One size does not fit all- Strategizing the vaccine supply chain in developing countries

The eradication of diseases through vaccination has been a long-standing problem in developing countries. The supply chain plays an essential role in end-to-end connection and enhancing the effectiveness of successful immunization. However, no study highlights the vaccine supply chain's role in maximizing stakeholder outreach and a successful vaccination campaign. The supply chain cannot be applied as a 'one size fits all,' 'centralized,' or a 'black box approach' to every vaccination area, as each may require specific inputs from the supply chain. This study considers the Poliovirus eradication program at immunization centres in several vaccination areas in Pakistan and proposes tailored supply chain strategies that are conducive to the requirements of vaccination areas. There are four-fold contributions of this study, i.e., identification of several factors from the literature that can trigger various responses from the supply chain, prioritization of these factors using a graph theory approach, grouping of vaccination areas based on the similarity of factors for the formulation of supply chain strategies, and proposing three tiers of the customer-facing arc of integration for the vaccination areas. The first tier of integration strategies comprises accurate demand forecasts, controlling wastage, and enhancing synchronization among vaccination and other health services. The second tier of integration strategies comprises a mix of centralization and de-centralization, coordination, and robust information systems, considering the relocation of vaccination centres to population epicentres. The third tier of integration strategies comprises increased investment in awareness programs, increasing partnerships with private partners, and ensuring the well-being of personnel and ground support staff. Finally, the conclusion, limitations, and future recommendations are provided.