By Dr. Manish Pant, Chief, Health and Governance Unit, UNDP India, delivered at the Global Forum 2020 Medical Devices and Safety session.

1. GLOBAL FORUM 2020
3 R D S A V I N G L I V E S S U S T A I N A B L Y:
SUSTAINABLE PRODUCTION IN THE HEALTH
SECTOR GLOBAL FORUM|2020 RIYADH
Dr. Manish Pant
Chief, Health and
Governance Unit
UNDP India
Transforming the Vaccine
Supply Chain in India

2. Transforming the vaccine supply chain in India
Dr Manish Pant
Chief, Health & Governance
UNDP India
A Government of India Initiative

3. Program Scope
Challenges
Solution
eVIN SYSTEM

4. India Has World’s Largest Immunization Programme
~27,000
vaccine storage points
(95% sub-district)
~78M
<5 years of age children
every year for immunization
>650M
doses procured every year
65%
full immunization coverage*
~26M
newborns every year for
immunization
~29M
pregnancies every year for
immunization
*according to UNICEF CES 2017
>12M
immunization sessions held every year

5. Vaccine Supply Chain Management Challenges
A Complex Six-Level Vaccine Supply Chain
Lack of
real-time
visibility
No visibility of
storage
temperatures
Short shelf life,
long supply chain
Non-standard
record-keeping
Mismatch in
demand and
supply
1
2
3 5
National store/
Manufacturer
State Store
Divisional
Store
District
Store
Taluk/Block PHC/CHC
Limited
infrastructure
Lack of
transparency

6. Barriers To Digitizing Vaccine Supply Chain
Poor/ Erratic
Electricity Supply
Unavailability of
‘Functional’
Computer
Unavailability of
Data Entry
Operator
Low Internet
Access
Vaccines work when
vaccine supply chains do
The eVIN
solution uses
smartphone
technology ,
to digitize the
entire vaccine
supply chain

7. 3 CRITICAL QUESTIONS
Where are
my vaccines?
Are they
stored in
adequate
quantities?
Are they
stored at
recommended
temperatures?

8. END TO END SOLUTION
eVIN SYSTEM
• Human Resource
• Technology
• Operational Protocols

9. The eVIN System
Digital-cloud based platform for real-time
visibility of vaccine stocks and consumption
patterns
Human resource at every district for support
and supervision
Standard operating procedures to streamline
vaccine supply chain
Replicable, Scalable, Customizable

10. Digital Platform
Smartphone App Online Dashboard Temperature Logger
Easy-to-use mobile app
for recording vaccine data
Web interface for
real-time visibility
Temperature loggers for accurate
remote
temperature monitoring in real time

11. How It Works
eVIN Cloud Server
MYeVIN
App
eVIN DashboardTemperature Logger
eVIN Mobile App
Health worker enters:
- issues
- receipts
- stock counts
- discards
- orders
Health worker/ manager gets:
- real-time stock views
- alerts on low stock/expiry
- optimal order recommendations
- delivery status
- temperature alarms
- SOP reminders
- general announcements

12. Strong Human Resource Network
National team
State Team
Regional Officers
District Managers
Continuous feedback for health workers and officials in the network

13. Big data architecture gives actionable analytics for efficient supply management
Enables optimal decisions to ensure stock distribution & availability
Temperature
sensors
National MoHFW
Central stores
State/Regional Stores
District Stores
Primary Health Centers
eVIN
Support
Connecting First Through The Last Mile – In Real Time

14. Visualizing Vaccine Flow Network
Digitizing Standard Operating Procedures for Vaccine Stock Management
Jaipur SVS Udaipur SVS
Jaipur RVS
Bharatpur
RVS
Kota RVS Ajmer RVS Bikaner RVS
Jodhpur
RVS
Udaipur
RVS
Alwar DVS Bharatpur DVS Baran DVS Ajmer DVS Bikaner DVS Barmer DVS Jalor DVS Rajsamand DVS Banswara DVS
93CCPs 59CCPs 49CCPs 87CCPs 67CCPs 86CCPs 65CCPs 49CCPs 59CCPs
1990SSs 614SSs 850SSs 1577SSs 1218SSs 1827SSs 1115SSs 767SSs 1468SSs
Dausa DVS Dholpur DVS Bundi DVS Bhilwara DVS Churu DVS Jaisalmer DVS Pali DVS Chittorgrh DVS
37CCPs 22CCPs 39CCPs 91CCPs 84CCPs 28CCPs 95CCPs 61CCPs
528SSs 587SSs 535SSs 2219SSs 1112SSs 518SSs 1728SSs 1439SSs
Jaipur I DVS Karauli DVS Jhalawar DVS Nagour DVS Ganganager DVS Jodhpur DVS Sirohi DVS Dungarpur DVS
110CCPs 34CCPs 43CCPs 120CCPs 57CCPs 109CCPs 30CCPs 56CCPs
1585SSs 930SSs 1197SSs 1994SSs 979SSs 1558SSs 503SSs 675SSs
Jaipur II
Sawai
Madhopur DVS
Kota DVS Tonk DVS
Hanumangarh
DVS
Pratapgarh
DVS
55CCPs 32CCPs 53CCPs 57CCPs 54CCPs 32CCPs
1138SSs 307SSs 1054 561SSs 942SSs 985SSs
Jhunjhunu DVS Udaipur DVS
88CCPs 106CCPs
1319SSs 2096SSs
Sikar DVS
81CCPs
1281SSs

