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Background: Effective Vaccine Management (EVM) initiative provides the platform needed to monitor and assess the vaccine supply chain system to identify strengths and weaknesses of the system at all levels and enhance the development of continuous improvement plan to strengthen the system. This study was conducted to determine the vaccine management performance in Health Facilities of Mwanza Region, Tanzania. Methods: This was a descriptive cross-sectional study that was carried out in 102 health facilities providing immunization services from eights districts of Mwanza Region in Tanzania. The World Health Organization (WHO) effective vaccine management assessment tools were used to collected data. Both quantitative and qualitative (through key informant interviews) approaches were used. The quantitative data were analysed using the existing WHO criteria for analysing effective vaccine management assessment data, while deductive thematic analysis was used for the qualitative data. Results: The finding shows that the overall score for vaccine management performance was 53% which is below the WHO acceptable minimum score of 80%. None of the health facilities had reached the benchmark but only 67% had an average performance (> = 50–< 80%). The highest health facility score was 76% and the lowest being 27%. Among the categories assessed, the highest score was on information technology with 72%, while the lowest was on standard operating procedures with a score of 43%. The major challenges which contributed to low performance were lack of training, low knowledge about vaccine management practices, unavailability of standard operating procedures (SOPs), and limited financial resources to support operations for vaccine management practices. Skills gap, incomplete stock records and management, as well as low availability of SOPs were the key challenges reported that affected vaccine management practices. Conclusions: Effective vaccine management performance was low across all districts under the study. Increasing personnel capacity and ensuring availability of resources to support operations were reported as key interventions in improving vaccine management practices. Hence, effectively working on continuous improvement plan with key highlighted actions is highly recommended to all actors from national level to sub-national level managers and healthcare workers as frontline vaccine handlers. [ABSTRACT FROM AUTHOR]

Background: Effective vaccine management is essential to maintain the quality of vaccines, minimise wastages, and prevent missed opportunities for vaccination at service delivery points. Objectives: This study aims to assess vaccine management practices among vaccinators at health facilities in the Morogoro region, Tanzania. Methodology: A descriptive cross-sectional study design involved health workers from 77 health facilities offering vaccination services. The study population consisted of vaccine handlers and vaccinators working in public health facilities in the Morogoro region. The vaccine management practices were assessed using data collected from ledgers and the Vaccine Information Management System (VIMS). The temperature records were downloaded from the Fridge-tag® 2 and Coldtrace5 devices. Results: The findings indicated that 65 (84%) health facilities had functional refrigerators and are using power from 26 (34%), 28 (36%), and 23 (30%) of grid electricity, solar, and Liquefied Petroleum Gas (LPG), respectively. Besides, 27 (35%) health facilities have an alternative energy source as a backup. In general, healthcare workers had a good knowledge of cold chain management, including the World Health Organization recommended storage temperatures for vaccines. Furthermore, vaccine stockout was found in 12 (15.6%) health facilities for at least one antigen and 4 (5.1%) health facilities for all five antigens under observation. This current study also revealed that the average calculated vaccine wastage rates for DTP, Measles–Rubella and Rotavirus vaccines were 7%, 19%, and 15%, respectively. More than half of health workers did not perform monthly temperature data reviews. In addition, poor performance led to high wastage rates, including the Rotavirus vaccines, and a change in VVM to discard points. Finally, a small number of 5 (6.5%) health facilities consecutively reported temperature exposure beyond + 8 Celsius (between 5.9 and 281 h). Conclusions: Healthcare workers' vaccine and cold chain management knowledge were good for temperature data reading and documentation. However, the practices were poor for some health facilities. The gaps observed in this study inform health managers and policymakers toward establishing interventions to improve health workers' knowledge and practice, including mentorships, supervision, and training to guarantee that each child in all communities reaps the benefits of immunisation services. [ABSTRACT FROM AUTHOR]

Background: Upon the authorization of COVID-19 vaccines worldwide, national and international standards were developed to help integrate mass COVID-19 immunization campaigns into the healthcare network. The primary objective is to evaluate the overall COVID-19 vaccination process through on-site visits to vaccination centers all over Lebanon to assess whether these are abiding by the national and international requirements for both Pfizer-BioNTech and AstraZeneca vaccines. The secondary objective is to explore whether the type of the facility, private versus governmental, and educational versus non-education, affects the vaccination process in these centers. Methods: A convenient sample of 33 vaccination centers was selected from a list of all COVID-19 vaccination centers operating in Lebanon. Data were collected using a structured checklist developed following an extensive literature review of the national and international standards for Pfizer-BioNTech and AstraZeneca COVID-19 vaccines. A scoring system for the overall vaccination process was developed. Results: Quality deficiencies were identified in several steps of the immunization process; however, the international standards were followed in most vaccination centers visited despite their limited resources. It was noticed that there were no significant differences between private and governmental, between educational and non-educational, and between Pfizer and AstraZeneca vaccination centers; the 33 vaccination centers visited have scored above 75 on the entire process immunization against COVID-19 with P-values above 0.05 in all steps evaluated. Conclusion: An optimization of the immunization process should be performed to ensure that the practice is within international standards. This can be done by conducting periodic vaccination center visits, implementing clear guidelines, training staff involved in the vaccination process, and ensuring continuous support of the Lebanese Ministry of Public Health. [ABSTRACT FROM AUTHOR]

Background: Immunization supply chains (iSCs) move vaccines from manufacturer to point of use with the added complexities of requiring cold chain and an increasing need for agility and efficiency to ensure vaccine quality and availability. Underperforming iSCs have been widely acknowledged as a key constraint to achieving high immunization coverage rates in low- and middle-income countries. This paper details the system design approach used to analyze the iSC network in Sierra Leone, Madagascar, Niger and Guinea and documents six lessons. Methodology: Between 2018 and 2020, these countries implemented the system design approach, involving four key steps: (1) advocate and introduce to engage stakeholders and prioritize identification of modeling scenarios; (2) collect data and plan analysis through document review and key informant interviews; (3) analyze system design scenarios using computer software modeling tools (LLamasoft's Supply Chain Guru and AnyLogic's AnyLogistix) for optimization and simulation modeling as well as further analysis with Excel, Google maps, and OpenStreetMap; and (4) build consensus on optimized model and implementation roadmap using the Traffic Light Analysis tool and building on stakeholder input. Findings: Key lessons include the following: (1) define system design objectives based on country priorities; (2) establish consensus with stakeholders on scenarios to model; (3) modeling provides the evidence but not the answer; (4) costs should not be weighted above other decision criteria; (5) data collection—work smarter, not harder; (6) not all questions can be answered with a computer model. Discussion: A system design approach can identify changes to the design of the supply chain that can introduce efficiencies and improve reliability. This approach can be more effective when these lessons and principles are applied at the country level. The lessons from these four countries contribute to global thinking and best practices related to system design. The modeling and system design approach provides illustrative results to guide decision-makers. It does not give a "final answer", but compares and contrasts. [ABSTRACT FROM AUTHOR]