Supply chain assessment reveals opportunities for Vietnamby Nguyen Tuyet Nga and Joanie Robertson, PATH, and Nguyen Van Cuong, NIHE When Vietnam’s National Expanded Program on Immunization (NEPI) and Optimize agreed to explore novel public-sector supply chain solutions for Vietnam, they started with an assessment of the current immunization supply chain system. The four-part assessment completed in March 2010 included one of the first large-scale uses of the Effective Vaccine Management Assessment Tool; an evaluation of commune-level cooling and storage practices; an assessment of the information system used to track vaccines and immunization coverage; and a study describing fee-based immunization practices, supply chains, and structures. Together, these assessments have revealed opportunities for Vietnam to develop, evaluate, and monitor an optimal public-sector supply chain for the future. Vietnam already enjoys high (93%) coverage through monthly immunization sessions. Cold chain capacity appears to be adequate, temperature-monitoring practices are consistently good, and infrastructure is in good condition. At the commune level vaccines are efficiently distributed and used throughout an impressively broad network of health centers. The information system that tracks and monitors immunization coverage and vaccines is increasingly being computerized at provincial and regional levels, and dedicated health workers maintain good records despite the labor involved in transferring numbers across multiple paper ledgers and reports. However, there remains some ambiguity about how to calculate the coverage target. There is high interest in exploring different technologies to make it more efficient. System enhancements should focus on several opportunities that surfaced in the assessments. For example, vaccine arrival procedures and stock management can be standardized, and good distribution management practices can be replicated throughout the system. At the commune level, hepatitis B vaccine birth-dose delivery is compromised because vaccines are not regularly stored there. This is in part because refrigeration technologies are not always appropriate for these settings where electricity can be intermittent and budgets for electric bills competes with other funding needs. An ideal technology at this level would be relatively small volume, require low or no energy consumption, would not rely on grid electricity, would be affordable to purchase and maintain, and be easy to use. There also may be an opportunity to explore controlled temperature storage of hepatitis B vaccine outside the cold chain. Efforts to enhance the immunization information system must attempt to reduce the burden of reporting on health care workers while simultaneously providing them more support and training. Good information systems must improve the quality, accuracy, and timely availability of information for stock management and immunization coverage, which then informs decisions at all levels. Experience with and interest in information technology is high, indicating that the country is ready to explore a more robust information system. Efforts to model the costs and efficiency of an optimal supply chain system in Vietnam are underway, and baseline figures have been calculated. Now the partners will agree on the next phase of work, exploring the impact of potential new management approaches and technologies on the system, using the computer model to simulate changes and measure effects. In this way Vietnam and other countries can relatively quickly and easily test ideas for preparing cold chain systems for future demands. Download the full report of Phase I assessments in Vietnam. We invite you to comment on or post a question relating to this article by clicking the “post reply” button on this page. You will have to log in or register; the process is very simple. Return to the Optimize newsletter.
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