TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.
  1. John Lloyd
  2. Immunization information systems & coverage monitoring
  3. Thursday, 09 July 2015
“Apps” (computer software applications) are being developed and used as tools to help manage the vaccines and medicines supply chain more and more. But are they directed at challenges that have persisted the longest and would have the greatest impact if resolved? Take, for example, the following two challenges; do you recognise them? Do you agree that they need to be addressed or do you believe that they have been addressed in your country (ies) and that other should be chosen? Challenge 1: Most health centres in the world keep a wall chart with a manual plot of the percent of surviving infants fully immunized during the calendar year. As each month passes the cumulative coverage reached is amended for that month indicating visually the performance of the service relative to the target population(s) in that year. This works until the coverage approaches 80-90% when the cumulative coverage plot is high and the marginal changes in the last three months of the year are quite small. Then it is hard to read the performance impact in the last months of the year and hard to assess visually the changes since last year. Solution 1: The number of people receiving each vaccine dose, each month is already kept in a database for the national immunization reporting system. So it will not require more data or more work to change the monthly coverage value from the cumulative coverage for the current year to date - to the total coverage for the last, running twelve months (this year and a part of last). Now the plot is a true ‘annual’ coverage measure for every month of the year, reflecting what has been achieved and what has still to be achieved correctly and visually. Challenge 2: The rate at which vaccine has been consumed at the level of service delivery over one or more of the most recent supply intervals, corrected for planned changes in target population or vaccine presentation, remains the most practical basis for calculating vaccine needs for the next supply period. The problem is that this arithmetic, while simple, takes no account of seasonal differences, wastage variations or migration movements historically or trends over the years. Where the changes in consumption are small or gradual, the current method works but when the change is important and rapid it no longer prevents stock-out. Solution 2: The consumption of vaccine (comprises the number of doses in opened vials that have been used or wasted for any reason) is already accessible via vaccine stock records kept by computerized stock control at district level. The aggregate number of doses for the whole zone for each vaccine and each month should be used by an application to forecast vaccine needs for the next supply period, adjusted for any vaccine or system changes planned for the next period. An application will do the necessary arithmetic and aggregation, adjusting for later reporting.   The resulting Dashboard in each district can also present the rates of vaccine utilization (Vaccine administered as % of vaccine consumed). Closed vaccine wastage, as a part of vaccine consumed needs to be analysed only when there is an overall problem of utilization rate, not simply monitored without site investigation.

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