Professional Documents
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By
Student No:
067709
Abstract
The Division of Vaccine and Immunization is facing increasing difficulty monitoring vaccines
and other commodities distribution once they have been distributed from the national stores.
With the introduction of new vaccines, more challenges have been anticipated with this
additions posing serious threat to the already over strained vaccine supply chain system in
Kenya. Access to these vaccines will have surpassed the current ability of the existing supply
and logistic system to distribute, track and store the vaccines at proper temperatures, condition
and quality and ensure they reach their destinations in a timely manner.
This paper is a system documentation for the development of Vaccine Stock Management Tool
for the Division of Vaccine and Immunization of Kenya. The study was conducted to research,
study and review existing literature and systems architecture for vaccine stock supply
management and studied the existing vaccine supply management system in use in Kenya. This
revealed the current inefficiencies in vaccine supply and stock management within the Division
of Vaccine and Immunization department in the Ministry of Health. The result of the study
were the design and implementation of a vaccine stock management tool that would address
the frequent levels of stock outs in the country by introducing a system based on a push or
requisition model rather than the push or allocation approach currently been used.
To achieve this, a web-based vaccine stock management tool was developed following the agile
methodology. The developed solution is an implementation of a vaccine supply chain and cold
chain management system that ensures efficient and effective vaccine delivery and that enable
better and timely decision-making. Availability of quality, real time data on vaccine supply and
demand at the national, regional, and lower levels would be critical to supporting improved
efficiencies in how vaccines are managed in Kenya.
ii
Declaration
I hereby affirm that this system documentation document is duly my original work and
therefore has not been submitted in any institution for the satisfaction of any academic award.
Date: ________________________
Date: ________________________
iii
Table of Contents
Abstract ......................................................................................................................................ii
Declaration ............................................................................................................................... iii
Table of Contents ...................................................................................................................... iv
List of Figures ......................................................................................................................vii
List of Tables ...................................................................................................................... viii
Abbreviations ........................................................................................................................ ix
1
1.2
1.3
1.4
1.5
Justification ............................................................................................................... 13
1.6
Scope ......................................................................................................................... 14
Introduction ............................................................................................................... 15
2.2
2.3
2.4
2.5
2.6
2.6.1
Online drug inventory & supply chain management system of Haryana .......... 20
2.7
2.8
2.9
Introduction ............................................................................................................... 24
3.2
3.3
3.3.1
Observation ........................................................................................................ 25
3.3.2
Interview ............................................................................................................ 25
3.3.3
3.4
3.5
Deliverables ............................................................................................................... 27
iv
3.5.1
3.6
4
Conclusion................................................................................................................. 27
Introduction ............................................................................................................... 28
4.2
4.2.1
4.2.2
4.3
4.3.1
4.3.2
4.3.3
4.3.4
4.4
4.4.1
5
High Level Architecture for the Vaccine Stock Management Tool .................. 38
Introduction ............................................................................................................... 39
5.2
5.3
5.3.1
Tasks .................................................................................................................. 40
5.3.2
5.3.3
5.3.4
5.4
Testing ....................................................................................................................... 43
5.4.1
5.4.2
5.4.3
5.5
6
Conclusions ............................................................................................................... 46
6.2
Recommendations ..................................................................................................... 47
6.3
References ........................................................................................................................ 48
APPENDICES .................................................................................................................. 50
8.1
8.2
8.3
8.4
vi
List of Figures
Figure 2-1: The current vaccine supply chain structure........................................................... 18
Figure 2-2: Procurement model for the system (Verma, 2014) ............................................... 20
Figure 3-1: Conceptual Research Design ................................................................................ 24
Figure 3-2: Agile system development methodology (Elezovic, E., 2012) ............................. 26
Figure 4-1: Entity relationship diagram ................................................................................... 30
