Removing the regional level from the Niger vaccine supply chain

Tina Marie Assi; Shawn T. Brown; Souleymane Kone; Bryan A. Norman; Ali Djibo; Diana L. Connor; Angela R. Wateska; Jayant Rajgopal; Rachel B. Slayton; Bruce Y. Lee

doi:10.1016/j.vaccine.2013.04.011

Removing the regional level from the Niger vaccine supply chain

Tina Marie Assi, Shawn T. Brown, Souleymane Kone, Bryan A. Norman, Ali Djibo, Diana L. Connor, Angela R. Wateska, Jayant Rajgopal, Rachel B. Slayton, Bruce Y. Lee

Research output: Contribution to journal › Article › peer-review

34 Scopus citations

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.

Original language	English (US)
Pages (from-to)	2828-2834
Number of pages	7
Journal	Vaccine
Volume	31
Issue number	26
DOIs	https://doi.org/10.1016/j.vaccine.2013.04.011
State	Published - Jun 10 2013
Externally published	Yes

Keywords

Immunization
Niger
Vaccine delivery
Vaccine distribution
Vaccine supply chain

ASJC Scopus subject areas

Molecular Medicine
General Immunology and Microbiology
General Veterinary
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1016/j.vaccine.2013.04.011

Cite this

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title = "Removing the regional level from the Niger vaccine supply chain",

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.",

keywords = "Immunization, Niger, Vaccine delivery, Vaccine distribution, Vaccine supply chain",

author = "Assi, {Tina Marie} and Brown, {Shawn T.} and Souleymane Kone and Norman, {Bryan A.} and Ali Djibo and Connor, {Diana L.} and Wateska, {Angela R.} and Jayant Rajgopal and Slayton, {Rachel B.} and Lee, {Bruce Y.}",

note = "Funding Information: The HERMES and Logistics Modeling Team consists of (in alphabetical order): Tina-Marie Assi, PhD, Shawn T. Brown, PhD (Technical Lead), Brigid E. Cakouros, MPH, Sheng-I Chen, PhD, Diana L. Connor, MPH (Co-Coordinator), Erin G. Claypool, PhD, Leila A. Haidari, MPH, Veena Karir, PharmD, Bruce Y. Lee, MD, MBA (Scientific Lead), Jim Leonard, Leslie E. Mueller, MPH, Bryan A. Norman, PhD, Proma Paul, MHS, Jayant Rajgopal, PhD, Michelle M. Schmitz, BA, Rachel B. Slayton, PhD, Angela R. Wateska, MPH (Co-Coordinator), Joel S. Welling, PhD, and Yu-Ting Weng, MS. For further questions regarding HERMES, please contact B. Lee, MD MBA (BYL1@pitt.edu) or S. Brown, PhD (stbrown@psc.edu). This study was supported by the Bill and Melinda Gates Foundation and the National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. We would also like to acknowledge the important contributions of the following individuals to our study: Carol Levin (PATH), Mercy Mvundura (PATH), Dr. Amadou Garba (Schistosomiasis Control Initiative), Dr. Tiekoura Coulibaly (EPI Officer, WHO Niger), Dr. Abdou M. Chitou (EPI Administrator, UNICEF Niger), and Mr. Harou Moussa (EPI Office, WHO Niger). For more information on HERMES, please visit: hermes.psc.edu.",

year = "2013",

month = jun,

day = "10",

doi = "10.1016/j.vaccine.2013.04.011",

language = "English (US)",

volume = "31",

pages = "2828--2834",

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T1 - Removing the regional level from the Niger vaccine supply chain

AU - Assi, Tina Marie

AU - Brown, Shawn T.

AU - Kone, Souleymane

AU - Norman, Bryan A.

AU - Djibo, Ali

AU - Connor, Diana L.

AU - Wateska, Angela R.

AU - Rajgopal, Jayant

AU - Slayton, Rachel B.

AU - Lee, Bruce Y.

N1 - Funding Information: The HERMES and Logistics Modeling Team consists of (in alphabetical order): Tina-Marie Assi, PhD, Shawn T. Brown, PhD (Technical Lead), Brigid E. Cakouros, MPH, Sheng-I Chen, PhD, Diana L. Connor, MPH (Co-Coordinator), Erin G. Claypool, PhD, Leila A. Haidari, MPH, Veena Karir, PharmD, Bruce Y. Lee, MD, MBA (Scientific Lead), Jim Leonard, Leslie E. Mueller, MPH, Bryan A. Norman, PhD, Proma Paul, MHS, Jayant Rajgopal, PhD, Michelle M. Schmitz, BA, Rachel B. Slayton, PhD, Angela R. Wateska, MPH (Co-Coordinator), Joel S. Welling, PhD, and Yu-Ting Weng, MS. For further questions regarding HERMES, please contact B. Lee, MD MBA (BYL1@pitt.edu) or S. Brown, PhD (stbrown@psc.edu). This study was supported by the Bill and Melinda Gates Foundation and the National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. We would also like to acknowledge the important contributions of the following individuals to our study: Carol Levin (PATH), Mercy Mvundura (PATH), Dr. Amadou Garba (Schistosomiasis Control Initiative), Dr. Tiekoura Coulibaly (EPI Officer, WHO Niger), Dr. Abdou M. Chitou (EPI Administrator, UNICEF Niger), and Mr. Harou Moussa (EPI Office, WHO Niger). For more information on HERMES, please visit: hermes.psc.edu.

PY - 2013/6/10

Y1 - 2013/6/10

N2 - 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.

AB - 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.

KW - Immunization

KW - Niger

KW - Vaccine delivery

KW - Vaccine distribution

KW - Vaccine supply chain

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ER -

Removing the regional level from the Niger vaccine supply chain

Abstract

Keywords

ASJC Scopus subject areas

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