马拉维IEP报告——冷链

MEDICAL COLD CHAIN & COVID-19 VACCINE DISTRIBUTION IN PARTNERSHIP WITH: Other reports in this series Malawi–Electrification Report Malawi–Clean Cooking Report This report provides an overview ofcleancooking opportunities to be achieved by 2030.By utilizing a dynamic data-driven methodology,the report identifies a mix of modern and cleanercooking technologies and solutions to achieveSDG7.1 targets by 2030 including realization ofMalawi’s SDG7 Cleaner Cooking Compact. This report covers the least-costelectrificationpathways for the country toreach universalelectrification, and ultimatelyachieve SDG7.1,accounting for the currentinfrastructure anddemography. It providesactionable intel forprivate as well as publicsector energy planners. DOWNLOAD HERE INTEGRATED ENERGY PLANNING TOOL EXPLORE THE RESULTS FOR YOURSELF malawi-iep.sdg7energyplanning.org Any Questions:iep@seforall.org Table of Contents 1.Executive Summary2.Project scope of work3.Routine and COVID Vaccine Overview4.Cold Chain Assessment1.Performance, Quality and Safety (PQS)2.Capacity Utilization Analysis3.COVID vaccines4.Vaccine Transportation Logistics5.Health Facility Energy Analysis1.Assumptions and Methodology2.Expansion plan: electricity and CCE needs3.Facilities and electrification status6.Considerations & Recommendations1.Cold-chain capacity analysis2.Health facility energy needs assessment7.Annex8.Malawi IEP Platform611132021252831343740414243454852 Acronym List EPIExpanded Program on ImmunizationCCECold Chain EquipmentDVSDistrict Vaccine StoreHFHealth FacilityMOHMinistry of HealthPQSPerformance, Quality and SafetyNVSNational Vaccine StoreRVSRegional Vaccine StoreUCCUltra Cold ChainWHOWorld Health OrganizationWICRWalk-in Cold RoomWICFWalk-in Cold Freezer ExecutiveSummary Executive Summary TheMinistry of Health in Malawi has had to pivot andquicklyadjusted to the COVID-19 pandemic and rapidlyscaledupintroducingofthisnewvaccine,usingleveragingthevaccine supply chain and a health system that werealreadyconstrained.ThisVaccineDistributionPlananalysisincludedanoverviewofthevaccineintroductiontodateinthecountry,a cold chain capacity assessment,and anassessmentoftheenergyneedsofhealthfacilities.Finalrecommendationsbuild on best practices for cold chainplanningandCOVIDcampaignplanning. transportation.TheCOVIDvaccinesaredeliveredfromtheNationalVaccine Store to the District Vaccine Stores forcampaignactivities and to facilities to administer duringroutineservices.The“Vaccinate MyVillage”approachisimplementingcommunityoutreachcampaignstwoweeksofeverymonthtoincreaseaccessdirectlytothevaccinesinthecommunity. Methodology.We worked closely with the MOH,EPI,UNDPandUNICEFprovidedtoobtaindatasources,whileJSIcross-checked sources,validated assumptions,andclarifiyremaining questions with MOH counterparts.Limitationsinclude multiple data sets with conflicting ormissinginformation,particularly related to the masterhealthfacilitylistandpopulationdata.AssumptionshavebeendocumentedandvalidatedbyMOHcounterparts. COVIDVaccine Activities to Date.The country hasreceivedabout6milliondosesoftheCOVIDvaccinesinceMarch2021.14%ofthetargetpopulation(of12yearoldsandolder)are fully vaccinated(either with two doses ofAstraZenecaorPfizer,oronedoseofJ&J),withcoverageabitlowerinthesouthernregionofthecountryduetovaccinehesitancy.The COVID vaccine is distributedthroughtheroutine immunizationsupplychainusing thesamecoldchainequipmentandvehiclesfor Coldchainassessment Thecountry has about 2,000 pieces of cold chainequipment(CCE)acrossthefourlayersofthesupply chain,the majority of which(92%)are reported asfunctioning.Themajority(76%)alsohavethestatusofareclassifiedasWHO’sPerformance,QualityandSafety(PQS)prequalification,whichassurestheirsuitabilityforuseinanimmunizationprogram.The 24%that are non-PQS maystillfunctionyetareappropriatelybeingphasedoutofthesystemfor newer,more reliable equipment.Fifty-threepercentof the equipment is 10 years old or less;theindustrylife expectancy is 10 years.This presents anopportunityreplaceolderequipmentandhaveamedium-andlong-termplanasCCEagesoutofutility.Therearemorethan50differentmodelsofCCEinthesystem,whichcomplicatesmaintenance and spare parts management.Investmentshouldbeprioritizedtoreplace~350CCEthatarenot working;increase freezer capacity at the districtlevel;andconsiderexpandingto healthfacilitiesthat donotcurrentlyhaveCCE(consideringtheadditionalhealthworkercosttoprovidevaccines,supplychaindandvaccinedistributioncosts,andCCEmaintenancecosts);CCEcostsarebetween$3,000and$6,000perunit. Coldchaincapacityutilization TodeterminethecapacityutilizationforPQScoldchain,weusedthevaccinequantityrequiredbasedontheEPIschedule(e.g.,vaccines approved for which targetpopulationandnumberofdosesrequiredofeach);stateddistributionschedule(e.g.,monthlydistributiontofacilityleveland district);target population of each facility anddistrict;and vaccine characteristics(vial size,cubic litersperdose,wastage rate,buffer stock).This is assessedagains