Figure 4-2: Managing the Sub-County Module ....................................................................... 31
Figure 4-3: Managing the National Module ............................................................................ 32
Figure 4-4: Class Diagram ....................................................................................................... 36
Figure 4-5: Database Schema .................................................................................................. 37
Figure 4-6: Technology Stack .................................................................................................. 38
Figure 5-1: Manage stock Module ........................................................................................... 41
Figure 5-2: Cold Chain Module ............................................................................................... 42
Figure 8-1: Cold Chain room ................................................................................................... 50
Figure 8-2: Login Page ............................................................................................................ 51
Figure 8-3: Sample Admin Dashboard .................................................................................... 51
Figure 8-4: Manage Stock Module .......................................................................................... 52
Figure 8-5: Document Manager Module ................................................................................. 52
Figure 8-6: Cold Chain Management Module ......................................................................... 53
Figure 8-7: Reports Module ..................................................................................................... 53
Figure 8-8: Admin System Configuration Module .................................................................. 54
Figure 8-9: Failed Login .......................................................................................................... 54
Figure 8-10: Unauthorized Access Error ................................................................................. 55
Figure 8-11: Part of the research team during the Central Vaccine Store site visit ................. 57
vii
List of Tables
Table 4-1: Use Cases List ........................................................................................................ 32
Table 4-2: Sub county Use Case .............................................................................................. 33
Table 4-3: Managing the National Module .............................................................................. 34
Table 5-1: Browser Compatibility tests ................................................................................... 44
viii
Abbreviations
CHAI
DVI
EPI
GAVI
GUI
IPV
MDG
MoH
Ministry of Health
RFID
ROTA
Rotavirus vaccine
UI
User Interface
WHO
ix
10
vaccines hinges on the ability of the already strained vaccine supply and logistic systems in
this countries.
In Kenya, the new vaccine landscape has been increasing with the Rotavirus vaccine introduced
in July 2014 and there are plans to introduce Inactivated Polio Vaccine, Human papilloma
Virus, Measles Rubella and switch to Bivalent oral polio vaccine (Chopra & Meindle, 2009).
The Rotavirus vaccine uptake was variable with slow uptake in some counties and rapid uptake
in other counties in terms of time and uptake. This was due to the existing inefficiencies in the
current supply system threatening the vaccine accessibility, quality and availability. With the
higher cost of these new vaccines, such programs are under considerable pressure to increase
performance through improved forecasting, wastage minimization and implementing efficient
vaccine management systems. Supply and logistic innovations are urgently needed to address
the current supply system bottlenecks.
The main challenge is difficulty in monitoring vaccines from the moment they leave the
national and regional stores. In the current system, this is almost impossible as keeping track
of how the vaccines are being used is a Herculean task. Kenyas spending on vaccines is set to
grow from $14 million annually to $53 million due to the introduction of the diarrhoea vaccine
and a medically beneficial polio vaccine (Mvundura et al, 2015). This calls for an automated
and more sensitive system that provides increased visibility and analysis of vaccine stock data,
consumption data, and interventions that are possible with current resources at levels. Currently
this is done in excel based tools, already shared with national.
Another challenge faced is the concern about the security and potency of these vaccines. It is
difficult to uniquely identify vaccines. There is also lack of visibility on the working conditions
of cold chain equipment. This is at the sub-county and the health facility levels. There is need
to design a system that assures users of the originality and potency of vaccines through the use
of batch numbers. Also, decisions made by users in different levels of the system need to be
tracked.
It is against this background that the problem statement addressed in the current study was
formulated.
11
1.5 Justification
With the current system, there are great challenges faced by its users, and with the government
set to introduce more vaccines, tracking vaccine stocks will be a Herculean task. However,
with the new developed system, this is made much easier. The major beneficiaries is the
government under the Ministry of Health. The government has time and time again had to go
through financial strain in order to buy vaccines which are left unaccounted for. With the new
system, the government is able to have an updated and accurate inventory.
Other beneficiaries of this system are the various users at the county and sub-county levels,
who make orders and have to wait; not knowing what time the stock will be brought to their
depots. This created lots of uncertainties, resulting in cases of inadequate stock in the depots,
in case the stocks fail to arrive in time. With the new system, they are able to get prompt
messages once their orders are approved, and in the case of rejection be provided with an
opportunity to reorder.
