GAVI Alliance Supply Chain Strategy > Data for management strategy framework

Please find below responses to questions raised by Jan. 1. Is this the right approach or would you like to suggest changes? Yes it is. While the strategy of being tool agnostic is the right one to pursue, it will also be useful to conduct and provide countries with a comprehensive landscape analysis of the existing tools that are available for data management. Doing so would complement any guidance and standards disseminated. This would also help to ensure country ownership but equally importantly, to guard against "reinventing the wheel" or having parallel tools running simultaneously - as there already are a large array of systems in use and/or in development that address many of the data management challenges that the Alliance is seeking to tackle. In this regard, we suggest incorporating learning from previous projects, grants and assessments - e.g. OPTIMISE, ARISE, analysis of country EVMAs, etc - to ensure that SC data for management moves from pilot to long term sustainability. 2. What does the GAVI Alliance need to do to make this happen? I.e. what are the concrete interventions that need to take place and who should be responsible for them? What is it going to cost? The GAVI Alliance will need to: a. Facilitate a global conversation on best practices which can then be translated into in-country strategies by the respective country teams. Responsible: GAVI b. Focus on the importance of and need for change management around the area of data use for routine decision-making which has been one of the biggest challenges Supply Chain systems have faced for years. "A Supply Chain is only as strong as its governance" (quote from Phillip Kamutenga in Malawi), and three questions we should ask ourselves are: "Does the EPI governance structure support its supply chain strategy? Who manages the EPI supply chain? and How is the Supply Chain managed?". While other health programs are investing in HR for Supply Chain/logistics and on innovative approaches, EPI has been stagnant on this for the last 7-10 years. In some countries (where feasible and realistic), the GAVI Alliance should work with EPI to build on initiatives already being done in countries - such as LMU, eLMIS (e.g. in Tanzania and Zambia), route optimization, etc... c. Additional considerations and emphasis are needed on the "people" component. GAVI should take into consideration that new technology and ensuring commodities do not "solve" supply chain management issues. Not all users have the same ability to generate, access, interpret/analyse and use the data for effective decision-making and to make real-time adjustments at the various levels (particularly at district and facilities). In addition, not only are new professionalized logisticians needed, but also clear job guidelines and a longer-term commitment by the system to building these logisticians' (pre-service and in-service) capacity in supply chain and stock management and data use. These performance requirements and improvements should also include building capacity in how to triangulate data (to have data that "walk and talk") as well as to contribute to better target-setting, forecasting, distribution and reporting. GAVI may not be able to address the need for more professional logisticians with immunization program management and data skills, but they can link with the networks and health systems that could support this and emphasize this with countries. Responsible: EPI and GAVI d. Develop standard assessment/evaluation tools that countries can use to determine their level of maturity to implement electronic information systems and also help monitor their impact. Responsible: GAVI e. Recognize that in order to tackle improved data for management information, system development will need to be complemented by a combination of (1) people with skills to use that data as well as (2) re-engineered processes for optimal data management. The costs for these various interventions will vary depending on the scale in which they are pursued and therefore different cost scenarios may be needed. Responsible: IVD program. GAVI could require in the conditions for HSS applications (and/or in APR reporting) that the country have completed a 'comprehensive logistics management situational assessment' that looks at EPI and overall health logistics in-country (including supply chain, staffing and HR capacity, stock management and reporting, linkages with logistics management for other health commodities). 3. What is your organization's role in this work and what would you expect from GAVI coordinating and funding mechanisms? JSI has been leading the implementation of logistics and health information systems (both paper and electronic) which will/can be used in the management of vaccines in sub-Sahara Africa and Asia. JSI has also provided technical support to MOHs and partners on immunization data monitoring, reporting, and use at all levels in countries around the world. That experience includes the design of systems, ensuring country capacity buliding and ownership of tools and processes, and the adherence to global MIS standards to develop tools. In Tanzania and Zambia, JSI is leading implementation of an electronic logistics management information systems (eLMIS) which will be used in the management of over 800 commodities. GAVI can help support additional countries to adopt these tools, if they meet their requirements. 4. What mechanism is needed to ensure that investment decisions are transparent, fair and objective (insofar not driven by countries, for example desire to invest in the development of a new technology or training curriculum)? The entire spectrum of activities - from problem statement definition to design, development, implementation, to handover (for sustainable solutions) - will need to be revisited and costed. A five year total cost of ownership should also be established and funding should be equitably distributed across the various areas required for the successful deployment of a system. This is where guidance and the use of standards will be important, and JSI is well-equipped to support the GAVI Alliance on this. JSI Immunization Team (Anakew Tsega, Jeff Sanderson, Lora Shimp, Marasi Mwencha, Michel Othepa, Ousmane Dia, Rebecca Field, Robert Steinglass and Vanessa Richart)

Dear Colleagues, As we conclude this series of discussions on Data for Management in GAVI’s Immunization Supply Chain Strategy, we would like to thank this community for its thoughtful and insightful comments. The use of data in decision-making is inseparable from the people, technology, and systems that are involved in delivering the right vaccine, in the right quantity, in the right place, at the tight time, in the right condition, and at the right cost. In the area of data for management, guidance and standard creation must also be paired with information sharing about the landscape of tools and the total costs of ownership. Beyond efforts to develop global and national leadership, it will be important to leverage the potential of tools to be motivational and their role in capacity building. We can build from this initial framework to develop specific mechanisms to better enable and support countries in this mission to deliver vaccines that save children’s lives and protect the health of communities. We invite you to share any further thoughts on the discussion forum: http://www.technet-21.org/forums/default-topic/3263-gavi-immunization-supply-chain-strategy-data-for-management Thank you! Week 1 discussion: http://www.technet-21.org/forum/global-strategies/8437 Week 2 discussion: http://www.technet-21.org/forum/global-strategies/8441