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Removing the regional level from the Niger vaccine supply chain
Tina-Marie Assi1, Shawn T Brown, Souleymane Kone
1Public Health Computational and Operations Research (PHICOR), University of Pittsburgh, Pittsburgh, PA, United States.
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.
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