Also, administrators at different levels are able to keep count of their cold chain systems in a
much efficient way, and also keep track of the systems users. Currently, this is quite difficult
with some of the users having provided details in the wrong format e.g. a user putting a random
word in place of his/ her phone number.
13
1.6 Scope
The developed system is a web-based application going to be used by the Division of Vaccines
and Immunization Kenya. This system covers national, regional, county and sub-county levels
of the country. However, the system at the moment is not able to cover the health facilities at
the grass-root level. This means that the user at the sub-county level have to go to the health
facilities and get information of the vaccines needed and the quantity required. The user at the
sub-county level then place an order to the county depot on the vaccines needed.
The user at the county level then assess the order placed, and either approves or rejects. After
approval, the user at the sub-county level receives a prompt message to inform him of that.
However, if the order gets rejected, the user is prompted with a message giving the reasons the
order was rejected, and be able to reorder. Reports are generated to act as proof of any
transaction that goes through the system. Currently, these functionalities are not in existing
system.
With the information collected by the system on matters such as dates in which vaccines are
ordered and the quantity ordered, the system provides crucial information to be used for
analysis purposes. Therefore, forecasts are easily made so as to make early arrangements to
avoid any future crisis.
On managing cold chain systems, the system has an inventory detailing all the systems
uniquely. This provides an opportunity to easily track any missing systems, and easily detect
malfunctions. At the moment, the system only has records of the cold chain systems but has
not uniquely identified them.
14
Introduction
This chapter reviews published information, trends and guidelines in vaccine supply chain and
cold chain systems.
15
expired and is also able to forecast which vaccines need to be reordered. An inspection and
update on vaccine stocks is done on a weekly basis.
In Cold Chain Management, vaccines are kept in a temperature-controlled environment so as
to be distributed in optimal conditions. The temperature of the storage units is also monitored
regularly to ensure that the appropriate conditions are maintained. This is because extreme
temperature conditions affect the vaccines thus reducing their potency.
In Africa, various countries, including Kenya have embraced similar systems to manage their
vaccines. According to a research carried out by the World Health Organization in Kenya,
Moldova, North Korea and other countries showed that approximately 50% of all vaccine doses
are wasted either before or after leaving the stores (Zaffran, 2013). This can be attributed to
supply chain management issues such as accidental freezing, expiry, breakage and even theft.
This poses a major challenge in economical circles since a lot of money is used to compensate
for these loses. In Kenya, the Division of Vaccines and Immunization has a system put in place
whose functions are to ensure vaccine stocks are well managed and monitored. (Ministry of
Public Health and Sanitation, 2013) This system however has a few challenges that need to be
rectified.
First, the system is only usable at the regional level. With the introduction of the new
constitution, a total of 47 counties were made. The system should be able to provide users as
far as the sub-county levels place their orders. This is done after the users at the sub-county
levels have received estimates on the number of vaccine stocks needed at the health facilities
in their respective counties. A situation analysis done by the Division of Vaccines and
Immunization identified that its programme was facing several setbacks.
One of these challenges is inadequacy or late disbursement of finances for procurement of
vaccines. This can be hugely attributed to the current system's inability to perform forecasts
and predict what vaccine stock will be required where and when. Another problem encountered
is vaccine stock outs at the depots. This can be attributed to late distribution from the national
depot. (Ministry of Public Health and Sanitation, 2013) Keenly monitoring the flow of vaccine
stocks right from the national depot, referred to as the central vaccine depot, will greatly boost
transparency and accountability.
division has a series of stores which vaccines are stored in refrigerators and have a distribution
network which utilizes cold boxes.
With the introduction of new beneficial vaccines (ROTA and IPV), the country is bound to
experience significant strain on an already overloaded vaccine supply and logistics systems. It
follows that we can easily resolve part of the challenge by; implementing supply systems that
support efficient and effective vaccine delivery and that enable better and timely decisionmaking. This means there is more need than ever to have a robust system than while ensuring
effectiveness provides increased accountability and traceability.
