Progress Report eVIN Roll-out in Madhya Pradesh Jan- Dec 2018 1 A brief state profile of MADHYA PRADESH ................................................. 3 Introduction: eVIN & UIP in Madhya Pradesh ……………………….........3 Overview: Vaccine Logistic Network in MADHYA PRADESH .................... 4 Manpower: eVIN team in MADHYA PRADESH ........................................... 5 How eVIN Works: ............................................................................................... 5 Support to UIP in Madhya Pradesh .................................................................. 7 Financial Report: ................................................................................................ 8 eVIN Dashboard Indicators ............................................................................... 8 eVIN showcase in Madhya Pradesh……………………………………..…...11 Acknowledgements: Digitalizing Immunization supply chain is optimistic and challenging task in a huge state like Madhya Pradesh. eVIN team acknowledge the support provided by Mrs. Gauri Singh, IAS, Principal Secretary, Health, Dr Pallavi Jain Govil, IAS, Commissioner Health, Mr Nishant Warwade, IAS, Mission Director, NHM, MP & Dr B N Chauhan, Director Health Services & NHM Madhya Pradesh for their invaluable support and guidance during eVIN Roll‐ out and eVIN transition to the NHM. eVIN team express heartfelt gratitude towards Mr V.Kiran Gopal, IAS, Ex‐MD NHM, MP, Mr S. Vishwanathan, IAS, Ex‐Mission Director, NHM,MP, Dr Santosh Shukla, SEPIO Madhya Pradesh, Er Vipin Shrivastav, SCCO, MP for being instrumental in utilizing eVIN for strengthening vaccine logistics and cold chain management in MP and projecting it as a sustainable model. eVIN team acknowledges the support extended by State NHM team for extending support to sustain eVIN with NHM resources and all the tireless efforts of the concerned officials of districts, the CMHOs, District Immunization Officers, state vaccine stores, district vaccine stores, cold chain technicians and cold chain handlers for their vital roles in eVIN implementation and its continuation in Madhya Pradesh. eVIN team is committed to strengthen Vaccine Logistics and Cold Chain management in Madhya Pradesh and will continue to excel and project Madhya Pradesh as an Ideal Supply Chain management model for the country. 2 State Profile: Madhya Pradesh As its name suggests, Madhya Pradesh is situated in the very heart of India. It shares its borders Location with five other states viz., Rajasthan in the north-west, Uttar Pradesh in the north, Gujarat in the west, Maharashtra in the south and Chhattisgarh in the north-east. Area The state spans over a geographical area of 3,08,000 sq.km. The state, by and large, tends to have a pleasant moderate climate round the year, sometimes Climate interspersed with extreme weather. Regions Regions Malwa, Nimar, Bundelkhand, Baghelkhand, Chambal and Mahakaushal. The main language of communication is Hindi. In and around the places viz., Bhopal, Sironj, Languages Burhanpur, Kurwai etc., Urdu mixed with Hindi is commonly used. Different dialects in different regions are spoken like Bundeli in Bundelkhand, Malwi in Malwa, Nimari in Nimar, Bagheli in and Dialects Baghelkhand and Bhili and Gondi in Tribal areas of Jhabua, Mandla, Dindori, Balaghat and Seoni districts. Means of Agriculture is the main source of livelihood of a large number of the people of the state. About 150.75 lakh hec. area is under cultivation and above 70% of total working population depends on Livelihoods agriculture sector. Main Crops Soybean, Wheat, Paddy, Jowar, Maize, Gram, Masur, Tuar, Mustard. Rivers Narmada, Chambal, Mahi, Tapti, Betwa, Sone, Banganga, Ken, Pench, Tawa and Shipra. Madhya Pradesh takes pride in having the country's largest forest coverage of 94689.38 sq.km. Out Forest Area of 94689.38 sq.km., 61886.49 sq.km. is reserved forest, 31098 sq.km. is protected forest and 1705.85 sq.km. falls under unclassified forest. Introduction: Madhya Pradesh has got highest Forest areas in the Country after Assam. It has got 21 Tribal districts with 89 blocks with Tribal population. Tribal, hard to reach, forest areas lack infrastructure development in terms of network in some parts of MP. Health infrastructure and availability of human resources are major concerns in the state. The state is relatively sparsely populated, with an average population density of 230 per square kilometer, compared to the country average of 274 per square kilometer. Madhya Pradesh is the second largest state in the country and accounts for 13.5 percent of the total area of India. The state is organized into small hamlets fragmented throughout the state. This geographic arrangement makes it difficult to position and develop health centers