Impact of adding cold chain capacity on vaccination coverage and vaccine wastage

Background

Vaccines, effective in reducing infant mortality and protecting children against harmful diseases, require dependable and resilient last-mile delivery mechanisms. Maintaining adequate temperatures (cold chain) during transit and storage is essential to ensure the efficacy of the vaccine. In island nations such as Fiji, among other emerging countries, issues such as extreme weather events and unreliable power supply cause disruptions in cold chain, leading to vaccine wastage, poor coverage and lack of timeliness. Even ice-based carriers cannot maintain constant temperatures for long durations, making it difficult to transport vaccines to remote communities. Fiji is piloting the deployment of a vaccine carrier, Emovolio, an advanced temperature-controlled vaccine carrier developed by Blackfrog, to address the challenges of proper vaccine storage and transport.

About the Study

The study involves collecting qualitative and quantitative data from the field during pilot deployment to understand the performance, user acceptability, and impact of Emvolio. Our research aims to answer the following questions:

• What was the impact of extending cold storage capacity to the last mile on vaccination coverage?
• What was the impact of extending cold storage capacity to the last mile on vaccine wastage?
• What is the impact of extending cold chain storage capacity to the last mile on work processes and inventory replenishment policies? (assuming Emvolio will impact these processes)

Methodology

We plan to integrate the data captured by the devices during their use, program records maintained by the Ministry of Health and Medical Services (MHMS), primary data collected by the healthcare workers /implementation partners on vaccine wastage, and survey of healthcare workers involved in vaccination program. Using this data, we intend to an analysis of the impact on vaccination coverage (through randomized or quasi-experimental comparisons) and vaccination wastage (using operational data and Difference-in-Differences where possible).

Intended Outcome

This study aims to provide policymakers with insights on how investments in last-mile vaccine delivery can reduce wastage and improve immunization coverage in remote regions.