For more than a decade the United Nations Children’s Fund (UNICEF) and the World Health Organisation (WHO) have been supporting the Expanded Programmes on Immunisation (EPI) with tools that allow for a better follow-up at both central and district or regional levels. The technology deployed for immunization supply chain management tool is Microsoft © Excel through large files called Stock Management Tool (SMT) and District Vaccination Data Management Tool (DVD-MT).
A rapid transformation of the technological landscape coupled with a renewed interest to address supply chain issues has given the opportunity to UNICEF and WHO to redesign the EPI-adopted supply chain management tools. The landscape evolves quickly with modern technologies very often reaching the lowest layers of the health pyramid. This includes the access to online tools, the interoperability to large applications such as District Health Information System 2 (DHIS2) or Open-Logistic Management Information System (Open-LMIS), as well as the use of Geographical Information Systems (GIS) that can contribute to greatly improving vaccination coverage. The integration of parallel supply chains also needs to be taken into consideration as national tools managing the essential medicines supply chain could also manage EPI supply chains.
UNICEF in Copenhagen has contracted the Swiss Tropical and Public Health Institute (Swiss TPH) to propose technical solutions for the future version of both tools. The Swiss TPH team started the assignment with a kick-off meeting in Copenhagen on the 06 June 2019. An inception report was then produced describing tasks to be undertaken and methodology to be followed. The team then visited three countries representing different environments and settings (Malawi, Cote d’Ivoire and Senegal) with the support of the respective UNICEF regional and country offices, to understand how users of both tools are working on a daily basis. Weaknesses and strengths of the current processes and tools were identified through in-depth analysis and interviews with tool users and EPI management staff.
Besides these visits, the data collection included the interviews of several UNICEF and WHO officials as well as some key informants in the regional and countries offices combined with a solid desk review of available documents.
Eventually, the Swiss TPH report came out by mid-December proposing UNICEF to invest in a modern web based solution at central, regional and district levels with option for health centres level. A real time assessment of vaccination coverage and a monitoring of remote stocks will help reducing drastically stock outs and losses by expiry.