The current stock outs about 56% in all facilities affect over 200,000 children monthly, with
immunization drop out as large as 25%, we are risking loss of lives for over 50,000 children
(CHAI Documents, 2015). We can save lives all these children by streamlining vaccine
delivery, through technology as part of other interventions.
There has been increased concerns about security and potency of vaccines, in Kenya. There
currently exists little information on the working status of the cold chain at sub-county stores
and health facilities, and their capacity to store vaccines. There is need to build a system that
ensure verifiability of vaccines against batch numbers, to allow retrieving vaccines, so as not
to harm our children.
With the decentralization health there is need for relegation of decision making from National
to County Level, this decision making needs to be evidence based. A vaccine information
system will provide the necessary information for these actions.
Availability of quality, real time data on vaccine supply and demand at the national, regional,
and lower levels would be critical to supporting improved efficiencies in how vaccines are
managed.
17
DVI calculates required vaccine quantities for each region and distributes to the region stores
(Figure 1). The counties and sub counties levels the submit stock order to their respective
regional stores
d) Use of the push system as opposed to the recommended pull system is causing over or
under stocking of vaccines in some facilities as it is not based on individual
performance
e) Unreliable minimum and maximum stock levels as they were not related to facility
coverage data
f) Vaccine wastage not included and factored in vaccine forecasts
19
Maximum stock level is set to guard against oversupply, it consists of the minimum stock plus
that amount of stock which is normally used between orders
The system prevalent challenges at that time was fraught with errors and there was no control
on critical issues like alerts on expiry medicine, supply of medicine by vendors, whether drugs
20
have reached the reordering level etc. The system led to lots of time wastage and requires
continuous monitoring to ensure that each transaction is accounted for and makes inventory
record keeping a more cumbersome process for the operator. Not more than one person was
able to access data at the same time unless they keep multiple copies of reports and the resultant
paper work takes lot of space and often searching the relevant information becomes a tedious
exercise.
The cold chain must never be broken. Vaccines are sensitive to heat and extreme cold and must
be kept at the correct temperature at all times.
Health workers at all levels are often responsible for maintaining the cold chain while vaccines
are stored in the vaccine stores at the province and county levels, or while they are being
transported to township and villages, and while they are being used during immunization
sessions or rounds. More and more often it is becoming the logisticians responsibility to
manage the cold chain as a part of the supply chain (Logcluster, 2004).
The need to monitor cold chain systems arises because they suffer weaknesses which include:
a) Loss of vaccines from accidental freezing
b) Inaccuracy in that for most cold chain applications, a sensor accuracy of 0.5 C or
better is expected.
22
Flexible, adaptable, and compatible with different contexts, programs, and changes over time
as needs evolve.
Driven by the needs of end-users, managers, planners, recipients of health services, and other
stakeholders.
Affordable and sustainable so decision-makers can evaluate the wider cost implications of
adopting an information system across the health system.
Reliable and secure from unauthorized use.
Built upon a consistent design framework with standards, common data, common software
applications, and technologies that are properly supported by clear design and user
documentation.
Designed and used for evidence-based decision-making.
23
24
25
The system development methodology aims to produce a high quality software that meets
customer expectations, reaches completion within times and cost estimates. It contains
definitions, guidelines, and templates for the various project management activities needed to
deliver successful projects.
The vaccine stock management tool was developed following the agile methodology approach
to achieve its intended objectives. This helped the development team keep focus on process
adaptability and customer satisfaction by rapid delivery of working software product in
iterative builds.
The agile methodology was used because:
a) Functionality could be developed rapidly and demonstrated.
b) Suitable for fixed or changing system requirements
c) Enabled concurrent development and delivery within an overall planned context.
d) Promoted teamwork and cross training.
e) Resource requirements were minimum.
f) Delivered early partial working solutions.
