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Redesigning immunization supply chains

Results from three country analyses

A community health worker, walking to a health centre in Madagascar’s Anosy region
Credit: UNICEF/UN0325680/Ralaivita

Analyses carried out in Guinea, Madagascar and Niger suggest that efficiencies in vaccine delivery can be made by making changes to the design of immunization supply chains (iSC). The research, led by John Snow, Inc. with technical support from UNICEF and financial support from Gavi, the Vaccine Alliance, is intended to contribute to the knowledge base on system design to strengthen health product supply chains.

The research, which has been published in ScienceDirect, summarises findings from the three countries, highlights common system design ideas and considers differences in each country’s redesign options.

According to co-author Olamide Folorunso, supply chain specialist with UNICEF, the research shows that country context should be a major factor in redesigning supply chains: “While there are common scenarios across the three countries, findings demonstrate that there isn’t a generalisable approach. The results of the network analyses show that efficiencies can be found in each country, but the benefits of each scenario must be considered in the context of the country and its priorities.”

“For example, changing the delivery frequency, particularly at the health facility level, showed cost savings in Madagascar yet a cost increase in Guinea,” he added

The authors conclude that design choices must have input from policymakers, SC managers, health care workers and partners. The research, they say, should be used as part of a broader approach towards continuous improvement that ensures that supply chain systems do not become static. Such an approach should also be able to adapt to evolving conditions to ensure needed health commodities are available to all populations.

In recent years, low- and middle-income countries (LMIC) have used system design to identify and implement more reliable and efficient systems. Such an evidence-based and structured system design approach can help stakeholders identify potential opportunities to increase supply chain effectiveness and efficiencies and inform and guide planning.

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