Re-designing the Mozambique vaccine supply chain to improve access to vaccines
Re-designing the Mozambique vaccine supply chain to improve access to vaccines
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DOI：
10.1016/j.vaccine.2016.08.036
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发表时间：
2016-09-22
期刊：
影响因子：
5.5
通讯作者：
Brown, Shawn T.
中科院分区：
文献类型：
--
作者：
Lee, Bruce Y.;Haidari, Leila A.;Brown, Shawn T.
简介：自1980年代设计供应链以来，人口和常规儿童疫苗方案发生了重大变化，在“疫苗十年”期间引进新疫苗可能会加剧现有瓶颈，进一步抑制所有疫苗的流动。与莫桑比克卫生部合作，我们的团队实施了一个新的流程，该流程集成了爱马仕计算模拟建模和实地执行人员通过整合新的供应链结构、信息技术、设备、人员和政策的系统重新设计，评估和改善莫桑比克疫苗供应链。替代系统设计提高了疫苗的可用性（加沙从66%提高到93%;德尔加多角从76%提高到84%），并降低了每次给药的后勤成本（加沙从0.53美元增至0.32美元;德尔加多角从0.38美元增至0.24美元）。在引入新疫苗后，替代系统还以较低的成本提高了可用性。自从对加沙北部每两个月交付一次的情况进行了评估后，省管理局决定试行这种方法，这与几十年来规定每月交付一次的政策不同。讨论：重新设计不仅提高了供应链的效力，而且提高了效率，这一点很重要，因为交付疫苗的资源有限。莫桑比克的经验和进程可以作为疫苗十年期间其他国家的榜样。对于疫苗十年来说，以负担得起的价格向市场提供疫苗是不够的。疫苗必须到达人群才能成功。(C)2016由Elsevier Ltd.出版
Introduction: Populations and routine childhood vaccine regimens have changed substantially since supply chains were designed in the 1980s, and introducing new vaccines during the "Decade of Vaccine" may exacerbate existing bottlenecks, further inhibiting the flow of all vaccines.Methods: Working with the Mozambique Ministry of Health, our team implemented a new process that integrated HERMES computational simulation modeling and on-the-ground implementers to evaluate and improve the Mozambique vaccine supply chain using a system-re-design that integrated new supply chain structures, information technology, equipment, personnel, and policies.Results: The alternative system design raised vaccine availability (from 66% to 93% in Gaza; from 76% to 84% in Cabo Delgado) and reduced the logistics cost per dose administered (from $0.53 to $0.32 in Gaza; from $0.38 to $0.24 in Cabo Delgado) as compared to the multi-tiered system under the current EPI. The alternative system also produced higher availability at lower costs after new vaccine introductions. Since reviewing scenarios modeling deliveries every two months in the north of Gaza, the provincial directorate has decided to pilot this approach diverging from decades of policies dictating monthly deliveries.Discussion: Re-design improved not only supply chain efficacy but also efficiency, important since resources to deliver vaccines are limited. The Mozambique experience and process can serve as a model for other countries during the Decade of Vaccines. For the Decade of Vaccines, getting vaccines at affordable prices to the market is not enough. Vaccines must reach the population to be successful. (C) 2016 Published by Elsevier Ltd.