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Pakistan NISP/Disbursement Linked Indicator 4: vLMIS System Coverage-December 2017 Update
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Federal EPI, Gavi Alliance and the World Health Organization help EPI
Programs Standardize Vaccine Logistics Reporting in Pakistan
Nationwide Standardization of the Pakistan Vaccine and Cold Chain Logistics
Transactional Information System for Improved Transparency, Accountability,
Monitoring and Quality of Immunization Supply Chain
BACKGROUND
Since decades, Pakistan has been struggling with
immunization coverage which is reported at 54% as
of 2012-2013 DHS, as opposed to currently
improving immunization coverage data. Because of
the inherent wastages and other factors, Pakistan
with multi-lateral financing procures
approximately150% vaccines againist desired 100%
coverage and availability. One of the major factors
responsible for these pendulating coverage figures
can be attributed to varying levels of accountability
of vaccine coverage, commodity and cold chain data.
Considering both reported and unreported Measles
related mortality post 2012 outbreak, Pakistan lost more than 3,000 children. On recommendation of the Federal
Ombudsman, Web based Vaccine Logistics Management Information System (vLMIS) was first launched in January 2014
in 54 priority and polio high risk districts of Pakistan with collaboration of Government of Pakistan, United States
Agency for International Development (USAID), WHO, UNICEF and other partners. The aim for development of web-
based vLMIS was to strengthen logistics and inventory management of vaccines in a comprehensive manner and to
provide tools needed to monitor and assess vaccine storage, planning and distribution flows, helping to improve
accountability for vaccine consumption and cold chain data. Given the success of the system, in February 2015, vLMIS
was deployed in all districts and towns of Sindh province. In February 2016, with Punjab and DfID co-financing, it was
further scaled up in 13 districts of Punjab. Until November 2017, the vLMIS was only deployed in 96 districts of Pakistan.
The web-based application is now implemented by the federal, provincial and regional governments http://v.lmis.gov.pk
(Figure 1) and since its launch has been constantly growing in terms of value added features and usage. The data is
government owned with servers hosted at the Ministry of Information Technology and the National Telecommunication
Corporation (NTC), thus making it a sustainable system. vLMIS is also the Disbursement Linked Indicator (DLI) 4 of the
National Immunization Support Program (NISP) under Multi Donor Trust Fund.
In 2017, the Federal EPI, Gavi Alliance and the World Health Organization (WHO) agreed to finance country wide scale
up of vLMIS for which it engaged Chemonics International Inc., one of the world’s leading partners in international
development and a company that combines broad regional experience with technical depth and unparalleled
management skill. As per the plan 384 government officials from 116 districts were to be trained on vLMIS in less than a
month’s timeframe. With this roll-out, Pakistan has achieved a significant milestone by having one standardized LMIS
system across the country in post devolution scenario. This will be the only logistics management information system of
its kind which will be reported nationally in a uniform pattern.
KEY CHALLENGES – SCALE UP:
Figure 1: Home page of first ever logistics management information system
www.lmis.gov.pk
• Compressed timeframe between contract signing
and completion date (approximately 25 days) given
for training of 116 districts
• Recruitment of appropriate short term technical
staff with requisite skills
• Obtaining timely nominations from federal,
provincial and regional governments for Training of
Trainers (ToT) and District level vLMIS operators
trainings
• Logistics arrangements: travelling, boarding/lodging
and venues for training of 384 government staff on
vLMIS within the timeframe of 16 days, sometimes
with 12 parallel sessions being conducted in one day
across the country
• Quality assurance
Pakistan NISP/Disbursement Linked Indicator 4: vLMIS System Coverage-December 2017 Update
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ACHIEVEMENT IN 12 DAYS:
The scale up could not have been possible without close coordination between Chemonics International Inc., Federal,
provincial and regional EPI programs, as it involved high pitched and intense activities throughout the width and breadth
of the country. The scale up tarining of 116 districts was actually accomplished in 12 days (18-29 December 2017); each
district trained for three days.
Following the signing of contract detailed consultation with all stakeholders on implementation of scale-up plan was held.
Federal, provincial and regional governments were requested for nominations for Master Trainers (MTs) and district
level operators as per pre-defined selection criteria, while Federal EPI constituted steering and technical committees to
ensure the effective implementation of scale up plan.
For the smooth execution of the trainings and to deal with quality
assurance challenge, recruitment of people with right caliber having
prior knowledge of LMIS or similar information system was
ensured. Newly hired on boarded Chemonics staff was vigorously
oriented and trained for five days i.e. Dec 09 – 13, 2017 at
Islamabad and Lahore, where staff was given hands on training on
different modules of vLMIS, in addition to special sessions on
communication skills.
Training material including communication material and curriculum was developed and printed in the meantime (Figure
2). Formal scale-up training sessions were conducted as per following training schedule (Figure 3) finalized after
consultation with federal, provincial and regonal governments.
ToT was held from December 14-16, 2017 at Avari Hotel, Lahore (Figure 4&5) with an aim to orientate federal and
provincial/regional staff on vLMIS and select Master Trainers (MT’s) amongst nominated government staff as part of the
vLMIS scale up sustainability strategy.
Roll-out trainings of district level operators of all 116 districts of provincial/regional EPI programs Punjab, KP,
Balochistan, GB, AJ&K, ICT & CDA commenced from Dec 18, 2017 and completed by December 29, 2017
A total of 348 district vLMIS operators were trained at Lahore, Karachi, Islamabad, Peshawar, Bhurban and Muzaffarabad
(Figures 6 to 12). These participants on their return will be the main force behind lightening up left over districts of
Pakistan. Hardware to scale up districts has already been provided by Federal EPI.
Figure 3: Training Schedule
Figure 2: Training Curriculum
Pakistan NISP/Disbursement Linked Indicator 4: vLMIS System Coverage-December 2017 Update
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PROJECT PLAN FOR JANUARY 2018:
With deployment of vLMIS across the country, Pakistan will not only achieve standardization of logistics reporting
system but an unprecedented capability around logistics data visibility and thus management of vaccines. The
MoNHSR&C and the entire EPI machinery are committed towards improving data quality to ensure vLMIS becomes a
decision-making tool for the country. Enhanced supply chain transparency, accountability and good governance that
system ensures is anticipated to show results after this important standardization.
• Retrospective vaccines data will be fed into the
system since June 2016 in January 2018.
• In the second phase of scale-up MTs and Chemonics
staff will visit districts to impart on the job trainings.
• For districts/regions where field visits would not be
possible, district staff will be called at a central
venue where three days on the job training will be
provided.
• Government will be requested to ensure proper
utilization of district staff ensuring their availability
at district stores for minimum one year
• Monitoring and Evaluation (M&E) and vLMIS Data
quality assurance
• Occasional refresher trainings of district staff on
vLMIS as per enhancements
Figure 6: AJ&K – December 18-20, 2017
Figure 7: GB – December 18-20, 2017
Figure 8: Balochistan – December 21-23, 2017
Figure 9: KP– December 25-27, 2017
Figure 10: FATA – December 25-27, 2017
Figure 12: Punjab – December 27-29, 2017
Figure 11: ICT/CDA – December 26-28, 2017
Figure 4: ToT – December 14-16, 2017
Figure 5: ToT – Certificate Distribution