Related Experiment Videos
Transforming vaccines supply chains in Nigeria
David Sarley1, Mustafa Mahmud2, Jide Idris3
1Bill and Melinda Gates Foundation, 500 5th Ave N, Seattle, WA 98102, United States.
Insights
Nigeria enhanced its immunization cold chain and supply chain to reduce child mortality. Despite challenges, this transformation is crucial for sustained vaccination coverage and public health.
Area of Science:
- Public Health
- Supply Chain Management
- Vaccinology
Background:
- Nigeria faced critically low vaccination rates and a dysfunctional immunization cold chain and supply chain in 2012.
- High under-5 mortality rates were linked to unimmunized children, jeopardizing health Millennium Development Goals (MDGs).
Purpose of the Study:
- To document the vaccine transformation project launched in 2013 to address systemic weaknesses.
- To highlight strategies and lessons learned from federal and Lagos State initiatives.
- To emphasize the need for a sustainable, end-to-end approach to immunization supply chains.
Main Methods:
- Implemented innovations in data capture, recording, and utilization for decision-making.
- Undertook systematic cold chain procurement, installation, maintenance, and performance monitoring.
- Redesigned supply chains at federal and state levels and transformed institutional capacity at the National Primary Health Care Development Agency (NPHCDA).
Main Results:
- Achieved impressive results in improving immunization systems over three years.
- Shifted towards a culture of active cold chain maintenance, increasing uptime.
- Established a data-driven Department of Logistics and Health Commodities (DLHC) within NPHCDA.
Conclusions:
- The vaccine transformation project demonstrated significant improvements but faces challenges to sustainability.
- An end-to-end approach addressing root causes is vital for weak system performance.
- A robust and agile cold chain and supply chain are essential for Nigeria's children's health and economy, especially post-GAVI graduation.
Abstract:
Nigeria is the most populous country in Africa and in 2012 was suffering some of the lowest vaccination rates in the World. A combination of factors had resulted in a dysfunctional immunization cold chain and supply chain. Recognizing that the number of unimmunized children contributed to high levels of under-5-mortality, and that health MDGs would not be attained, Minister of State for Health Mohammed Pate launched a vaccines transformation project in 2013. In partnership with BMGF, GAVI, UNICEF, WHO, other donors and implementing partners the transformation journey has so far taken three years and achieved impressive results. It has though faced challenges along the way and with the financial burden of GAVI graduation facing Nigeria, the economic downturn and the decentralized funding of health services, the results are far from sustained. This paper documents the work undertaken at the Federal level and then highlights specific work undertaken in partnership with Lagos State Government. It identifies the importance of taking an end to end approach and looking at the root causes of weak system performance. The strategy combined simple innovations in how data was captured, recorded and used to drive decision making. It included a comprehensive and systematic approach to cold chain procurement, installation and maintenance with a shift to a culture of active cold chain maintenance that is performing with higher levels of uptime. It also included supply chain redesign at both the Federal and State level. Finally, it involved an institutional transformation at the National Primary Health Care Development Agency (NPHCDA) to establish a data driven Department of Logistics and Health Commodities (DLHC) to manage the many challenges in immunizing 7.5 million children annually. While results have been impressive, there have been many challenges and lessons learned on the way. As Nigeria gets ready for its graduation from GAVI, a robust agile performing cold chain and supply chain will be essential for the good health of Nigeria's children and its economy. The necessary transformation journey has only just begun.