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

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Abstract below; full text is at http://www.sciencedirect.com/science/article/pii/S0264410X16312932

Vaccine

Volume 35, Issue 17, 19 April 2017, Pages 2162–2166

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

• Wendy Prosser^a, , , 
• Philippe Jaillard^b, 
• Emmanuelle Assy^c, 
• Shawn T. Brown^d, 
• Graça Matsinhe^e,
• Mawutondji Dekoun^f, 
• Bruce Y. Lee^g
• ^a VillageReach, Seattle, WA, USA
• ^b Agence de Médicine Préventive (AMP), Paris, France
• ^c Agence de Médicine Préventive (AMP), Cotonou, Benin
• ^d Pittsburgh Supercomputer Center, Carnegie Mellon University, Pittsburgh, PA, USA
• ^e Mozambique Ministry of Health, Maputo, Mozambique
• ^f UNICEF, Cotonou, Benin
• ^g Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Available online 30 March 2017

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http://dx.doi.org/10.1016/j.vaccine.2016.09.073

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Highlights

• New vaccines and growing populations are constraining supply chains.

• System redesign can alter the supply chain structure for better performance.

• This paper documents the system redesign process and improvements in Benin and Mozambique.

• These countries demonstrate the feasibility of system redesign for other countries.

Abstract

Introduction

Evidence suggests that immunization supply chains are becoming outdated and unable to deliver needed vaccines due to growing populations and new vaccine introductions. Redesigning a supply chain could result in meeting current demands.

Methods

The Ministries of Health in Benin in Mozambique recognized known barriers to the immunization supply chain and undertook a system redesign to address those barriers. Changes were made to introduce an informed push system while consolidating storage points, introducing transport loops, and increasing human resource capacity for distribution. Evaluations were completed in each country.

Results

Evaluation in each country indicated improved performance of the supply chain. The Effective Vaccine Management (EVM) assessment in Benin documented notable improvements in the distribution criteria of the tool, increasing from 40% to 100% at the district level. In Mozambique, results showed reduced stockouts at health facility level from 79% at baseline to less than 1% at endline. Coverage rates of DTP3 also increased from 68.9% to 92.8%.

Discussion

Benin and Mozambique are undertaking system redesign in order to respond to constraints identified in the vaccine supply chain. Results and learnings show improvements in supply chain performance and make a strong case for system redesign. These countries demonstrate the feasibility of system redesign for other countries considering how to address outdated supply chains.