Continuous Improvement Plans

Without an adequate supply of vaccines at service delivery levels, children cannot be vaccinated against life-threatening diseases.


The successes of the Expanded Programme on Immunization (EPI) can be attributed in large part to the immunization supply chain and logistics systems and the professionals who run them. However, the Effective Vaccine Management initiative has uncovered important shortcomings in the performance of many countries’ immunization supply chains – specifically in regards to improvement plans and their implementation.


Until now, most country improvement plans lacked a cohesive strategic vision. They assumed no linkage to broader health initiatives being conducted in country. In too many instances, the right decision makers were not involved in the planning process. Budgets to address bottlenecks in the supply chain were ad hoc and too often there was no mechanism in country to oversee their implementation. In short, plans did not address the root cause of systemic problems in the supply chain and therefore, improvements were not sustainable.

Comprehensive Effective Vaccine Management

To address these challenges, UNICEF and WHO are working closely with countries to re-envision the management of their immunization supply chains by embracing two fundamental changes to the EVM process:

1. Integrate their immunization supply chain planning & resourcing with the broader health, human resource, and technological systems within their Ministries of Health.

2. Enable country ownership and capacity development through every aspect of the life cycle of the EVM (including Assessment, Improvement Planning, and Programme Implementation).

Continuous Improvement Plans

Under these guiding principles, the Continuous Improvement Plan (cIP) is a national multi-year operational and strategic plan that is developed through input and commitment from key stakeholders.

Stewardship by National Logistics Working Groups or equivalent type of group is critical for its successful year-on-year implementation. Improvements are built on six fundamentals of the supply chain essentials with the goal of achieving three key objectives.


  1. Immunization supply chain system design
  2. Cold chain equipment and management optimization
  3. Temperature management during storage and transport
  4. Efficient transportation systems up to the last mile
  5. Skilled human resources for effective vaccine management
  6. Logistics information systems for management




Uninterrupted availability of vaccines up to service delivery points.



Quality storage for all vaccines with no breaks in the cold chain that can compromise vaccine potency.



Vaccines delivered with efficient use of resources up to the last mile



  • Shifts away from the use of multiple plans towards a single forward-looking multi-year strategy.
  • Aligns with national immunization and health sector planning and financing.
  • Harnesses in-country advisors through National Logistics Working Group or similar group of key stakeholders.
  • Includes detailed timelines, monitoring & evaluation of the plans implementation.

Linked to:

  • GAVI HSS and CCEOP grant applications
  • National multi-year health strategy
  • Health sector strategies and plans

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