Enhancing community based health programs in Iran: a multi-objective location-allocation model

Community Based Organizations (CBOs) are important health system stakeholders with the mission of addressing the social and economic needs of individuals and groups in a defined geographic area, usually no larger than a county. The access and success efforts of CBOs vary, depending on the integration between health care providers and CBOs but also in relation to the community participation level. To achieve widespread results, it is important to carefully design an efficient network which can serve as a bridge between the community and the health care system. This study addresses this challenge through a location-allocation model that deals with the hierarchical nature of the system explicitly. To reflect social welfare concerns of equity, local accessibility, and efficiency, we develop the model in a multi-objective framework, capturing the ambiguity in the decision makers' aspiration levels through a fuzzy goal programming approach. This study reports the findings for the real case of Shiraz city, Fars province, Iran, obtained by a thorough analysis of the results.