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Vaccine Management System Project Report Documentation.
Vaccine Management System Project Report Documentation.
INTERNSHIP REPORT
ON
VACCINE MANAGEMENT SYSTEM PROJECT
BY
KAMAL ACHARYA
(Tribhuvan University)
Date: 2023/06/21
i
Abstract
The Division of Vaccine and Immunization is facing increasing difficulty monitoring vaccines
and other commodities distribution once they have been distributed from the national stores.
With the introduction of new vaccines, more challenges have been anticipated with this
additions posing serious threat to the already over strained vaccine supply chain system in
Kenya. Access to these vaccines will have surpassed the current ability of the existing supply
and logistic system to distribute, track and store the vaccines at proper temperatures, condition
and quality and ensure they reach their destinations in a timely manner.
This paper is a system documentation for the development of Vaccine Stock Management Tool
for the Division of Vaccine and Immunization of Kenya. The study was conducted to research,
study and review existing literature and systems architecture for vaccine stock supply
management and studied the existing vaccine supply management system in use in Kenya. This
revealed the current inefficiencies in vaccine supply and stock management within the Division
of Vaccine and Immunization department in the Ministry of Health. The result of the study
were the design and implementation of a vaccine stock management tool that would address
the frequent levels of stock outs in the country by introducing a system based on a “push” or
requisition model rather than the “push” or allocation approach currently been used.
To achieve this, a web-based vaccine stock management tool was developed following the agile
methodology. The developed solution is an implementation of a vaccine supply chain and cold
chain management system that ensures efficient and effective vaccine delivery and that enable
better and timely decision-making. Availability of quality, real time data on vaccine supply and
demand at the national, regional, and lower levels would be critical to supporting improved
efficiencies in how vaccines are managed in Kenya.
ii
Declaration
I hereby affirm that this system documentation document is duly my original work and
therefore has not been submitted in any institution for the satisfaction of any academic award.
iii
Table of Contents
Abstract................................................................................................................................. ii
Declaration........................................................................................................................... iii
Table of Contents ................................................................................................................. iv
List of Figures.................................................................................................................. vii
List of Tables .................................................................................................................. viii
Abbreviations.................................................................................................................... ix
1 Chapter One: Introduction ............................................................................................ 10
1.1 Background of the Study ....................................................................................... 10
1.2 Problem Statement ................................................................................................ 12
1.3 General Objective .................................................................................................. 12
1.4 Specific Objectives ................................................................................................ 13
1.5 Justification ........................................................................................................... 13
1.6 Scope .................................................................................................................... 14
2 Chapter Two: Literature Review .................................................................................. 15
2.1 Introduction........................................................................................................... 15
2.2 Vaccines and Vaccine Supply Systems .................................................................. 15
2.3 Vaccine Situational Analysis in Kenya .................................................................. 16
2.4 The current Kenya Vaccine Supply Chain Structure .............................................. 17
2.5 General Supply-Chain Management ...................................................................... 19
2.6 Review of existing models and systems in vaccine management ............................ 20
2.6.1 Online drug inventory & supply chain management system of Haryana .......... 20
2.7 Components of a Vaccine Stock Management Tool ............................................... 21
2.8 Cold Chain Systems .............................................................................................. 21
2.9 Functionality Testing for the Vaccine Stock Management Tool ............................. 22
2.10 Characteristics of Ideal Health Information Systems .............................................. 22
3 Chapter Three: Research Methodology and Design....................................................... 24
3.1 Introduction........................................................................................................... 24
3.2 Research Design .................................................................................................... 24
3.3 Data Collection ..................................................................................................... 25
3.3.1 Observation .................................................................................................... 25
3.3.2 Interview ........................................................................................................ 25
3.3.3 Secondary Data .............................................................................................. 25
3.4 Software Development Methodology..................................................................... 25
3.5 Deliverables .......................................................................................................... 27
iv
3.5.1 System Modules ............................................................................................. 27
3.6 Conclusion ............................................................................................................ 27
4 Chapter Four: System Analysis and Design .................................................................. 28
4.1 Introduction........................................................................................................... 28
4.2 System Requirements ............................................................................................ 28
4.2.1 Functional Requirements ................................................................................ 28
4.2.2 Non-functional requirements .......................................................................... 28
4.3 System Analysis .................................................................................................... 29
