Optimize Albania Projects Report

54 Pages·2013·1.3 MB·English

by  Dan Brigden

OPTIMIZE

Albania

Report
This report was commissioned by Optimize: Immunization Systems and Technologies for
Tomorrow, a collaboration between the World Health Organization and PATH. The report was
authored by Silvia Bino and Erida Nelaj of the Albanian Institute of Public Health, Artan Mesi of
the Shkodra Regional Directorate of Public Health, and Jan Grevendonk of PATH.

Contact information:

Silvia Bino
Associate Professor of Infectious Diseases, Albanian Institute of Public Health
[email protected]

Erida Nelaj
Expanded Program on Immunization Manager, Albanian Institute of Public Health
[email protected]

Artan Mesi
Chief of Prevention and Control of Infectious Diseases, Shkodra Regional Directorate of Public
Health
[email protected]

Jan Grevendonk
Technical Officer, PATH
[email protected]

PATH addresses:

Mail
PO Box 900922
Seattle, WA 98109 USA

Street
2201 Westlake Avenue, Suite 200
Seattle, WA 98121 USA

www.path.org

Suggested citation
World Health Organization, PATH. Optimize: Albania Report. Seattle: PATH; 2013.

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This work was funded in whole or part by a grant from the Bill & Melinda Gates Foundation. The
views expressed herein are solely those of the authors and do not necessarily reflect the views of
the Foundation.

Copyright © 2013 World Health Organization (WHO), Program for Appropriate Technology in
Health (PATH). All rights reserved. The material in this document may be freely used for
educational or noncommercial purposes, provided that the material is accompanied by an
acknowledgment.

Cover photo: PATH/Ilir Kaso
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Albania

Report
March 2013

Albania Report
CONTENTS
Acknowledgments ..................................................................................................................... vi
Acronyms ................................................................................................................................. vii
1. Introduction ............................................................................................................................1
1.1. Overview ...................................................................................................................1
1.2. About project Optimize .............................................................................................1
1.3. Finding more information ..........................................................................................2
2. Albania in Context ..................................................................................................................3
2.1. The immunization system .........................................................................................3
2.2. The supply chain .......................................................................................................5
2.3. Baseline assessment ................................................................................................6
2.4. Challenges and opportunities ...................................................................................8
3. Immunization Information System .........................................................................................9
3.1. Goal ..........................................................................................................................9
3.2. Rationale ...................................................................................................................9
3.3. System overview .....................................................................................................1 0
3.4. Implementation .......................................................................................................1 7
3.5. Results ....................................................................................................................2 0
3.6. Acceptability and feasibility .....................................................................................2 8
3.7. Cost .........................................................................................................................3 2
3.8. Challenges ..............................................................................................................3 3
3.9. Scale-up ..................................................................................................................3 4
3.10. Conclusions ..........................................................................................................3 5
4. Remote temperature monitoring ..........................................................................................3 7
4.1. Goal ........................................................................................................................3 7
4.2. Rationale .................................................................................................................3 7
4.3. Implementation .......................................................................................................3 8
4.4. Results ....................................................................................................................3 9
4.5. Acceptability and feasibility .....................................................................................3 9
4.6. Cost .........................................................................................................................4 0
4.7. Challenges ..............................................................................................................4 1
4.8. Scale-up ..................................................................................................................4 1
4.9. Conclusions ............................................................................................................4 1
Appendices ..............................................................................................................................4 2
A. Monitoring activity performance ................................................................................4 2
B. Acceptability and feasibility assessment ...................................................................4 5
Albania Report v
ACKNOWLEDGMENTS
Optimize would like to thank staff at the following institutions for their help, enthusiasm, and
hospitality:
• Ministry of Health, Albania.
• Institute of Public Health, Albania.
• Health Insurance Institute, Albania.
• Shkoder Directorate of Public Health, Shkoder, Albania.
• World Health Organization country office, Albania.
Particular thanks go to:
• Silvia Bino, Gazmend Bejtja, and Gazmend Koduzi for sharing our vision and
championing this project.
• Erida Nelaj, for all the hard work to coordinate the project and design the information
system.
• Artan Mesi and Arben Xhabija, for driving the implementation in Shkoder, Albania.
• The 30 nurses in Shkoder, Albania who adopted the system so enthusiastically, for their
patience and feedback.
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ACRONYMS
The following acronyms are used in this document.
AEFI adverse events following immunization
BCG Bacillus Calmette-Guérin
DPH Directorate of Public Health
DTP a combination vaccine containing diphtheria, tetanus toxoid, and pertussis vaccines
DTP-3 third dose of DTP
EPI Expanded Programme on Immunization
EVM Effective Vaccine Management
HII Health Insurance Institute
IIS Immunization Information System
IPH Institute of Public Health
IT information technology
MOH Ministry of Health
MMR a combination vaccine containing measles, mumps, and rubella vaccines
MMR-1 first dose of MMR
NIP National Immunization Program
Penta-1 Pentavalent vaccine containing DTP, hepatitis B, and Haemophilus influenzae
type b vaccines (first dose)
Penta-3 Pentavalent vaccine containing DTP, hepatitis B, and Haemophilus influenzae
type b vaccines (third dose)
PATH Program for Appropriate Technology in Health
SFAT Stock Flow Assessment Tool
SMS short message service
UNICEF United Nations Children’s Fund
USB universal serial bus
WHO World Health Organization
Albania Report vii

