A fuzzy multi-criteria framework to identify barriers and enablers of the next-generation vaccine supply chain

PurposeDue to the introduction of new vaccines in the child immunization program and inefficient vaccine supply chain (VSC), the universal immunization program (UIP), India is struggling to provide a full schedule of vaccination to the targeted children. In this paper, the authors investigate the critical factors for improving the performance of the existing VSC system by implementing the next-generation vaccine supply chain (NGVSC) in India.Design/methodology/approachThe authors design a fuzzy multi-criteria framework using a fuzzy analytical hierarchical process (FAHP) and fuzzy multi-objective optimization on the basis of ratio analysis (FMOORA) to identify and analyze the critical barriers and enablers for the implementation of NGVSC. Further, the authors carry out a numerical simulation to validate the model.FindingsThe outcome of the analysis contends that demand forecasting is the topmost supply chain barrier and sustainable financing is the most important/critical enabler to facilitate the implementation of the NGVSC. In addition, the simulation reveals that the results of the study are reliable.Social implicationsThe findings of the study can be useful for the child immunization policymakers of India and other developing countries to design appropriate strategies for improving existing VSC performance by implementing the NGVSC.Originality/valueTo the best of the authors’ knowledge, the study is the first empirical study to propose the improvement of VSC performance by designing the NGVSC.

Parental conceptions of the rotavirus vaccine during implementation in Stockholm: A phenomenographic study

In 2014, Stockholm became the first Swedish county to introduce the rotavirus vaccine, which is given from as early as six weeks of age. The aim of this study was to describe parental conceptions of rotavirus infection and vaccination during its implementation as part of the child immunization program, as their support is vital for any new vaccine. The study followed a descriptive, qualitative design with a phenomenographic approach. Ten in-depth interviews with parents were conducted in Stockholm County, transcribed and analyzed to describe qualitatively different conceptions of rotavirus infection and vaccination. Four main categories were identified: to vaccinate without doubt, hesitant to vaccinate, risky to vaccinate, and unnecessary to vaccinate. All the parents had in common the desire to protect their children from suffering, either by vaccinating their child in order to avoid rotavirus infection or by not vaccinating their child because of concerns about the side effects. It is important that child health-care professionals understand the variations of conceptions that influence the parents’ decisions and that these conceptions may differ considerably. Individualized parental information about rotavirus infection and vaccination would help to achieve a successful implementation of the vaccination program.

Hidden Menace in the Universal Child Immunization Program

Short-term, technocentric approaches to health care–“selective primary health care”–in Third World countries, as advocated by UNICEF and other international agencies, threaten to reverse the historic gains made at the Alma-Ata Conference in 1978. The primary health care strategy presented in the Alma-Ata Declaration was the culmination of the struggle for democratization of health services in the Third World. In this article, the author discusses the effects of the selective primary health care approach, as exemplified by the Universal Child Immunization Program, on general health services and its fundamental contradictions with the primary health care approach, and presents the manifesto drawn up at the Meeting on Selective Primary Health Care held in Antwerp in 1985.