With high risks of communicable diseases like bacterial diarrhea, malaria, hepatitis A and E and typhoid, there’s a rising necessity for a proper immunization program in India. The United Nations Development Programme (UNDP) has partnered with the Indian government and Ministry of Health and Family Welfare to design and put into effect an Electronic Vaccine Intelligence Network (eVIN). This project, known as Improving Efficiency of Vaccination Systems in Multiple States, has already run since 2014 and is to run until 2021 to strengthen the evidence base for policy-making related to vaccine delivery, procurement and planning, and ensure equity in availability.
As the world’s largest immunization program, eVIN technology has already shown results in enabling real time information on cold chain temperatures and vaccine stocks and flows in all 371 implementing districts in India. It has managed to achieve over a 98 percent reporting rate from vaccine storage areas, with over 2 million transactions logged each month, and developed the skills of over 17,000 government staff in store keeping, data operating or cold chain handling in over 550 batches of training programs.
The eVIN is setup on a mobile application that easily allows cold chain handlers to log stock positions at the end of each routine immunization day, which is then relayed immediately onto a web interface for assessment by health officials. In India, this can come to play an important role as geography and communications can pose an issue, like in the small hill-state of Manipur, where vaccine vials are carried over extensive distances to session sites by auxiliary nurses and midwives. Instances of stock-outs have decreased by more than six times here, and eVIN has enabled staff to learn how to use a smartphone and other technology, improving quality of work and management in the process.
This immunization program in India has also significantly empowered women health workers, giving them the opportunity to work with technology after attending regional and district eVIN training sessions. This allows them to manage stocks and temperatures themselves, bridges the digital divide in rural parts of India and ensures transparency alongside accuracy. Over 50 percent of cold chain handlers are women, and many are from older age groups.
EVin has taken India out of the unproductive days of delayed decision making, shortages and expirations, and has created an efficient health system that allows for valuable state-wide geographic, stock-out or excess stock and temperature overviews on each district’s centers. It also allows for large savings by reducing vaccine wastage and allowing for timely and quality injections, as in Rewa, where around $70,000 was saved after six months of eVIN activation.
Though led by the UNDP and Ministry of Health and Family Welfare in India, the Universal Immunization Program is largely supported by GAVI, a global vaccine alliance established in 2000. With support from GAVI and the Indian government, the Universal Immunization Program in India has immunized at least 65 percent of India’s children and expects to immunize 27 million more each oncoming year.
– Zar-Tashiya Khan