System redesign of the immunization supply chain: Experiences from Benin and Mozambique

Prosser, Wendy; Jaillard, Philippe; Assy, Emmanuelle; Brown, Shawn T.; Matsinhe, Graça; Dekoun, Mawutondji; Lee, Bruce Y.

doi:10.1016/j.vaccine.2016.09.073

Cited by 36 publications

(34 citation statements)

References 7 publications

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“…Four studies met our inclusion criteria-three before-after studies and one randomized trial. 4,[22][23][24] The reasons for excluding the three remaining studies 21,25,26 are provided in Table 1. Figure 1 is a flow diagram showing the process of study selection.…”

Section: Resultsmentioning

confidence: 99%

“…The second study showed that redesigning a supply chain from a four-level system to a three-level system can improve vaccine availability and reduce stock-outs. 22 The redesigned process reduces the complexity of getting vaccines from the highest level in the supply chain to health facilities. This process resulted in an informed push system, in which vaccines are supplied from the higher levels of the supply chain to the health facilities, which is often informed by the level of consumption in these facilities.…”

Section: Discussionmentioning

confidence: 99%

“…4 The second before-after study that was conducted in Benin and Mozambique by Prosser et al involved redesigning the supply chain system. 22 This redesign process involved the reduction of a four-level supply chain structure to a three-level structure. In a typical four-level system, supply of vaccines begins from the national store (level 1), through the provincial level (level 2) and districts or subdistricts (level 3), to the health facilities (level 4) where they are administered to the target population.…”

Section: Studymentioning

confidence: 99%

“…The study observed fewer errors when using barcode scanning, although the exact values were not reported. 24 All included studies 4,[22][23][24] were judged to have high-risk of bias since they scored high at least in one of the three domains, that is, completeness of outcome data, similarity of baseline characteristics, and similarity of outcome characteristics. The summary of our risk of bias assessment is shown in Table 2.…”

Section: Studymentioning

confidence: 99%

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A scoping review of interventions for vaccine stock management in primary health-care facilities

Iwu

Jaca

Abdullahi³

et al. 2019

Human Vaccines & Immunotherapeutics

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One of the challenges facing the success of immunization programs is shortages of vaccines at health facilities, which could result from inadequate vaccine stock management. Several approaches have been designed by countries to improve vaccine stock management. This review summarizes currently available information on interventions for vaccine stock management. We considered both randomized trials and non-randomized studies eligible for inclusion in this review. The following databases were searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization Library Information System, Web of Science, and PDQ-Evidence. We searched the websites of the World Health Organization, Global Alliance for Vaccine and Immunization, PATH's Vaccine Resources Library, and United Nations Children's Fund. The reference lists of all the included studies were also searched. Two authors independently screened search outputs, reviewed full texts of potentially eligible articles, evaluated risk of bias, and extracted data; resolving disagreements through consensus. Four studies met our inclusion criteria (three before-after studies and one randomized trial). Three studies were conducted in low-and middle-income countries while one was conducted in Canada (a high-income country). All the studies had various limitations and were classified as having a high risk of bias. Study findings suggest that the use of digital information systems to improve information and stock visibility, coupled with other interventions (such as training of health-care workers on the use of innovative tools and redesign of the supply chain to tackle certain bottlenecks), has the potential to increase vaccine availability, reduce response times, and improve the quality of vaccine records.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

See 2 more Smart Citations

A scoping review of interventions for vaccine stock management in primary health-care facilities

Iwu

Jaca

Abdullahi³

et al. 2019

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

show abstract

“…Fixing such flaws is not necessarily an overwhelming and cost prohibitive task. For example, published work in Benin9 15 19 has shown that re-designing the immunisation supply chain can actually end up saving money immediately and over time due to gains in efficiency.…”

Section: Discussionmentioning

confidence: 99%

How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India

et al. 2019

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IntroductionCoping occurs when health system personnel must make additional, often undocumented efforts to compensate for existing system and management deficiencies. While such efforts may be done with good intentions, few studies evaluate the broader impact of coping.MethodsWe developed a computational simulation model of Bihar, India’s routine immunisation supply chain where coping (ie, making additional vaccine shipments above stated policy) occurs. We simulated the impact of coping by allowing extra trips to occur as needed up to one time per day and then limiting coping to two times per week and three times per month before completely eliminating coping.ResultsCoping as needed resulted in 3754 extra vaccine shipments over stated policy resulting in 56% total vaccine availability and INR 2.52 logistics cost per dose administered. Limiting vaccine shipments to two times per week reduced shipments by 1224 trips, resulting in a 7% vaccine availability decrease to 49% and an 8% logistics cost per dose administered increase to INR 2.73. Limiting shipments to three times per month reduced vaccine shipments by 2635 trips, which decreased vaccine availability by 19% to 37% and increased logistics costs per dose administered by 34% to INR 3.38. Completely eliminating coping further reduced shipments by 1119 trips, decreasing total vaccine availability an additional 24% to 13% and increasing logistics cost per dose administered by 169% to INR 9.08.ConclusionOur results show how coping can hide major system design deficiencies and how restricting coping can improve problem diagnosis and potentially lead to enhanced system design.

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Immunization in Low- and Middle-Income Countries

Sodha¹,

Cherian²,

Lydon³

et al. 2023

Plotkin's Vaccines

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System redesign of the immunization supply chain: Experiences from Benin and Mozambique

Cited by 36 publications

References 7 publications

A scoping review of interventions for vaccine stock management in primary health-care facilities

A scoping review of interventions for vaccine stock management in primary health-care facilities

How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India

Immunization in Low- and Middle-Income Countries

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