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Resource	Guide for Equitable Health Access through Supply Chain Design
Purpose	This guideline describes how to plan for equity in supply chain design.
Content	Describes a four-step process to identify supply chain design strategies to reach under-served populations and track progress reducing inequities. (1) Identify the population; (2) Consider supply chain related challenges; (3) Determine mitigation strategies and (4) Measure progress. The process identifies populations, challenges, strategies, and progress indicators for supply chain for underserved populations. The contents also describe supply chain equity metrics (1) Cold chain coverage per fully immunized child (FIC). (2) Average resupply distance of vaccines between the health facility and resupply store. (3) Inbound resupply distance of vaccines between district store and the next level of the system.
Expected outcomes	Vaccines must be both available and potent whenever a caregiver reaches a point in the health system where immunizations are provided.
Strengths	(a) The guidance provides a good example of pro equity planning based on situation analyses and strategies adapted to context. (b) The guide provides access to a set of “equity metrics” that includes (i) Cold chain coverage per fully immunized child (FIC): litres of cold chain per surviving infant available measured against cold chain that would be needed for the target population; (ii) Average resupply distance of vaccines between the health facility and resupply store (e.g. division, district or other warehouse); (iii) Inbound resupply distance of vaccines between district store and the next level of the system from which it received vaccines (e.g. province, state, or division).
Contraints/Limitations	Measuring equity and addressing it in the immunization supply chain is a challenge given the lack of previously used metrics as well as limited access to data.
Why use it	To address inequities in supply chain distribution, and support design features adapted to the context of underserved populations including targets supply chain design to the urban poor; people living in remote, rural areas; people in conflict or security-compromised areas; and internal and cross-country migrants.
Who should use it	Governments, National and sub national program managers, the private sector and implementing partners.
Additional Links
Link to access the resource	/en/resources/guidance/guide-for-equitable-health-access-through-supply-chain-design