Removing the regional level from the Niger vaccine supply chain.

TitleRemoving the regional level from the Niger vaccine supply chain.
Publication TypeJournal Article
Year of Publication2013
AuthorsAssi T-M, Brown ST, Kone S, Norman BA, Djibo A, Connor DL, Wateska AR, Rajgopal J, Slayton RB, Lee BY
JournalVaccine
Volume31
Issue26
Pagination2828-34
Date Published2013 Jun 10
ISSN1873-2518
KeywordsHumans, Models, Organizational, Models, Theoretical, Niger, Software, Vaccines
Abstract

OBJECTIVE: Since many of the world's vaccine supply chains contain multiple levels, the question remains of whether removing a level could bring efficiencies.METHODS: We utilized HERMES to generate a detailed discrete-event simulation model of Niger's vaccine supply chain and compared the current four-tier (central, regional, district, and integrated health center levels) with a modified three-tier structure (removing the regional level). Different scenarios explored various accompanying shipping policies and frequencies.FINDINGS: Removing the regional level and implementing a collection-based shipping policy from the district stores increases vaccine availability from a mean of 70-100% when districts could collect vaccines at least weekly. Alternatively, implementing a delivery-based shipping policy from the central store monthly in three-route and eight-route scenarios only increases vaccine availability to 87%. Restricting central-to district vaccine shipments to a quarterly schedule for three-route and eight-route scenarios reduces vaccine availability to 49%. The collection-based shipping policy from district stores reduces supply chain logistics cost per dose administered from US$0.14 at baseline to US$0.13 after removing the regional level.CONCLUSION: Removing the regional level from Niger's vaccine supply chain can substantially improve vaccine availability as long as certain concomitant adjustments to shipping policies and frequencies are implemented.

DOI10.1016/j.vaccine.2013.04.011
Alternate JournalVaccine
PubMed ID23602666
PubMed Central IDPMC3763189
Grant ListU54 GM088491 / GM / NIGMS NIH HHS / United States
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