Objectives: A country’s immunization system's effectiveness depends on its supply chain's efficacy. To assess the challenges of maintaining an efficient vaccine supply chain, Malawi conducted its assessment using The EVM2.0 tool (Effective Vaccine Management).

Methods: It is a cross-sectional study in which all EVM requirements were assessed between September and October 2021. Data were collected from eighty-two randomly selected sites using the site selection tool of the EVM. Data were entered into the EVM assessment tool 2.0 version 1.12 for analysis. This tool generates performance indicators and criteria scores for assessed sites, compared with a WHO minimum score of 80%.

Results: Overall criteria scores across all levels of the immunization supply chain showed a statistically significant mean difference of 5.92 (t = 2.58, P = 0.02). Comparative overall mean criteria scores across different levels of the immunization supply chain showed no statistically significant difference for primary (p = 0.76), sub-national (p = 0.69), and lowest distribution stores (p = 0.12). However, a substantial gap was found in the overall mean scores of the health facility’s service point (SP) (t = 4.12, P = 0.001). The overall category scores across all immunization supply chain levels did not show a statistically significant difference. However, among individual category scores, Infrastructure (76 %), Equipment (67 %), Policies and procedures (62 %), Financial (47 %), and Resources (64 %) were found to be below the WHO minimum score.

Conclusion: Though the 2021 Malawi EVM assessment findings are promising, they still identified the gaps to be improved to ensure the vaccine availability in the right amount, at the right time, and at the right cost.


  • English

Publication year



Journal article


  • Supply chain & logistics


  • Malawi

WHO Regions

  • African Region

Topic references


Assessment of vaccine management performance in health facilities of Mwanza Region, Tanzania: a cross-sectional studyGreen Sadru, Makhado Mulatedzi, Omary Swalehe, Stany Binzimana, Domina Asingizwe, Shital Mahindra Maru2023Journal articleEnglish
Effective Vaccine Management: The Case of a Rural District in GhanaEric Osei, Mohammed Ibrahim, Gregory Kofi Amenuvegbe2019Journal articleEnglish
Key lessons learned from the immunization supply chain of Malawi, an African country using EVM2.0Ghanshyam Sethy, Mike Nenani Chisema, Lokesh Sharma, Olamide Folorunso, Dereje Haile, Zeinab Reda Berri, Krupal Joshi, Mphatso Ntenje, Collins Mitambo, Beverly Laher, Sanjay Singhal, Samuel Chirwa, Tedla Damte, Flint Zulu, Antoinette Eleonore Ba, Michelle Seidel, John Phuka2022Journal articleEnglish
Strengthening the immunization supply chain through EVM assessment: Comparing India's two successive national assessmentsLokesh Sharma, Ginisha Gupta, Bhrigu Kapuria, Snehil Kumar Singh, Sanjay Gupta, Mahesh Kumar Agarwal, Harshad Thakur2022Journal articleEnglish