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Vaccine. 2013 Jun 10;31(26):2828-34. doi: 10.1016/j.vaccine.2013.04.011. Epub 2013 Apr 17.

Removing the regional level from the Niger vaccine supply chain.

Author information

1
Public Health Computational and Operations Research (PHICOR), University of Pittsburgh, Pittsburgh, PA, United States.

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.

PMID:
23602666
PMCID:
PMC3763189
DOI:
10.1016/j.vaccine.2013.04.011
[Indexed for MEDLINE]
Free PMC Article
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