Zambia improves real-time tracking of vaccines, reduces stock outs

In Zambia, spreadsheets, paper registries and phone calls were once the only way for staff in the Ministry of Health, based in the capital Lusaka, to know if district and provincial health facilities and warehouses had adequate supply of vaccines. Since none of the supply registries were connected to the national warehouse, reporting was never timely.

"It would often take days to reach someone on the phone and track-down each registry," said Guissimon Phiri, Chief Logistician for the Expanded Programme on Immunization (EPI) in the Zambian Ministry of Health. "By the time we received the registries they were already out-of-date and inaccurate."

A real-time, cost-saving solution

In search for a solution to track vaccines in real-time, the Zambian Ministry of Health and WHO decided to pilot a web-based logistic management information system in 34 facilities at the start of 2016.

Through the web and mobile phones, the system allows supply chain managers in the country’s national, district and provincial vaccine warehouses and stores to monitor vaccine stocks, use, and expirations minute-by-minute. The system also monitors the cold chain to ensure vaccines are kept at the correct temperature at all times.

"There is now more control in the system," says Phiri. "Whenever a vaccine is used, the system is automatically updated. We can see vaccine levels in all of the facilities, make quick decisions about how many vaccines to buy and with the click of the button place an order."

Back in the capital, the Ministry of Health staff can also log into the system and see when supply registries have not been updated. If significant time has passed since a facility registry has been updated, they can call the supply chain manager and ask them to improve their reporting. The Ministry of Health can also see who is ordering what and how much, which helps to hold health workers accountable for over- or under-stocking.

"Vaccines are becoming more expensive," says Abrahams Mwanamwenge, EPI Logistician WHO Zambia, who helped implement the system. "The system helps health facilities ensure the vaccines they have do not go unused."

Enables quick response for supply movement

The system is already proving essential for introducing new vaccines and implementing nationwide immunization campaigns. When the country switched from the trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in April 2016, the process was seamless. Supply chain managers could see how much tOPV stock they had in each facility and could easily replace it with bOPV.

Likewise, when more than 6 million children aged 9 months to 15 years were vaccinated during a nationwide measles and rubella campaign in September 2016, health workers could see when facilities were low on vaccines and were able to directly transfer vaccine to where they were needed most.

"Prior to the system, health facilities were not able to anticipate demand, which resulted in stock outs," says Mwanamwenge. "Now, they can see when vaccines are running short and pre-warn when stock outs are expected."

With additional funding from UNICEF, the system has now been scaled up to 115 facilities in every district in Zambia, each with at least one trained staff to manage it. As a result, nearly all facilities are reporting on-time each month to the Ministry of Health and nearly all are correctly stocked so vaccines do not go unused.

In the future, the Ministry of Health is looking to expand the system to see how it can be used for other essential medicines and tracking disease outbreaks.