Vaccine Wastage Assessment, India

Dear Sir, When India is procuring vaccine from private sources, this exercise of vaccine wastage assessment is timly, but too much emphasis on accurate orders by the states may lead the states to actually under-order the vaccines and thereby compromising the routine immunization coverage that is already going down. Thanks.

Thanks for the early dissemination of information ahead of the report. Having worked in the field for quite sometime, there are some natural responses to this information. Traditionally, some of the reasons for Vaccine wastages would be as follow:-

Inefficient Planning:- (Target approach) Lower immunization targets and higher buffer stocks at different levels.Inefficient transport system between various levels from point of serviceInefficient supply of vaccines:- Higher supply in first two quarters and then absence of lowered suplly laterHigh breakdown rates of ILR's/DF's at various levels of delivery system. Poor monitoring and control system for vaccine supply.Poor knowledge and improper practices of field staff at various levels.

With greater empasis on improving RCH services, PIP's were submitted by all states to rectify these problems. My question is whether these aspects were studied in a before-after the new RCH program was initiated. It would be heartening to see if there are improvements from earlier set-points. In particular, how has the breakdown rates of equipments has been improved? The mail mentions that ..... "inadequate estimations "..is still a big problem. The PIP's sent by states after calculation of vaccine needs should have been reviewed by GoI and other partners at central level. Why were'nt the states/districts informed about incorporating proper wastage rates in calculation of stocks. I am sure the report might address the specific details but was strange to know that only knowledge levels play such a big role in vaccine wastage. There are several trainings conducted on vaccine storage and efficient vaccine management system under NRHM. At this point, it might be worth sending warnings (according to report) that such trainings and planning initiatives were ineffiective. with regards Dr.Giridhara R Babu, MBBS, MPH, PhDc Department of Epidemiology, University of California Los Angeles PhD scholar, Public Health Foundation of India.