Division of Health systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
Hum Vaccin Immunother. 2019;15(11):2666-2672. doi: 10.1080/21645515.2019.1607130. Epub 2019 May 22.
One of the challenges facing the success of immunization programs is shortages of vaccines at health facilities, which could result from inadequate vaccine stock management. Several approaches have been designed by countries to improve vaccine stock management. This review summarizes currently available information on interventions for vaccine stock management.We considered both randomized trials and non-randomized studies eligible for inclusion in this review. The following databases were searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization Library Information System, Web of Science, and PDQ-Evidence. We searched the websites of the World Health Organization, Global Alliance for Vaccine and Immunization, PATH's Vaccine Resources Library, and United Nations Children's Fund. The reference lists of all the included studies were also searched. Two authors independently screened search outputs, reviewed full texts of potentially eligible articles, evaluated risk of bias, and extracted data; resolving disagreements through consensus.Four studies met our inclusion criteria (three before-after studies and one randomized trial). Three studies were conducted in low- and middle-income countries while one was conducted in Canada (a high-income country). All the studies had various limitations and were classified as having a high risk of bias. Study findings suggest that the use of digital information systems to improve information and stock visibility, coupled with other interventions (such as training of health-care workers on the use of innovative tools and redesign of the supply chain to tackle certain bottlenecks), has the potential to increase vaccine availability, reduce response times, and improve the quality of vaccine records.
免疫规划成功面临的挑战之一是卫生机构疫苗短缺，这可能是由于疫苗库存管理不当造成的。各国已经设计了几种方法来改进疫苗库存管理。本综述总结了目前关于疫苗库存管理干预措施的信息。我们考虑了符合纳入标准的随机试验和非随机研究。检索了以下数据库：PubMed、Embase、Cochrane 对照试验中心注册库、世界卫生组织图书馆信息系统、Web of Science 和 PDQ-Evidence。我们还检索了世界卫生组织、全球疫苗和免疫联盟、PATH 疫苗资源图书馆和联合国儿童基金会的网站。所有纳入研究的参考文献也进行了检索。两名作者独立筛选了检索结果，审查了潜在合格文章的全文，评估了偏倚风险并提取了数据；通过协商解决分歧。有四项研究符合我们的纳入标准（三项前后研究和一项随机试验）。三项研究在中低收入国家进行，一项在加拿大（高收入国家）进行。所有研究都存在各种局限性，被归类为具有高偏倚风险。研究结果表明，使用数字信息系统来改善信息和库存可见性，并结合其他干预措施（例如培训卫生保健工作者使用创新工具和重新设计供应链以解决某些瓶颈问题），有可能增加疫苗供应，缩短响应时间，并提高疫苗记录的质量。
