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On Equitably Reducing Stock-Outs for Essential Pharmaceuticals in Low-Resource Countries Bhattacharya, Biplab Sudhin Lin, Li Industrial and Systems Engineering operations research public health industrial engineering Ph.D. The United Nations (UN) urged acceleration efforts to tackle inequity through its Sustainable Development Goals set in 2015. The need for focusing on equity has been highlighted in the field of public health for improved health outcomes. Pharmaceutical stock-outs at the last mile is a complex challenge that hinders the efforts of equitable pharmaceutical access and availability. Severity experienced due to drug stock-outs is not equal among a group of mutually exclusive and collectively exhaustive populations. This dissertation aims to assess and improve inequity in pharmaceutical supply chains for low-resource settings.Currently, there are no measures to assess inequity among communities in low-resource settings due to pharmaceutical stock-outs. Chapter 2 proposes the Stock-out Severity Index (SSI) to measure severity due to availability of drugs or lack thereof by incorporating risk factors and determinants of health from a combination of data sources. The chapter demonstrates how the SSI can help define priority levels of varying population groups, rather than making decisions solely from an equality perspective that assumes uniform characteristics of communities (It also demonstrates the impact of rearranging the priorities when the SSI is used). The chapter presents guidelines for incorporating and implementing the SSI.The next step after development of the SSI is to develop methods that implement it and improve equity. In chapter 3, a mobile pharmacy is used to alleviate the burden due to pharmaceutical stock-outs among rural communities and improve equity. The Stock-out Severity Index (SSI) is used to assess inequity. We develop two mathematical programming approaches for routing of the mobile pharmacy so as to optimize the SSI. 2019-10-29T16:48:04Z 2019-10-29T16:48:04Z 2019 2019-08-07 18:15:15 Text Dissertation http://hdl.handle.net/10477/80909 eng Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions. Copyright retained by author. application/pdf State University of New York at Buffalo