A scoping review of interventions for vaccine stock management in primary health-care facilities

Abstract

One of the challenges facing the success of immunization programs is shortages of vaccines at health facilities, which could result from inadequate vaccine stock management. Several approaches have been designed by countries to improve vaccine stock management. This review summarizes currently available information on interventions for vaccine stock management. We considered both randomized trials and non-randomized studies eligible for inclusion in this review. The following databases were searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization Library Information System, Web of Science, and PDQ-Evidence. We searched the websites of the World Health Organization, Global Alliance for Vaccine and Immunization, PATH's Vaccine Resources Library, and United Nations Children's Fund. The reference lists of all the included studies were also searched. Two authors independently screened search outputs, reviewed full texts of potentially eligible articles, evaluated risk of bias, and extracted data; resolving disagreements through consensus. Four studies met our inclusion criteria (three before-after studies and one randomized trial). Three studies were conducted in low-and middle-income countries while one was conducted in Canada (a high-income country). All the studies had various limitations and were classified as having a high risk of bias. Study findings suggest that the use of digital information systems to improve information and stock visibility, coupled with other interventions (such as training of health-care workers on the use of innovative tools and redesign of the supply chain to tackle certain bottlenecks), has the potential to increase vaccine availability, reduce response times, and improve the quality of vaccine records.

he challenges to a successful COVID-19 vaccination programme in Africa

“…Some of the major problems for the achievement of the set goals in an immunization exercise are inadequate vaccines at vaccination centers and the standard storage facilities for vaccines to ensure safety and to preserve efficacy. 46 African countries should invest more in cold chain facilities that would preserve larger vaccines for the vaccination programme in the second phase in order to maintain the potency and safety of the vaccine doses before usage. The second phase of the vaccination exercise will involve larger populations compared to the first phase; there should be enough cold chain logistics in place that will preserve the vaccines that will serve the target and intended populations.…”

Experts’ opinion for improving global adolescent vaccination rates: a call to action

“…Structural barriers may impede adolescent vaccination in some cases, such as the lack of easily accessible platforms to administer vaccinations during routine primary care visits [10] in some areas, or underutilization of immunization information systems [26]. Additionally, many providers have inadequate office resources (e.g., financial resources, staffing, patient-tracking systems, and vaccine storage and management) to support adolescent vaccination [26,30]. These challenges are likely amplified by a lack of clarity on 2 fronts: ownership of adolescent vaccination decisions (by adolescents and parents) and relative responsibilities of organizations (e.g., schools, public health authorities) to provide vaccination venues.…”

Improving the availability of vaccines in primary healthcare facilities in South Africa: is the time right for a system redesign process?

“…A scoping review has shown that digital devices such as computers, mobile devices, and digital screens designed to improve the quality of vaccine records and stock visibility are commonly used in low and middle-income countries. 28 These interventions have led to increased vaccine availability, improved accuracy of records, and reduced response times. Some of the interventions highlighted in this review can be applied to the South African context.…”

“…A system redesign approach offers a blueprint that can improve any vaccine supply chain system component, including programme requirements, distribution, warehousing and storage, human resources, equipment, stock management, monitoring, planning, and information. 28 , 39 This approach also helps determine how different components in the supply chain influence each other and how changes in a particular component can affect the overall performance of the immunization supply chain. 40 It also provides managers and decision-makers with the evidence and confidence required to improve the supply chain’s performance.…”