Closing the Gap: Refining Vaccine Forecasting and Resupply Calculations in Mozambique Through Advanced Routine Data...

Vaccines save lives, but only if they are available at health facilities for administration. Stockouts occur for various reasons, including inaccurate forecasting and resupply calculations. Population-based forecasts are typically used for immunization programs, yet they are often based on inaccurate population estimates. This retrospective study analyzed available routine facility-level data from two districts in Mozambique to provide insights for improved supply chain management, including resupply decisions, at the facility level.

Data from August to October 2023 were collected and analyzed for wastage rate, session cohort, and forecast accuracy.

The results show that district-level wastage rates are nominally different from globally acceptable standards, while being significantly different at the facility level. Analysis also showed divergence of vaccination doses provided to a session cohort during the month-long periods that appear to be correlated with periods of stockout. Using population-based forecasting for resupply methodology consistently undersupplied facilities by 20% (ranging from 5 to 41% across 16 facilities), while using the number of doses of administered BCG as a proxy for the population oversupplied by 12% (ranging from 1% underforecast and 28% overforecast), with tighter variance.

Despite limitations due to the availability and quality of data, the results suggest an opportunity to shift from a traditional population-based approach to forecasting and resupply decisions, leveraging existing data systems, applying tailored wastage rates, and adjusting inventory management policies to ensure vaccine availability.