26
Client interaction is the backbone of Agile methodology, and open communication with
minimum documentation are the typical features of Agile development environment. This
worked well for us as we were having regular meetings with the project co-ordinators from the
Clinton Health Access Initiative offices.
3.5 Deliverables
The following are the expected deliverables of the system:
a) Fully functioning stock management system
b) System documentation
c) System user manual
3.5.1 System Modules
The tool was design in a modular approach with different users been assigned different roles
and permission to different modules. The vaccine stock management tools modules to be
delivered in this project include but not limited to:
a) Manage stock
b) Cold Chain
c) Reports
d) Documents
e) Configurations
3.6 Conclusion
In this chapter, the research methods selected for the research were discussed. This research
primarily uses document analysis, interview and observation for facts finding purposes. The
systems development methodology selected is agile methodology as it offers numerous
benefits which are well suited for rapid development web-based applications. There was also
a review of the deliverables that were aimed at in the conducting of this research.
27
28
b) Users with basic computer skills should be able to use the new system and the system
should be robust.
c) The system should be mobile responsive and run well on any screen size. The rollout
plan targets to issue out tablets to all system users.
d) Non authorised users should be denied access to the system. All system data should be
secured at all times (See Appendix B).
29
30
31
Use Case ID
Primary Actor
UC 1
UC 2
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4.3.2.2
UC 1
Name:
Created By:
Date Created:
Actors:
Description:
This Use Case describes the process by which vaccines stocks are supplied and
distributed at the Sub County level. It also sets up a stock ledger platform for
inventory management at the Sub County level
Trigger:
Preconditions:
Postconditions: 1. Sub County meets the vaccines demand from the Heath facilities
2. Sub County managers maintain accurate vaccine stocks records for planning
and forecasting.
Normal Flow:
10. Sub County manager pulls vaccine immunization reports and information
from the DHIS
Alternative
2a. In step 2 of the normal flow, if the Sub County is in a County that has a depot
Flows:
1. System will prompt Sub County manager to place the order to the County
depot manager
[Alternative
Flow
County
own depot]
4b. In step 2 of the normal flow, if the Sub County is in a County that has a depot
1. System will prompt Sub County manager to place the order to the County
depot manager
2. Sub County manager declines
3. Order is placed to the Region Depot manager
4. Use Case resumes on step 3 of normal flow
Exceptions:
2a. In step 5 of the normal flow, if the consignment are discover to have quality
and/or quantity discrepancies
1. Sub County manager reports the issue
2. Order is rejected and returned to the Regional Depot
3. Regional Depot updates his/her stock information
4. Use Case resumes on step 7 of normal flow]
UC 2
Name:
Created By:
Date Created:
Actors:
1. National Manager
34
2. Regional Manager
Description:
This Use Case describes the process by which vaccines are purchased from world
vaccines distributors and donors to serve the country demands. It also sets up a
stock ledger platform for inventory management at the National level
Trigger:
Preconditions:
Postconditions: 1.
2. Sub County managers maintain accurate vaccine stocks records for planning
and forecasting.
Normal Flow:
inventories
4. National Manager receives vaccines order from the Regions
5. National Manager issues vaccines against the order from Regions
35
36
37
38
39
5.3.1 Tasks
Based on the magnitude and timelines applicable to the undertaking of the project, we were
inclined towards an agile methodology approach. This was beneficial to both the clients
coordinators (Clinton Health Access Initiative Team) and the final system users. We had the
initial meeting were the tasks and requirements were handed over to the team tasked with the
development of the task. The successive meeting were all about refining the problem statement
and reviewing the system requirements.
requirements we had already been brief on. The technology stack decisions were informed
based on security, scalability and robustness of the system during the roll out.
With an always growing list of user requirements as is case with most large projects, agile
methodology helped us maintain a list of product backlogs. The list was managed on a feature
priority basis that saw the first prototype shipped with the most basic and essential features.
