Transforming inventory management to improve Kenya's vaccine program

by Dr. Joyce Charo, DVI, Kenya and Dr. Anthony Ngatia, CHAI A web-based stock management tool has just been deployed in five regional stores across Kenya. The goal is to ensure the availability of vaccines by reducing stockouts and improving vaccine program performance. Dr. Joyce Charo from the Division of Vaccines and Immunisation (DVI) in the Kenyan Ministry of Health and Dr. Anthony Ngatia from the Clinton Health Access Initiative (CHAI) provide an update. In February 2011, Kenya became the first country in Africa to introduce the 10-valent pneumococcal conjugate vaccine (PCV10). Demand for the new vaccine was unprecedented, with the ministry of health reporting stockouts in a number of facilities. This highlighted weaknesses in the existing paper-based stock management system which was unable to provide up-to-date information on stock levels that may have prevented such stockouts. “We have very limited visibility of vaccine stock once it leaves the national store,” said one central vaccine store officer. In response to these challenges, the DVI is working with CHAI to transform the way vaccine stock is managed. A major part of this initiative is the development and implementation of a web-based stock management tool (SMT) that will provide DVI staff with the ability to manage vaccine stock from national to health facility level in real time, greatly reducing the likelihood of stockouts. Applying previous experience of developing a web-based tool for the ministry of health to improve early infant diagnosis of HIV, CHAI assembled a team from Kenya’s Strathmore University to develop the SMT. From the outset, CHAI staff and the Strathmore team worked closely with DVI logistics officers and stock clerks to understand their needs. The SMT has been designed as a holistic platform for vaccine program performance management, enabling managers at all levels to manage stock and monitor the supply chain. Simple interfaces enable staff at the national, regional, and (eventually) district level to input issuances and receipts of vaccine stocks. The tool uses population and target coverage data to automatically generate warnings when stock levels fall below the levels required to meet forecasted demand. Reports are automatically generated and sent monthly via email to Expanded Programme on Immunization (EPI) managers to ensure that stock records are up to date. The tool also includes a mapping application to visually depict stock levels at each store. The SMT was implemented at the national level in October 2011 and has now been implemented in five regional stores, with rollout to the three remaining regional stores expected by the end of July 2012. The main district stores in each of the 47 counties are expected to begin using the tool by the end of 2012. The response from users has been positive. “This tool has made work much easier. We can now aggregate our monthly reports at the touch of a button,” said one Kisumu store clerk. The monthly stock status email sent to senior managers has also been well received and has led to a request by EPI managers that such regular alerts are maintained. The EPI has also suggested new features, such as the use of specific information and data from the tool to compile monthly stock status report requests by WHO and UNICEF. The DVI has committed to cover Internet connection costs at regional stores after CHAI’s initial three-month support expires. A significant challenge has been the requirement for DVI staff to keep paper-based stock records, in line with ministry of health auditing policy. These records are used to update the SMT and can be a laborious activity. While the utility of both systems is acknowledged, the expectation is that the SMT will be viewed as complementary to the paper-based records. Although the SMT will enable a change in vaccine program performance, it must go hand in hand with a change in thinking about stock inventory management. The development of the SMT has sparked thinking in Kenya about how it can provide a broader platform for the national immunization program. Following a cold chain inventory conducted in 2011, there is an opportunity to add a module to the SMT to update cold chain equipment inventories and monitor cold chain capacity and equipment performance. Most significantly, the platform could be used to bring together stock, cold chain, and coverage data by interfacing directly with the District Health Information System for a more holistic analysis of program performance. This approach could help to eliminate stockouts by revising forecasts based on previous months’ consumption, identifying opportunities to optimize allocation of supplies, generating new insights into wastage, and ensuring optimal selection and utilization of appropriate equipment at each site. For more information on the SMT, please contact [[email protected]]Dr. Joyce Charo[/email] or [[email protected]]Dr. Anthony Ngatia[/email]. To comment, make sure you are logged in and click Reply.