Many country vaccine distribution systems in low to middle income countries feature scheduled deliveries from central to intermediate level stores. But they depend on collection or a mix of collection and delivery at service delivery level of the system. The mode of travel varies as transport becomes available, the timing of trips varies widely and there are many unexpected delays. Under these unpredictable conditions requests by those collecting and arriving vaccine deliveries are often unscheduled, even chaotic at times.
There are five features of efficient vaccine distribution system to enable them to be regular, reliable, complete and timely while being achieved at least cost. These are:
- Every vaccine collection or delivery is pre-planned and scheduled to occur on a certain day in each supply period and at a certain time (within a set tolerance).
- The design of the distribution system, the circuits that are chosen are optimized for duration and best use of the visiting team
- The choice between collection and delivery is dependent mainly on availability of dedicated transport, or managerial control over shared transport and availability of a travel budget for distribution
- The cost of the distribution of 1m3 of tertiary packed vaccine per km travelled is minimized
- Supervision combined with supply can be very effective.
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