRP in the literature | the capacitated VRP. Investigations are launched into (i) the computational complexity of the exact solution procedure, (ii) the quality of solutions returned by the approximate solution technique with respect to a real-life instance of the TVRPGC within a South African pathology healthcare service provider context, and (iii) the desirability of a facility clustering-based approach toward decomposing instances of the TVRPGC into smaller problem subinstances.
- ItemTowards the interoperability of spontaneous reporting systems in pharmacovigilance : a maturity model approach with a sociotechnical system focus(Stellenbosch : Stellenbosch University, 2020-03) Schurer, Maximillian Juan; Louw, Louis; Bam, Louzanne; De Kock, Imke; Stellenbosch University. Faculty of Industrial Engineering. Dept. of Industrial Engineering.ENGLISH ABSTRACT: It is universally accepted that all medicines have the potential to cause adverse drug reactions (ADRs) during the course of their normal therapeutic use. Drug safety surveillance during the post-marketing authorisation phase generates the majority of drug safety data, even more so than the clinical trials during the drug development process. Pharmacovigilance (PV), is based on the medical assessment of ADRs or drug-related problems, collected within organised health programmes. PV systems, by nature, are complex. The large number, fragmentation, and complexity of existing PV systems, the equally large number of stakeholders within such systems (i.e. pharmaceutical companies, government regulatory authorities, national and international clinical regulatory bodies, healthcare workers, etc.), as well as the significant number of dimensions along which the effectiveness and efficiency could be in uenced and also measured, adds to this complexity. The primary goal of any PV system is to improve and protect patient safety by enabling health care professionals to make more informed therapeutic decisions. Achieving this goal is dependent on the successful communication of relevant ADR information from the patient to the relevant PV authority. One such method of communication is the spontaneous reporting of ADRs, which is widely regarded as the cornerstone of data generation in PV during post-marketing authorisation safety surveillance. Currently, spontaneous reporting systems (SRSs) are faced with problems such as under-reporting and the communication of incomplete, unrepresentative, and uncontrolled data. The lack of standardisation and interoperability among these systems results in a reduced capability to detect and characterise new adverse drug interactions and ADRs. The primary obstacle to achieving interoperability between SRSs is the fundamental difference in the purpose of the existing SRSs. Stakeholders in the PV system operate SRSs with different goals and perspectives such as maintaining regulatory compliance, mitigating financial risk, and for the protection and promotion of patient safety in public health programmes. The aim of this study is to contribute towards the interoperability of SRSs in the PV landscape through the development of a novel maturity model with a sociotechnical system focus. The aim of the model is to promote and improve interoperability by addressing the degree of integration of systems involved, provide guidance on which system components need to be improved, as well as provide a means for measuring interoperability progress across the community of SRSs in the global PV landscape. A multidisciplinary literature review covering PV, capability maturity models, interoperability, and sociotechnical systems served as a theoretical foundation for the development of the model. The development of the model followed an adaptation of the 8-phase procedural model for developing maturity models, proposed by Becker et al. (2009). A comparison of 18 existing maturity models in the fields of: (i) PV; (ii) eHealth; (iii) eHealth/interoperability; (iv) interoperability; and (v) IT infrastructure, was conducted. The model is made up of three domains, seven subdomains, and thirty dimensions which were identified as a result of the preceding literature review and comparison of existing models. Through a combination of verification and validation processes involving subject matter experts, the maturity model was refined. The resulting maturity model was implemented in a case study within a national regulatory authority context, to determine the generalisability and empirical validity of the model. The model was deemed a useful, unique, and valuable contribution to organisations operating SRSs, having achieved the stated aim.