There was always a review and testing done upon each release. We could build on the feedback
and keep updating the product backlogs. Then we could work on the next build, this
incremental approach saw the product get better and better with each release and a reducing
item list on the project backlog list
A basic stock management system was first implemented and after being tested and debugged
the other features and functionalities were added to the system. Every feature was individually
tested and in conjunction with the rest of the system. We followed a more pragmatic
programming techniques where all system component were highly modularised and tightly
coupled, thus they could be removed from the system and test ran on them extensively.
The components were built on each other as subsystems until a vaccine stock management tool
was produced, which matched the specification. The subsystem were divided as per modules.
The main modules in this project included:
a) Stock management module
b) Cold chain management module
c) User management and authentication module
d) Document management module
e) Database and data objects management module
40
41
5.3.1.3 Reports
This interface displays the various reports that can be generated from the system based on the
users designations. (See Appendix B)
5.3.1.4 Documents
This interface displays the various documents, newsletters and communications that can be
downloaded from the system based on the users designations. (See Appendix B)
5.3.1.5 Configurations
This can only be accessed by the administrators at the national level currently. This modules is
responsible in major system customization settings and user management functions. (See
Appendix B)
42
Certain basic features re-used as there were many available open source PHP vaccine inventory
management systems.
5.3.3 End of Phase One and Piloting
The completion of phase one was announced on 18th February 2016, with plans to roll out the
first phase of the system in the national central vaccines store and regional vaccine stores set
out for discussions with the people in the Ministry of Health. This stage is to serve as a further
testing and review on a wider scale function. We plan to continue building up the system till
the problem statement is well addressed.
5.3.4 Features not Implemented
A number of features of the vaccine stock management tool were not implemented as on the
submission of this document because of time constraints. Most of the reporting module is yet
to be built as we are still in discussions on the types of report to be generated by the system
with a keen concern of the system latency and utilization.
The remote temperature monitoring was also not implemented because of lack of time and
limited documentation on using a machine sensors data logs with the procured thermometers.
I will however be implementing this in the next build that will be released with the current
feedback and product backlogs.
5.4 Testing
The vaccine stock management tool was tested throughout its development lifecycle by fellow
developers attached to the Strathmore HP lab, project supervisor from Strathmore University,
program coordinators from the Clinton Health Access Initiative Kenya and selected
individuals from the Ministry of Health.
5.4.1 Test Basis
The testing of the vaccine stock management tool was done as it was been implemented, that
was the basis of incremental development. Every component of the tool was individually tested
for statement coverage and its functionality verified. Features and components were only
integrated to the system after they passed the test criteria.
When a feature failed the test criteria, the implementation was debugged and in some occasions
the design revised, until the cause of the error is found and resolved.
5.4.2 Test Approach
There were three approaches used to test the system:
43
a) Functional testing
b) Usability testing
c) Compatibility testing
5.4.2.1
Functional Testing
Functional testing was done to determine if the various functionalities of the system were
working as they were expected to work. All the modules were individually tested before and
after integration. Before integration, each module was tested with sample data.
5.4.2.2
Usability Testing
Usability testing was done to determine the ease of use of the system and whether the users
would struggle to learn and use the system. This was done prior to the announcement of the
end of phase one of the project with the eventual system users, selected individuals from the
Ministry of Health.
5.4.2.3
Compatibility Testing
Compatibility testing was done to determine whether the system developed would work on
different web browsers. The vaccine stock management tool is compatible with all the major
modern web browsers in the market. The system works when java script is enabled in the
browser.
Table 5-1: Browser Compatibility tests
YES
YES
YES
YES
YES
The system is also compatible with the personal computers, laptops and mobile platforms. It
runs all the major operation system distributions i.e. Windows, Mac and Linux.
5.4.3 Testing Conclusion
The test results from all the types of testing conducted, we confirmed that the tool met the
qualities of a robust, highly available and user friendly.
to. For robustness and quick recovery there would different environment set up i.e. (Production
and Development) and a MySQL replication should be setup for the database.