1. INTRODUCTION
1.1. Overview
This report presents the results of demonstration projects and other activities undertaken in
Albania as part of a partnership between project Optimize and the Albanian Institute of Public
Health (IPH).
Between 2010 and 2012, Optimize collaborated with the IPH to demonstrate innovations in the
supply chain that can help to meet the demands of an increasingly large and costly portfolio of
vaccines. This report describes the two demonstration projects undertaken in Albania as part of
the collaboration:
1. Immunization Information System (IIS).
The project developed and implemented an online Immunization Information System that
can record immunization data and manage vaccine stock. The new system—named IIS—
can schedule and record child immunizations, as well as manage vaccine stock and
storage. The aim of the project was to measure the impact of accurate and timely
immunization data on immunization and vaccine stock management.
2. Remote temperature monitoring.
The project tested a short message service (SMS, or text-message)-based system to
monitor and log temperature conditions in peripheral cold chain equipment. The aim was
to assess whether these remote alarm systems facilitate better vaccine and cold chain
management than non-connected temperature loggers.
1.2. About project Optimize
Project Optimize is a five-year partnership between the World Health Organization (WHO) and
PATH to identify ways in which supply chains can be optimized to meet the demands of an
increasingly large and costly portfolio of vaccines.
Optimize works directly with national governments and other institutions to identify problems in
the supply chain and test innovative solutions. It also works with vaccine manufacturers and
policymakers to help ensure that new products and policies enable supply chain systems to
function effectively. The goal is to help define an ideal vaccine supply chain that can be used to
develop stronger, more adaptable, and more efficient logistics systems, extending the reach of
lifesaving health technologies to people around the world.
For more information, please visit the Optimize website:
PATH: www.path.org/projects/project-optimize
WHO: www.who.int/immunization_delivery/optimize

Albania Report
1.3. Finding more information
In 2013, Optimize will publish comprehensive information on the demonstration projects and
other initiatives it has been involved in. To view a full list of the resources that Optimize has
published to document its work in Albania, please refer to the Albania resources page of the
Optimize website. This is available on both PATH and WHO’s website.
PATH: www.path.org/projects/project-optimize-resources-country.php#albania
WHO: www.who.int/immunization_delivery/optimize/albania
You can also find these documents, as well as detailed information on other innovations relating
to vaccine supply and logistics systems, on the TechNet21.org website.
www.technet21.org
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