by Nguyen Van Cuong, NEPI, and Vu Minh Huong, PATH
Earlier this year, Vietnam’s National Expanded Programme on Immunization (NEPI) conducted an Effective Vaccine Management (EVM) assessment to evaluate the country’s immunization logistics systems. The results reveal that key improvements have been made since the previous assessment was conducted in 2009.
The EVM assessment and planning tool was developed by the World Health Organization to provide countries with the means to systematically assess their vaccine management processes. This can enable them to identify areas that need to be improved and focus their resources accordingly. An EVM assessment uses a structured questionnaire to evaluate a country’s supply chain at different levels using specific criteria based on good storage and distribution practices. The EVM assessment is just the beginning of a continuous process of improvement, and the assessment tool can also be used as a supervisory aid to monitor and support individual facilities on a regular basis.
The 2009 EVM assessment in Vietnam, conducted by NEPI with the help of project Optimize, highlighted several areas for improvement in the country’s vaccine supply chain. These included recommendations to improve vaccine arrival procedures, prioritize and strengthen standard operating procedures (SOPs) for vaccine management, and put in place a preventive maintenance plan for refrigerators. Since then, NEPI has worked hard to strengthen these areas and the findings of the 2012 EVM assessment indicate that these efforts have paid off. They also demonstrate the effectiveness of the EVM assessment and planning tool as a means for countries to improve their vaccine management practices.
Comparing results of the 2012 and 2009 assessments, we see that the national store has made significant improvements in establishing procedures for vaccine arrival, stock management, and distribution. The national store now meets the 80 percent target in all criteria, compared to just 18 percent in 2009. At the provincial level, results have been improved in most criteria, notably in vaccine management and storage capacity. Many of these improvements are due to the efforts that NEPI has made to strengthen and reinforce SOPs in various functions within the EPI. The EVM assessment has been a useful tool to identify these problems, enabling NEPI to prioritize and direct resources and training to resolve them.
Key recommendations of the 2012 EVM assessment include the following:
? Integrate the EVM assessment tool into regular EPI supervision at all levels, and urge managers to reinforce and regularly review areas identified in the assessment as needing strengthening.
? Improve temperature monitoring by upgrading the monitoring equipment for vaccine refrigerators, cold rooms, and refrigerated trucks at the national, regional, and provincial levels with devices capable of continuous temperature monitoring.
? Work to raise awareness of the importance of preventing vaccines from freezing, retrain staff to use the “shake test” to detect freeze-damaged vaccines, and provide freeze indicators for district-level refrigerators and for transport between province and district.
? At the district level, improve the time it takes to repair broken cold chain equipment.
? Disseminate SOPs widely to all levels so that staff are provided with specific and clear guidelines for vaccine management practices.
For more information, or to request a copy of NEPI’s 2012 EVM assessment report (available in English and Vietnamese), please contact Nguyen Dac Trung (firstname.lastname@example.org).
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