in the state. India conducts one of the largest Universal Immunization program (UIP) in the world. The coverage is more than 26 million newborns and 30 million pregnant women each year translating into more than 30 million doses of vaccine each year. At Madhya Pradesh, there are total 4 Regional Vaccine Stores, 3 Divisional Stores, 51 District vaccine stores and 1126 Cold Chain Points (CCPs) in which 95% are below the district level. The full immunization coverage for infants is 56% (NFHS 2015‐16) in Madhya Pradesh. A key challenge for Madhya Pradesh in realizing its vision of 100 percent immunization is to address inadequate vaccine logistics and temperature monitoring systems right from manufacturer down to the mother and child. The availability of quality vaccines at session sites is a contributor to low coverage. 3 The Madhya Pradesh was the first state in India to launch Electronic Vaccine Intelligence Network (eVIN)under GAVI Health System Strengthening (HSS) support. During the training 2480 CCH & Link mobile handset (smartphone) by the United Nations Development Programme (UNDP) with Data sims by the National Health Mission (NHM), amounting to Rs. 5 lacs per month approx. Post implementation the Vaccine Cold Chain Managers (VCCMs) monitored the work of CCH and gave feedback to the District Level Managers and corrective measures were taken. This resulted into: Digitalization of Vaccine Logistics/records Real time monitoring of vaccine temperature Reduction in Vaccine wastage Reduction in discards Shortening of pipelines for vaccines Reduction in wastage of short expiry vaccines. E.g. DPT. With UNDP funding for eVIN ending in December 2017, it has become crucial to continue with the activities under eVIN to sustain the results achieved so far. During the video conference held on 15th September 2017 to discuss transition and sustainability plan for eVIN under chairmanship of Shri Manoj Jhalani, ASMD (NHM), Govt. of India, it was decided to include HR, operational and implementation cost under state PIPs. In 2018, Madhya Pradesh, State NHM has signed an MoA with UNDP to implement eVIN with domestic funding. Overview: Vaccine Logistic Network in MADHYA PRADESH: 4 eVIN team in Madhya Pradesh For the smooth Roll‐out of eVIN across the state, UNDP deployed following resources at State, Divisional and District level. •Senior Project officer (1) •Project officer IT (1) State •Accounts & Finance Asst (1) •Project officer- Operations (6) Divisional •Vaccine and Cold Chain manager (51) District How eVIN Works: eVIN enables real‐time visibility of vaccine logistics and cold chain by digitizing stock supplies and storage temperature across vaccine cold chain points in India. And thus visibility of real time vaccine stocks and temperature data through eVIN is strengthening the evidence base for improved policy‐making in vaccine delivery, procurement and planning for new antigens. eVIN gives solution to three crucial questions related to vaccine logistics and cold chain management: Where are my vaccines? Are they available in adequate quantities? Are they being stored in appropriate conditions? eVIN is made up of three components – Processes (Standardisation of record keeping tools) Product (Technology consisting of eVIN mobile based application and remote temperature loggers) People (Strong Human resource network at different levels) Processes: Under eVIN, GoI has introduced two types of registers, one for recording detailed distribution data on every immunisation session day, and another for recording changes in total stock levels. Government of Madhya Pradesh adopted these registers and revised/customized as per States specifications. 5 Standardized Vaccine Stock and Immunization Session Registers in Hindi Product: The technology in eVIN is a LMIS (logistic management information system) software which is an android based simple mobile application where the vaccine cold chain handler feeds regularly the vaccine and logistics data from the Standardized Vaccine Stock and Immunization Session Registers and the data is sent into a central server through the mobile‐ cloud technology. It also has a Remote Temperature Loggers (RTL) which captures the real time temperature data which is then sent to the same server and both the information gets shared at a single platform and it gets presented in Dashboards. eVIN Dashboard view RTL is a low cost, SIM‐based remote temperature monitoring system, with 2 sensors for ILR & DF and 5 sensors for WIC/WIF. Sensor unit collects temperature data every 10 minutes and updates eVIN server every 60 minutes. Three types of alarms‐ device, SMS and email sent immediately to any 5 concerned authorities upon sensing temperature breach. People: A strong human resource network at National,