The benefits of redesigning Benin's vaccine supply chain
The benefits of redesigning Benin's vaccine supply chain
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DOI：
10.1016/j.vaccine.2014.04.090
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发表时间：
2014-07-07
期刊：
影响因子：
5.5
通讯作者：
Lee, Bruce Y.
中科院分区：
文献类型：
--
作者：
Brown, Shawn T.;Schreiber, Benjamin;Lee, Bruce Y.
新疫苗的引入给世界各地的疫苗供应链带来了压力。虽然增加储存和运输可能是最直接的选择，但考虑可能产生的财务和运营效益也很重要。2012年，次优疫苗覆盖率和即将推出的疫苗促使贝宁共和国卫生部（MOH）探索改善其疫苗供应链的方法：与贝宁卫生部合作，我们利用我们的计算模型，爱马仕，探索三种可能的选择对成本和疫苗可用性的影响：（1）将公社一级合并为卫生区一级，（2）完全取消公社一级，（3）取消公社一级并扩大到12家百货公司。我们还分析了在delivery.Results中增加运输循环的影响：在基线时，新疫苗的引入没有对当前系统进行任何更改，增加了每剂的物流成本（0.23美元至0.26美元），并将疫苗可用性降至71%。虽然实施乡一级搬迁方案的资本成本与实施卫生区方案的资本成本相同，但卫生区方案的业务成本较低。讨论：最佳的重新设计方案被证明是转换为卫生区设计和使用运输回路（为10个卫生站/回路服务）的协同方法。虽然过渡到重新设计或只增加运输回路是有益的，但实施重新设计选项和运输回路可以降低资本支出和运营成本。(C)2014作者爱思唯尔有限公司出版
Introduction: New vaccine introductions have put strains on vaccine supply chains around the world. While increasing storage and transportation may be the most straightforward options, it is also important to consider what financial and operational benefits can be incurred. In 2012, suboptimal vaccine coverage and impending vaccine introductions prompted the Republic of Benin's Ministry of Health (MOH) to explore ways to improve their vaccine supply chain.Methods: Working alongside the Beninese MOH, we utilized our computational model, HERMES, to explore the impact on cost and vaccine availability of three possible options: (1) consolidating the Commune level to a Health Zone level, (2) removing the Commune level completely, and (3) removing the Commune level and expanding to 12 Department Stores. We also analyzed the impact of adding shipping loops during delivery.Results: At baseline, new vaccine introductions without any changes to the current system increased the logistics cost per dose ($0.23 to $0.26) and dropped the vaccine availability to 71%. While implementing the Commune level removal scenario had the same capital costs as implementing the Health Zone scenario, the Health Zone scenario had lower operating costs. This increased to an overall cost savings of $504,255 when implementing shipping loops.Discussion: The best redesign option proved to be the synergistic approach of converting to the Health Zone design and using shipping loops (serving ten Health Posts/loop). While a transition to either redesign or only adding shipping loops was beneficial, implementing a redesign option and shipping loops can yield both lower capital expenditures and operating costs. (C) 2014 The Authors. Published by Elsevier Ltd.