dr shachi adyanthaya, sr. programming officer, undp india
TRANSCRIPT
Transforming Immunization Supply Chain using Last Mile Data
The India StoryElectronic Vaccine Intelligence Network
April, 2017
SCALE
World’s Largest Immunization Programme
~27,000 facilities(95% sub-district)
~27M newborns~30M pregnant women~100M <5 years of age
>650M doses>9M immunization sessions
CONFIDENTIAL 4
Six-level Vaccine Supply Chain
Low resource environmentAnnual estimationsMonthly targetsDelivery and Pickup
70,000 CCEs27,000 CCPs
National Store / Manufacturer
State Store
Divisional Store
District Store
Taluk/Block
PHC/CHC
Vaccine Supply Chain Management Challenges
Non- Standardized Vaccine Stock Record-keeping
Diverse Terrain
Mismatch in Demand & Supply
No Real-time Visibility of StocksNo Real-time Visibility of Storage Temperatures
Barriers to Digitizing Vaccine Supply Chain
Electricity Supply
Availability of ‘Functional’
Computer
Availability of Data Entry Operator
InternetAccess
TECHNOLOGY AND DATARobust Technology & Simplified Procedures
Good Data
Mobile-cloud technology gives visibility into stock consumptionEnables optimal decisions to ensure stock distribution & availability
Temperaturesensors
Connecting first through last mile
National MoHFWCentral stores
State/Regional Stores
District Stores
PHCs/CHCs
eVIN
Support
Optimized Data Entry - Simple Tools - Contextual Analytics
Logistics Data: Physical & Digital
Temperature Data
• Temperature sensors sending temperature and device health over GPRS / SMS
• Multiple monitoring points – top, middle, bottom, ambient
• Hot/cold alarms, analytics on vaccine exposure & asset functioning
• Remote logger device management
Empowering Cold-chain HandlersHealth worker enters: - issues - receipts - stock counts - discards - orders
Health worker gets: - real-time stock views - alerts on low stock/expiry - optimal order recommendations - delivery status - temperature alarms - SOP reminders - general announcements
GPRS / SMS
Visibility and analytics at the last mile for the last mile
* Closed and open vials
Empowering Managers
Visibility and analytics at every level
Robust Technology for Low-resource Environments
Device heterogeneity VoiceGPRS SMS
Service Management Middleware
Transactions Events Locations Devices
Logistics AnalyticsHuman resources
Easy to Use – Web and Mobile
1. Inventory Management2. Order Management3. Batch & Expiry Management4. Demand Forecasting5. Replenishment Optimization6. Workforce Monitoring 7. Geo-tracking & Location services8. Transport Routing & Scheduling9. Integrated Temperature Monitoring10. Big data analytics & dashboards
Strong Human Resource Network
National CommitteeState OfficersRegional Managers
District Manager
Continuous feedback for health workers and officials in the network
9500+ village stores,500+ stores above
district
Big Data, Actionable Analytics
Per month> 2M transactions
> 80M temperature samplesQualitative feedback
> 20 major indicators
Footprint> 500GB of raw data
> 2TB of analytical data
Transformation
People, Information & Procedures
USAGE & TRANSFORMATION
System Strengthening & Improving Programme
Governance
Standardizing stock keeping
and distribution procedures
Strengthening cold
chain HR
Use of simple mobile based
application
Innovative use of
technology for temp.
monitoring
Real time stock and
temp visibility
Real Time Monitoring System
Real-time Visibility of Vaccine Data
SCALE
36 States And Union Territories
27,000 Vaccine Storage Points
56,000 Government Staff Trained
55,000 Temperature Sensors
650 Million Doses Tracked
DataVisibility Analytics
StockAt every store
Temperature & StatusOf every cold-chain equipment
DemandFrom each store
SupplyAt warehouse & in-transit
Stock abnormalityZero stock, < min, > max
Optimal replenishmentsConsumption based forecasting
Trends of nearly “everything”By time, product, location, …
Human PerformanceData quality, response times
Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-170
200000
400000
600000
800000
1000000
1200000
1400000
1600000
1800000
2000000
732673
998172
1367201
1635921
18045571869407
Digital Transactions
Digital Transactions
Digital TransactionsNearly 2 million every month
Madhya
Pradesh
Uttar Prad
esh
Gujarat
National
Rajasth
an
Jharkhan
d
Manipur
Chhattisga
rhBihar
Assam
Odisha
Nagala
nd0.0
20.0
40.0
60.0
80.0
100.0
120.0
98.7 97.8 97.8 97.1 96.9 96.7 96.5 95.6 93.7 92.1 85.8 83.9
% of CCP that have vaccine availabil ity index >90%
Stock Availability> 95%
Rajasthan
GujaratM.P.
Chhattisgarh
Manipur
Assam
Odisha
U.P.
JharkhandBihar
Nagaland
50
55
60
65
70
75
80
85
90
95
10093.53 93.93 94.68 94.86 96.49 96.49 96.53 98.11 98.34 99.69 100
Health centres updating their vaccine data on eVIN in the last 7 days
National %
Weekly Reporting Rate> 98%
• Moving to an “informed push” model• Consumption-based demand forecasts, flowcasting• Policy compliance & evidence-based advocacy-
Open vial policy compliance, vaccine stacking guidelines, capacity building, and so on
• Last mile decision-making based on eVIN data
Impact
Simple and robust technology and processes are essentialLow resource environments pose significant challenges to achieve high data quality from the last mile
Big and small data are both important, along with actionable analyticsHuman behaviors have to be changed towards timely actions, supported by highly usable supply chain analytics
Empowering people locally at every level drives better adoptionContextual analytics, accessible and usable (on computers or mobile phones), drives adoption and ownership at each level
Connecting people within and across levels enables good feedback loopsEnabling a human “network” that has good visibility makes them work together to solve problems
The model can scale cost-effectively only with robust technologyMobile and cloud-based computing technology has to deliver actionable analytics at all levels, esp. so at the last mile
Summary
Improved & Efficient Vaccination Systems