Simplifying Vaccination Stock Management in The Gambia To Reach Every Child with Vaccines

A health worker providing immunisation services at Serrekunda Health Centre in The Gambia.

Today, almost 85% of children worldwide receive the vaccinations they need to protect themselves from diseases (WHO, 2018). However, in the last few years, the progress of expanding global immunisation coverage through global initiatives, like the Expanded Programme on Immunisation, has stagnated. (WHO, 2018). What about the 15% of children who do not receive the vaccinations they need? How can organizations, governments, and health clinics ensure that these children also receive the help they need? There are many ways to ensure that every child receives the vaccinations they need. One way is to simplify vaccination stock management for health workers.

It is truly important that stock management and request processes for vaccines are simple and accurate. Although it may sound uninteresting, these processes are important because they can either simplify or complicate a vaccination programme. Ideally, stock management processes should help health workers keep track of their vaccines and supplies stock. Keeping track of stock is necessary because it can help health clinics predict and decide how many vaccines and supplies to order each month.

Ordering vaccines is a tricky business. If a health clinic orders too many vaccines, they risk having to throw out expired vaccines. If a health clinic does not order enough vaccines, they risk having a stock out. This is where proper stock management comes into use . The more stock information health clinics have when preparing vaccine orders, the better chance the health clinics have at ordering the right amount of vaccines and supplies.

One of the major weaknesses in stock management systems is that calculations are done manually by health workers and are recorded in heavy ledgers. This is common practice in many health clinics and it is time-consuming and prone towards human error. Public Health Officer (PHO) Jainaba Sarr, at the Serrekunda Health Centre in Western Region 1 in The Gambia, explained what the health workers had to do in the manual process in stock management. Jainaba declared, “We had to do a daily summary of the children that we vaccinated and the vaccines that we used. After that we did a weekly summary and from the weekly summary we did a monthly summary, thereby calculating everything on our own.” Creating these summaries manually by health workers is time-consuming and decreases health counseling time with each child. The human error in these summaries also creates a weak determination of how many vaccines should be ordered at health clinics each month. The photograph below displays an example of how manual stock management systems can be inaccurate and prone towards human error.

Notes on how many vaccinations have been used scribbled on a piece of cardboard.

Shifo Foundation (Shifo) is an organisation that focuses on strengthening health management information systems including stock management systems. Shifo has put great effort into understanding current health processes in the countries they work with. This is so that Shifo and their partnering countries can find weaknesses within health processes and create solutions to improve them. Therefore, Shifo has included a stock management component to their own innovation called MyChild Solution based on Smart Paper Technology. MyChild Solution is a health management information system used by health clinics.

Some health workers in The Gambia are currently using MyChild Solution for stock management instead of the former manual process. When these health workers use MyChild Solution’s stock management system, they only have to report how many vaccinations and supplies they have at the beginning and at the end of each month. Then, MyChild Solution will use this information in combination with visit information to calculate the following:

1. The opening balance for the upcoming month.
2. How many doses were used during the month. This includes both doses given to children as well as doses that were wasted.
3. How many doses were administered to children.
4. The vaccine wastage rate of vaccines and supplies.

With MyChild Solution, health workers do not need to keep track of as many calculations as they did before with the manual stock management process. This is important because the risks for calculation errors are significantly smaller when using a digital system than with a manual system. Also, it saves time for health workers so that they can spend more time providing health services to children and their families. Health workers in The Gambia have affirmed that MyChild Solution saves them more time. Public Health Officer and nurse-in-charge at Serrekunda Health Centre Tida Darboe proclaimed, “We’re spending less time at the clinic than with the normal [manual] routine. Our vaccine stocks are monitored so we know the number of vaccines we have at the end of the month, and we know that we need to request a particular amount of vaccines for our clinic instead of calculating our stock”.

With MyChild Solution, health facilities can simplify vaccination and stock management systems. When health workers can reduce their time spent on stock management and increase time spent on children and their families, they have more capacity to give health care to every child. When there are appropriate stock levels of vaccines and supplies, key actors who are working to ensure every child is fully vaccinated will be one step closer to reaching this goal.

References

WHO. (2018). Immunization Coverage. Retrieved from http://www.who.int/news-room/fact-sheets/detail/immunization-coverage