16. Enhanced Accountability & Transparency
Real Time dashboard and analytics at every level
Latest Stock Position Storage Temperature TrackingGeo-Mapped Health Centers
District Maps Facility level
dashboard

17. Monitoring
Pipeline Impacts
Cost Savings
TRANSFORMING THE VACCINE SUPPLY CHAIN

18. Critical indicators
Good Performance
Indicators
Expiry date and
other alerts
eVIN Monitor Board

19. >90% VACCINE AVAILABILITY AT ALL CCP 80% REDUCTION IN STOCK OUTS
eVIN Impact on Vaccine Supply Chain

20. Lesser procurement
Lower handlingcosts
Lower probability of expiry
Lower probability of temperature excursion
Less cold chain capacity needed
Reducedpipeline stock
By minimizing the time duration thatvaccines spendin the pipeline
eVIN Saves Costs for Government
For every 1 Rupee invested on eVIN, the Government is currently saving 2.93 Rupees: MoHFW Report
eVIN saves money and pays off for itself

21. ADDRESSING HEALTH SYSTEM CHALLENGES
Governance
Workforce
Supply Chains
Financing
Health Information Systems

22. Interaction of eVIN with Health System Elements
Health System
Financing
eVIN Financing
Govt budget
Health Supply
Chains
• Forecasting
• Procurement
• Distribution
Health Information
Systems
eVIN Data
Coverage, Quality, Efficiency, Equity
Population - Beneficiaries
Health Systems Governance
Health Workforce – Trained Vaccine Managers
Adapted from: Prashant Yadav. http://dx.doi.org/10.4161/23288604.2014.968005

23. HEALTH SYSTEM CHALLENGE
Accountability
CHALLENGE
• Poor stock visibility
• Fragmented accountability for poor
stock management
• No clear role definition between State
– District – Health centers on
governance and responsibility
• Last mile health worker often held
responsible for stock out
eVIN IMPACT
• Real time dashboard at all levels
• Discrepancy reports available on stock
management for remedial actions

24. HEALTH SYSTEM CHALLENGE
Long Procurement & Short Consumption Times
CHALLENGE
• Maintain a functioning vaccine
pipeline at all times
• Procurement delays need to be
factored
• Vaccines have short shelf life – 12
months – consumption tracking
needed
eVIN IMPACT
• Provides consumptions data –
aggregated for optimized national
indents
• Predictive analytics - information on
expiry dates before time

25. HEALTH SYSTEM CHALLENGE
Multi Level Vaccine Supply Chain
CHALLENGE
• 5 levels of vaccine storage points from
National to Last mile health center
• Stock requirement calculated for
every level based on population
• Long lead times for distribution
• Small variations in demand at last mile
leads to large variations in
procurement order at national level-
BULL WHIP EFFECT
eVIN IMPACT
• Optimized vaccine inventory pipeline
management is now possible
• Moving to consumption-based
procurement and distribution of
vaccine across all levels
• Lower level demands can now be
predicted using big-data analytics
algorithms in eVIN

26. HEALTH SYSTEM CHALLENGE
Lack of HR Capacity and Incentives
CHALLENGE
• Last mile vaccine handlers are usually
midwives or other workers with no
skills on vaccine stock management
• Vaccine stock management is not
incentivized - no clear goals and
outputs
• No back up support to store-managers
eVIN IMPACT
• District level vaccine manager is part
of eVIN– support system
• S/he is critical for supporting all
vaccine handlers in the district and
ensuring efficient distribution of
vaccines
• Online trouble shooting system in
place to resolve field queries
• Provision of mobile is big incentive to
vaccine handlers at last-mile

27. eVIN contributes to Sustainable Development Goals
Connecting with SDGs

28. eVIN contributes to an improved
vaccination coverage thereby reducing
morbidity and mortality due to vaccine
preventable diseases, ensuring a
healthy future for all.
eVIN will empower over 50,000 last mile
healthcare workers and vaccine handlers
in India, more than 60% of them being
women, by introducing them to digital
technology for vaccine management.
Connecting with SDGs

29. eVIN ensures equitable and
efficient distribution of vaccines
to make sure that no child is left
behind from an equal chance of a
healthy life.
eVIN strengthens health systems
by streamlining processes and
providing real-time data on
vaccine logistics for informed
decision-making.
eVIN collaborates and coordinates
with the government, donors and
partner agencies; building
stronger partnerships for common
goals.
Connecting with SDGs

30. Leveraging eVIN Learnings Across Sectors – Scaling up Digital Solutions
HealthAgriculture and
fisheries
EducationRural
development
Digital payments
and transfers
Supply management
system
Digitize systems and supply chains
Improve Efficiency
Improve Governance
Build data base for informed decision-making
Link multiple services through a single integrated platform
holds expertise in:
Procuring commodities and drugs
(Global Fund Programme)
Sustainable Procurement Systems
System Strengthening in various sectors

31. GLOBAL FORUM 2020
THANK YOU
#eVINIndia
www.in.undp.org/ev
in