Mollel Henry A, Mushi Lawrencia D, Nkwera Richard V
Department of Health Information Systems, Mzumbe University, Morogoro, Tanzania.
Centre of Excellence in Health Monitoring and Evaluation, Mzumbe University, Morogoro, Tanzania.
BMC Health Serv Res. 2025 Feb 25;25(1):306. doi: 10.1186/s12913-025-12383-8.
The uptake, scale-up, and integration of technologies and innovations have been the emphasis of the government of Tanzania for sustained health systems strengthening. This study sought to assess the state and factors for the uptake, scale-up, and integration of Vaccine, Immunization, and Health Supply Chain Management (VIHSCM) technologies and innovations into policy, drawing on experiences from Tanzania.
An exploratory descriptive cross-sectional design with a mixed approach was conducted to assess associated factors for uptake, scale-up, and integration of VIHSCM technologies and innovative solutions for a wide coverage of the quality of vaccines. The data were collected from purposively and conveniently key informants from national, regional, district, and a health facility. A questionnaire was administered to 37 respondents at the health facility level and in-depth interviews were conducted with 104 key informants across all levels. Two Focus Group Discussions (FDGs) comprising 3 and 8 key informants were in one faith-based organization and a privately owned health facility respectively. An observational checklist and desk review were implemented to collect additional data and validation. As regards data analysis, qualitative data were thematically analyzed and quantitative data were analyzed descriptively using SPSS version 21.
The findings show that a range of innovations and technologies have been implemented for VIHSCM, with a primary focus on management and storage to guarantee consistent availability and caliber of vaccinations. Although the advantages of these technologies in improving availability and coverage are well acknowledged, the state of implementation indicates several challenges. Vaccine Information Management System (VIMS) has been put into practice at the council, regional, and national levels. Nevertheless, their efficacy is hampered by their continued fragmentation and lack of integration. Comparably, just 15 councils report that Tanzania Immunization Registry (TImR) has sufficient capability at the facility level. The potential influence of these technologies on VIHSCM is undermined by their incomplete scale-up and limited usefulness. Furthermore, the Remote Temperature Monitoring (RTM) tool, crucial for maintaining vaccine quality, is only operational up to the council level and suffers from inadequate integration. Consequently, many health facilities still rely on outdated methods like 30-day temperature loggers, which may compromise the integrity of temperature-sensitive vaccines.
The value of technologies and innovations for improving VIHSCM is highly recognized for facilitating high-quality, effective, efficient, and equitable immunization services. However, the adopted technologies and innovations have been beneficial to only a small group of the population and for a short time because of inadequate scale-up and integration. Effective integration and scale-up of technologies and innovations are critical for a sustained effective VIHSCM.
技术与创新的采用、推广及整合一直是坦桑尼亚政府加强卫生系统可持续性的重点。本研究旨在借鉴坦桑尼亚的经验，评估疫苗、免疫及卫生供应链管理（VIHSCM）技术与创新在政策层面的采用、推广及整合状况和影响因素。
采用探索性描述性横断面设计并结合混合研究方法，评估VIHSCM技术及创新解决方案在广泛覆盖疫苗质量方面的采用、推广及整合的相关因素。数据收集对象为来自国家、地区、县级和医疗机构的目标性及便利性关键信息提供者。在医疗机构层面，向37名受访者发放了问卷，并对各级别的104名关键信息提供者进行了深入访谈。在一个基于信仰的组织和一家私立医疗机构分别组织了两场焦点小组讨论（FDG），参与人数分别为3人和8人。同时实施了观察清单和案头审查以收集更多数据并进行验证。在数据分析方面，对定性数据进行了主题分析，对定量数据使用SPSS 21版本进行了描述性分析。
研究结果表明，VIHSCM已实施了一系列创新和技术，主要集中在管理和存储方面，以确保疫苗的持续供应和质量。尽管这些技术在提高供应和覆盖率方面的优势得到广泛认可，但实施状况显示出若干挑战。疫苗信息管理系统（VIMS）已在县级、地区级和国家级层面付诸实践。然而，其功效因持续的碎片化和缺乏整合而受到阻碍。相比之下，只有15个县报告称坦桑尼亚免疫登记系统（TImR）在医疗机构层面具备足够的能力。这些技术对VIHSCM的潜在影响因推广不完全和实用性有限而大打折扣。此外，对维持疫苗质量至关重要的远程温度监测（RTM）工具仅在县级层面运行，且整合不足。因此，许多医疗机构仍依赖诸如30天温度记录仪等过时方法，这可能会损害对温度敏感疫苗的完整性。
技术与创新对于改善VIHSCM的价值在促进高质量、有效、高效和公平的免疫服务方面得到高度认可。然而，由于推广和整合不足，所采用的技术和创新仅使一小部分人群在短时间内受益。技术与创新的有效整合和推广对于持续有效的VIHSCM至关重要。
