by Dao Ding Sang and Vu Minh Huong, PATH Over the last three years, Optimize has been working with Vietnam’s National Expanded Programme on Immunization (NEPI) to pilot a new computerized logistics management information system. The new system, named VaxTrak, is designed to help immunization health workers keep track of vaccine stock as it is received and dispatched, and to facilitate aggregated monthly reporting on immunizations given. The goal is to increase the accuracy and timeliness of vaccine inventory and immunization reports, to reduce the amount of time health care workers spend on reporting duties, and to increase the availability of data, especially at national and regional levels. Vietnam’s paper-based vaccine stock-management and reporting system In Vietnam, storekeepers use a paper-based stock ledger to record information on vaccine stock transactions, such as when and where vaccines were received or dispatched, the number of doses involved, the expiration date, and the lot number. These vaccine registers are kept at every level of the health system, and are updated as vaccines move from national to regional, provincial, and district levels, on their way to the commune health center where immunizations are administered. Compiling the monthly immunization report on vaccine use can be complicated. Health workers must pore over the vaccine register, previous immunization reports, and receipt and distribution vouchers to try to reconcile the data in order to provide an accurate report. Using this paper-based system, recording vaccine-related data is an administrative burden. The work is tedious and can easily lead to inaccuracies. In addition, there are often delays in making the completed reports accessible to national level authorities who have oversight of the entire vaccine supply chain. Managing information in VaxTrak With VaxTrak, information about vaccine stock is managed in a computer database. When dispatching a shipment of vaccines, users at the point of departure enter information into the system about the products and quantities being dispatched. When the vaccines arrive, users at the destination can find the shipment in the system and confirm receipt. Then the vaccines are automatically added to the inventory at the destination location. The system also allows users to enter aggregated data on immunizations administered in the user’s territory. At the end of the month, reports on both vaccine stock and immunizations given can be easily generated by the system without the need for health workers to painstakingly review the paper records. VaxTrak benefits Once in the VaxTrak system, information is available in real-time via the Internet to staff of the immunization program at all locations with proper authorization. Health workers can access up–to-date information about vaccine stock, such as the number of doses distributed or in stock. They can also view expiry and lot number information on vaccines. This can help with planning the amount of vaccine to order and allocating available vaccines among different locations. Better planning can help to avoid stockouts that can result in missed opportunities to vaccinate, as well as over-ordering, which can result in vaccines being wasted. NEPI and Optimize first introduced VaxTrak in the national store, three regional stores, and three provincial stores (one in each of the three regions). After six months, Optimize collected data to evaluate the system’s performance. By comparing actual vaccine stock quantities with the quantity recorded in the paper registry and in the VaxTrak database, we found that VaxTrak significantly increased the accuracy of vaccine data: the number of lots with matching data went from 77 percent before VaxTrak to 100 percent after using the software for several months. The number of lots counted before and after implementation was 39 and 40, respectively. The assessment also showed that using VaxTrak reduced the time burden of reporting. In provinces, the average amount of time needed to complete the monthly immunization report changed from 22 minutes to 16 minutes. Likewise, the average amount of time needed to complete the vaccine register decreased from 88 minutes to 43 minutes. The users’ perspective VaxTrak users have expressed satisfaction with the system because it enables them to access data whenever and wherever they have an Internet connection, it has an easy-to-use interface in Vietnamese, and they feel it helps them to manage vaccine stock more accurately. They are pleased with the ease of reporting, since the software automatically compiles and aggregates data. For users at higher levels, seeing the real-time balance of the vaccine stocks not only at their own facility store but also at lower level stores is extremely helpful for management and planning. Despite its impressive performance, users faced some challenges with the VaxTrak software. First, the development and introduction of VaxTrak took significantly more time than originally planned. As a result, users did not have much time to become familiar with the software and help detect defects that needed revision. In addition, outside of Optimize’s intervention, NEPI was also testing other software applications; evaluating multiple programs at once overburdened some health workers. Scaling up the system presents another challenge, as managers need to address shortages of human and financial resources to provide technical support for facilities, as well as sufficient training for users. The latter is a particular problem, given the high rate of staff turnover at lower levels. Looking to the future Based on the strong performance, useful functions, and good acceptability of the VaxTrak system, NEPI is interested in exploring avenues for scaling up the system to additional provinces following the close of project Optimize. If funding can be identified, NEPI would like to take these additional steps: [indent][/indent]- Reinstate monitoring and evaluation, especially at district level, to identify all [indent][/indent] issues that need to be resolved in the next stage. [indent][/indent]- Work with software developers on improvements to the system and ensure that [indent][/indent] software design allows for the proposed increased number of users in the system. [indent][/indent]- Develop a plan to progressively implement the system in new sites and ensure that [indent][/indent] adequate training and technical support are available for all users on an ongoing [indent][/indent] basis. In 2013, Optimize will publish comprehensive information on the demonstration projects and other initiatives it has been involved in, including VaxTrak. To view a full list of the resources that Optimize has published to document its work in Vietnam, please refer to the Vietnam resources page of the Optimize website.
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- Wednesday, 06 February 2013
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