Mobile-based effective vaccine management tool: An m-health initiative implemented by UNICEF in Bihar.

BACKGROUND: UNICEF launched the mobile-based Effective Vaccine Management (EVM) system in Bihar in 2014 along with the state government to electronically capture information and identify gaps in the existing vaccine management system for appropriate action. OBJECTIVE: This study accessed the implementation process of this initiative. METHODS: Quantitative data related to vaccine supply chain management indicators were collected in November-December 2015 using factsheets and dashboards, representing the situation of the vaccine supply and cold chain management system at regular intervals since the launch. In-depth interviews were conducted with the program specialists to understand the initiative's genesis, its challenges and strengths. RESULTS: This initiative resulted in an increased cold chain space from 49% (July 2014) to 87% (September 2015), deployment of sufficient human resource; 38 cold chain technicians for regular maintenance of the machines and equipment, installation of necessary equipment, and upgradation of state and regional vaccine stores. In health facilities, district vaccine stores, and regional vaccine stores, marked improvements were observed in the overall EVM criteria indicators (82%, 84%, and 80% in September 2015, respectively, as against 51%, 46%, and 43% in July 2014, respectively) as well as EVM category indicators (83%, 84%, and 76% in September 2015, respectively, as compared to 54%, 53%, and 54% in July 2014, respectively). CONCLUSION: The EVM mobile initiative was successfully implemented and it complies with its objective of providing experienced guidance to the human resource responsible for vaccine cold chain management. The initiative is scalable and its sustainability depends on its thoughtful merger with the existing immunization ecosystem.