Heuristic approaches to decision-making in the delivery of primary health care within developing regions

The delivery of primary health care (PHC) services is now recognized as a crucial element in the development of low-income regions. Effective delivery of these services requires the ability to solve a variety of policy decision problems. Research has demonstrated the utility of operations research/management science (OR/MS) models and methodologies in the analysis and solution of such problems. However, this approach may be limited in some regions by the data and computational requirements of the models. Intuitive approaches in the spirit of OR/MS models, termed heuristics, can provide an effective alternative in such cases. The current paper proposes a general heuristic procedure for solving problems of PHC delivery in developing regions. The heuristic is applied, in detail, to the problem of identifying "best" community financing schemes for PHC services in low-income sections of Rio de Janeiro, Brazil.