Uptake, scale up, integration of caccine, immunization, and health supply chain management technologies and innovation into policy: experience from Tanzania.

backgroundThe 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.

methodsAn 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.

resultsThe 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.

conclusionThe 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.