Cost Analysis of Current Distribution Systems for Vaccines in Rwanda

Abstract

Background: Immunization program is one of the recognized and successful public health cost effective investment. Immunization supply chain management is among components of immunization program and is a program’s drive making vaccines delivery possible to reach every child even in hard to reach areas, though found to be static as the program is experiencing rapid changes with introduction of new vaccines. Rwanda immunization programme has been rating successful and the coverage reached 94.3% attributed to HR and capital investment from both Ministry of Health and its development partners. However, the way the current system is designed, requires the programme to avail a budget on annual basis dedicated to support vaccines delivery to lower levels. Current distribution system design does not contribute to self-financing of the programme in the long-run considering the mode and frequency applied. Assessing how much the programme would save if the system is re-designed by changing distribution mode and frequency is the purpose of the study.

Methods:

Financial documents were reviewed to determine the cost of the current vaccine distribution system and compare it with an estimated cost of a new distribution system with reduced frequencies between CVS and DVS.

Results:

The key drivers of the current distribution system are fuel, and per-diems for drivers and nurses during travels from their working places to CVS while the new distribution model are vehicle maintenance with reduced expenses on fuel and per-diems to optimization of route planning. The current vaccines distribution system is costly expensive as it requires DHS to always avail two staff, vehicles and time for vaccines pick-up while the new distribution model would only require efficient use of existing resources by changing the distribution model and frequencies. From the costs comparison, applying the new distribution model with reduced frequencies the current distribution costs would decrease at 37%. onclusion:

The study findings have confirmed a huge opportunity of getting the current distribution costs reduced when the distribution is redesigned from pull to push and frequency from twelve to four per year. It was discovered that the programme would save 37% of the current distribution costs once the system is redesigned.