Supporting immunization programs with improved vaccine cold chain information systems
Abstract
Immunization is recognized as one of the most successful public health interventions ever devised. A critical component of immunization programs is the vaccine cold chain - the cold storage to keep vaccines safe from manufacture to eventual delivery to the child. Countries need to manage their vaccine cold chains and logistics systems to ensure sufficient storage capacity, distribution of adequate supplies of vaccines, and functional cold storage equipment. There are particular challenges for remote facilities where transportation costs are high, power infrastructure is lacking, and communication is limited. Accurate information about the cold chain is essential to address these challenges and to evaluate the impact of different interventions. A Cold Chain Information System (CCIS), which tracks health facility information and the country's cold chain equipment can help address these challenges at both the strategic (planning) and tactical (management) levels. This paper describes our efforts to develop a CCIS for Laos, in collaboration with UNICEF and the Lao Ministry of Health. The work builds on experience with deploying CCIS's in multiple countries along with developing analysis tools and data standards. The CCIS in Laos uses DHIS2, a widely used web based health indicator system as the back end, which is integrated with SMS reporting from the district and health center level where internet is not guaranteed to be available. A central goal of the system is to allow regular reporting of vaccine stock levels and vaccine refrigerator status (measured by logging devices recording high and low temperature alarms). The system is designed with notifications to promote action by technicians or managers. The technical contributions of this work include the development of a new data model for DHIS2 and a text message system using an Android gateway to RapidSMS with a custom notification engine interfacing to DHIS2.
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A study in Laos found that although remote reporting of temperature data was successful, additional training was required to enable data managers to effectively use the data and translate it into effective decision making.
“For example, a study in Laos found that although remote reporting of temperature data was successful, additional training was required to enable data managers to effectively use the data and translate it into effective decision making, highlighting the importance of addressing health worker behavior in addition to technical solutions.15”
From Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring With Data Review Teams for Vaccine Management (2019) · cites this paper as [15]
Lack of information about what is happening in the vaccine cold chain at the intermediate and facility levels, particularly about the state of functionality of vaccine storage equipment and the exposure of vaccines to temperature extremes at the last mile of the distribution network, is common among many cold chains in developing countries.
“In addition, lack of information about what is happening in the vaccine cold chain at the intermediate and facility levels, particularly about the state of functionality of vaccine storage equipment and the exposure of vaccines to temperature extremes at the last mile of the distribution network, is common among many cold chains in developing countries.15”
From Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring With Data Review Teams for Vaccine Management (2019) · cites this paper as [15]
RTM technology alone is not enough to ensure optimal outcomes in maintaining ideal temperature ranges.
“However, as with any technology, RTM technology alone is not enough to ensure optimal outcomes in maintaining ideal temperature ranges.”
From Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring With Data Review Teams for Vaccine Management (2019) · cites this paper as [15]
Previous research by Anderson and Comes suggested that a combination of RTM data with improved processes for data review and issue management can lead to important improvements in cold chain performance in resource-constrained settings.
“This study reinforces and expands on previous research by Anderson and Comes, which suggested that a combination of RTM data with improved processes for data review and issue management can lead to important improvements in cold chain performance in resource- constrained settings.15,17”
From Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring With Data Review Teams for Vaccine Management (2019) · cites this paper as [15]
Cites
Barrington, J., Wereko-Brobby, O., Ward, P., Mwafongo, W., & Kungulwe, S. (2010) · Malaria Journal · doi:10.1186/1475-2875-9-298 · Cited by 163 · see citing works
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Lutukai, M., Bunde, E. A., Hatch, B., Mohamed, Z., Yavari, S., Some, E., Chweya, A., Kania, C., Ross, J. C., Keddem, C., et al. (2019) · Global Health: Science and Practice · doi:10.9745/ghsp-d-19-00157 · Cited by 17 · see citing works
“15 Similarly, Comes et al. identified real-time temperature monitoring as a promising technology for transforming the performance of cold chains but concluded that there are major gaps in the research into how information gets used by decision makers in the field to support improvements in the…”
Background
- Authors
- Anderson, R., Perrier, T., Pervaiz, F., Sisouveth, N., Kumar, B., Phongphila, S., Rahman, A., Dhiman, R., & Newland, S.
- Affiliations
- University of Washington (US)
- United Nations Children's Fund (US)
- United Nations Children's Fund India (IN)
- Program for Appropriate Technology in Health (US)
- Venue
- IEEE Global Humanitarian Technology Conference (GHTC 2014)
- Publisher
- IEEE
- Published
- 2014-10
- Pages
- 215-222
- OpenAlex
- W2017775535
- Cited by
- 23
- References
- 1
- Citations by year
- 2025: 2 · 2023: 4 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 2 · 2015: 2
- FWCI
- 1.14
- Type
- conference paper
- Language
- en
- Open access
- closed
- Locations
- IEEE Global Humanitarian Technology Conference (GHTC) (publishedVersion)
- Funders
- National Science Foundation
- United States Agency for International Development
- GAVI Alliance
- UNICEF
- Topics
- Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Supply Chain Traceability
- Keywords
- vaccine cold chain, immunization programs, DHIS2, data model design, remote health facilities, Laos
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