45
46
The adoption of the developed solution would see the following benefits; increased visibility,
accountability and traceability of stocks at all levels, packaged immunization data in ways that
ease/prompt decision making, planning /and taking real time actions and developed and
sustained use of Cold Chain Equipment and Temperature Monitoring information for planning
and actions
6.2 Recommendations
The following recommendations are offered for related research in the field of technology and
vaccines.
a) All targeted users with no computer skills should be given basic training on computer
system to ensure that they are able to work with technologies introduce to them in future
and have positive attitude towards technology.
b) There should be a series of conferences and workshops organised throughout the
country to ensure all stakeholders are aware of the current implementation and
transitions taking shape in this sector.
c) Ensure availability of internet accessibility at the facilities where the tool will used, this
will ensure the availability of the tool 24/7.
47
7 References
Benzzine, A. (2002). System Development Methodologies a framework for comparison.
Retrieved
from
University
of
Missouri:
http://www.umsl.edu/~sauterv/analysis/488_f02_papers/methodologies.html
CHAI Documents. (2015). National Vaccine Supply Documents, 14(2).
Chopra, S., & Meindl, P. (2007). Supply chain management: Strategy, planning, and
operation. Upper Saddle River, NJ: Pearson Prentice Hall.
Elezovic, E. (2012, December). Agile Methodology. Retrieved March 03, 2016, from
http://www.adfkickstart.com/agile-methodology
Hyde, T. B., Dentz, H., Wang, S. A., Burchett, H. E., Mounier-Jack, S., & Mantel, C. F.
(2012). The impact of new vaccine introduction on immunization and health systems: A
review of the published literature. Vaccine, 30(45), 6347-6358.
Kaufmann, J, Miller, R, & Cheyne, J. (2011). Vaccine Supply Chains Need To Be Better
Funded And Strengthened, Or Lives Will Be At Risk
Logistics update / March 16th - 22nd 2006 | Logistics Cluster. (16 March 2006.). Retrieved
March 18, 2016, from http://www.logcluster.org/document/bulletin-39-logistics-updatemarch-16th-22nd-2006
Mvunduraa, M, Lorensona, K, Chweyab, A, Kigadyec, R, Bartholomewa, K, Makamef, M,
& Otieno, A. (2015). Estimating the costs of the vaccine supply chain and service delivery
for selected districts in Kenya and Tanzania. Vaccine, 33
Shikanga, O., Mutonga, D., Abade, M., Amwayi, S., Ope, M., Limo, H., . . . Feikin, D. R.
(2009). High Mortality in a Cholera Outbreak in Western Kenya after Post-Election
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http://www.who.int/immunization/policy/WHO_EPI_Sum_tables_Def_200713.pdf
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354-354.
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Verma, v. (2014). Online drug inventory & supply chain management system of haryana.
Online drug inventory & supply chain management system of haryana. Retrieved March
18, 2016.
Zaffran, M., Vandelaer, J., Kristensen, D., Melgaard, B., Yadav, P., Antwi-Agyei, K., &
Lasher, H. (2013). The imperative for stronger vaccine supply and logistics systems.
Vaccine, 31.
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8 APPENDICES
8.1 Appendix A: Cold Chain Room
50
51
52
53
54
55
56
function update(){
$update_id= $this->uri->segment(3);
$data = array();
$this->load->model('mdl_spareparts');
if (!isset($update_id )){
$update_id = $this->input->post('update_id', $id);
}
if (is_numeric($update_id)){
$data = $this->get_data_from_db($update_id);
$data['update_id'] = $update_id;
}
$data['section'] = "Maintenance";
$data['subtitle'] = "Spare Parts";
$data['page_title'] = "Update Cold Chain Spare Parts and
Accessories";
$data['module'] = "spareparts";
$data['view_file'] = "update_spareparts_form";
$data['user_object'] = $this->get_user_object();
$data['main_title'] = $this->get_title();
echo Modules::run('template/'.$this->redirect($this->session>userdata['logged_in']['user_group']), $data);
}
Figure 8-11: Part of the research team during the Central Vaccine Store site visit
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