Across Africa, immunization programs face a persistent challenge: ensuring vaccines reach every child who needs them. Despite significant investments in vaccine procurement and cold chain infrastructure, last-mile stockouts continue to undermine coverage goals and leave vulnerable populations without protection. The solution lies not just in technical improvements but in rethinking how stakeholders collaborate to strengthen supply chain systems.
The Foundation of Collaboration
Indeed, at the heart of sustainable immunization supply chains lies a fundamental truth: partnerships matter. Effective immunization programs require diverse networks of stakeholders and implementing organizations.
For example, under the Immunization Collaborative Supply Planning Strengthening (ICSPS) project, partners came together to strengthen the capacity and agency of countries to apply evidence-based forecasting and supply planning (FSP) decisions. Led by JSI, the project focuses on strengthening routine immunization data systems and enhancing data analysis to support more responsive vaccine forecast and supply decisions.
The initiative is being implemented by JSI in Ethiopia, with VillageReach leading efforts in DRC and Mozambique and CHAI in Nigeria. Working alongside Ministries of Health, WHO, UNICEF and Gavi, this collaborative model demonstrates that sustainable change requires more than technical solutions—it demands shared ownership and collective commitment.
Project members held a three-day Technical Summit in Nairobi to allow countries to share common challenges and solutions and to develop a deeper understanding of effective tools and approaches.
As Dr. Laila Akhlaghi, Senior Technical Advisor at JSI and ICSPS’s Project Director, noted in her reflections on the summit, the project has adopted a core strategy of “leveraging established supply chain management methods from other health programs, such as HIV/AIDS, Malaria, and Family Planning, with adaption to the unique properties of vaccines.” This approach recognizes that forecasting and supply planning challenges are common across health programs, often leading to persistent last-mile stockouts that undermine immunization coverage goals.
VillageReach participants at the ICSPS Technical Summit in Nairobi. Photo credit: Leticia Buluma
Beyond Demographics: Evidence-Based Forecasting
The summit highlighted a critical evolution in vaccine forecasting methodologies. Forecasts that relied on traditional demographic estimates and safety stock percentages can be improved with the addition of more sophisticated, consumption-based methods that account for real-world usage and wastage patterns, program activities, and system capacity.
The ICSPS project has identified a primary challenge: limited capacity and skills to perform forecasting methods beyond the historically recommended demographic approach, compounded by the lack of quality data necessary for additional methods. This has led to innovative approaches, including the triangulation of Health Management Information Systems (HMIS) and Logistics Management Information Systems (LMIS) data to provide routine wastage information—a critical component for accurate forecasting and re-supply .
Strengthening Systems Through Regular Reviews
One of the most impactful innovations emerging from the ICSPS work is the implementation of quarterly supply planning meetings. These gatherings bring together all relevant stakeholders to review consumption patterns against forecasts, assess stock status, evaluate confirmed and planned shipments and identify risks requiring (immediate) action. The effectiveness of this approach has been compelling and some countries have now moved to monthly meetings, recognizing the value of frequent reviews and data-driven decision-making.
These regular reviews represent a shift toward collaborative governance and shared accountability. By creating structured opportunities for dialogue and decision-making, countries are building the institutional capacity necessary for sustainable supply chain management.
The Human Element: Communication and Negotiation
Effective supply chain management requires significant attention to behavior change, negotiation skills and communication strategies. The Nairobi summit recognized that technical recommendations from supply planning committees require effective communication and implementation by diverse stakeholders across the health system. Successful supply planning isn’t just about accurate forecasts and plans—it’s about ensuring that stakeholders understand and follow through on recommended actions.
The emphasis on communication skills reflects a broader understanding that sustainable supply chains depend on human relationships and trust. When health workers, ministry officials, donors and partners can communicate effectively and negotiate solutions collaboratively, the entire system becomes more resilient and responsive to community needs.
Data as the Foundation for Action
A key feature of the ICSPS approach is a strong commitment to data-driven decision-making. The project has helped strengthen countries’ ability to collect, analyze and act on supply chain data, going beyond basic stock counts to include insights from consumption trends, program activities and system capacity.
This focus on data helps reveal critical information about vaccine wastage, stock management and supply chain performance. It also supports the creation of effective feedback loops, ensuring that decisions and recommendations based on data are acted upon, especially when they result in measurable benefits. By understanding consumption patterns more clearly, countries can improve forecasting and allocate resources more efficiently—ultimately helping vaccines reach the children who need them most.
Sustainable Partnerships for Lasting Impact
The ICSPS Technical Summit reinforced that sustainable immunization supply chains require more than technical fixes. They demand fundamental shifts in how stakeholders work together. The emphasis on building local capacity, fostering collaborative decision-making and strengthening institutional relationships reflects a deeper understanding of what sustainability means.
As the project enters its final year, the focus has shifted toward capturing and sharing these collaborative approaches globally, ensuring that other countries can learn from and adapt these proven strategies to their contexts. This commitment to knowledge sharing exemplifies the partnership ethos that has made ICSPS successful: strengthening one country’s capacity strengthens the entire global immunization community.
Looking Forward: A Collaborative Future
The reflections from Nairobi envision immunization supply chains characterized by strong partnerships, evidence-based decision-making and shared accountability. The quarterly supply planning meetings, the emphasis on communication and negotiation skills and the commitment to data-driven approaches all represent building blocks for more resilient and sustainable systems.
The ultimate goal is to achieve sustainable immunization supply chain changes, with improved coverage, reduced waste and a reduction in zero-dose children. By strengthening partnerships between countries, organizations and communities, these efforts help ensure that every child, regardless of where they live, has access to life-saving vaccines.
The journey toward sustainable immunization supply chains is complex and challenging. Still, our experience demonstrates that with strong partnerships, evidence-based approaches and a commitment to shared learning, lasting change is possible.
As health systems continue to evolve and strengthen, they carry forward not just technical knowledge, but also the relationships and collaborative spirit that will sustain progress long into the future.