4.3.1 Entity Relation Diagram ................................................................................. 30
4.3.2 Use Case Modelling ....................................................................................... 31
4.3.3 Class Diagram ................................................................................................ 36
4.3.4 Database Schema ........................................................................................... 37
4.4 System Design ...................................................................................................... 38
4.4.1 High Level Architecture for the Vaccine Stock Management Tool.................. 38
5 Chapter Five: System Implementation and Testing ....................................................... 39
5.1 Introduction........................................................................................................... 39
5.2 System Development Tools ................................................................................... 39
5.3 Implementation methodology ................................................................................ 40
5.3.1 Tasks ............................................................................................................. 40
5.3.2 A web-based application ................................................................................ 42
5.3.3 End of Phase One and Piloting ....................................................................... 43
5.3.4 Features not Implemented............................................................................... 43
5.4 Testing .................................................................................................................. 43
5.4.1 Test Basis....................................................................................................... 43
5.4.2 Test Approach ................................................................................................ 43
5.4.3 Testing Conclusion......................................................................................... 44
5.5 System Deployment .............................................................................................. 44
6 Chapter Six: Conclusions and Recommendations .......................................................... 46
6.1 Conclusions ........................................................................................................... 46
6.2 Recommendations ................................................................................................. 47
6.3 Future Work .......................................................................................................... 47
7 References .................................................................................................................... 48
8 APPENDICES ............................................................................................................. 50
8.1 Appendix A: Cold Chain Room............................................................................. 50
8.2 Appendix B: System Screen Shots......................................................................... 51
v
8.3 Appendix C: Sample System Code ........................................................................ 56
vi
List of Figures
Figure 2-1: The current vaccine supply chain structure ........................................................ 18
Figure 2-2: Procurement model for the system (Verma, 2014) ............................................. 20
Figure 3-1: Conceptual Research Design ............................................................................. 24
Figure 3-2: Agile system development methodology (Elezovic, E., 2012)............................ 26
Figure 4-1: Entity relationship diagram ............................................................................... 30
Figure 4-2: Managing the Sub-County Module .................................................................... 31
Figure 4-3: Managing the National Module ......................................................................... 32
Figure 4-4: Class Diagram ................................................................................................... 36
Figure 4-5: Database Schema .............................................................................................. 37
Figure 4-6: Technology Stack.............................................................................................. 38
Figure 5-1: Manage stock Module ....................................................................................... 41
Figure 5-2: Cold Chain Module ........................................................................................... 42
Figure 8-1: Cold Chain room ............................................................................................... 50
Figure 8-2: Login Page ........................................................................................................ 51
Figure 8-3: Sample Admin Dashboard ................................................................................. 51
Figure 8-4: Manage Stock Module....................................................................................... 52
Figure 8-5: Document Manager Module .............................................................................. 52
Figure 8-6: Cold Chain Management Module ...................................................................... 53
Figure 8-7: Reports Module ................................................................................................. 53
Figure 8-8: Admin System Configuration Module ............................................................... 54
Figure 8-9: Failed Login ...................................................................................................... 54
Figure 8-10: Unauthorized Access Error .............................................................................. 55
Figure 8-11: Part of the research team during the Central Vaccine Store site visit ................ 57
vii
List of Tables
Table 4-1: Use Cases List .................................................................................................... 32
Table 4-2: Sub county Use Case .......................................................................................... 33
Table 4-3: Managing the National Module........................................................................... 34
Table 5-1: Browser Compatibility tests ................................................................................ 44
viii
Abbreviations
ix
1 Chapter One: Introduction
1.1 Background of the Study
According to the Kenyan constitution, every person has the right to the highest attainable
standard of health. It states that it is the right of every child to basic nutrition, shelter and
healthcare. The Government of Kenya, following its mandate stipulated in the Constitution to
provide healthcare to its citizens, has among one of its key ministries, the Ministry of Health.
The Ministry of Health, keen to ensure that children at a young age are saved and protected
from killer diseases such as Measles, Pneumonia, initiated a program, The Division of Vaccines
and Immunization.
The Expanded Program on Immunization (EPI) established by the World Health Organization
(WHO) in 1974 to provide six vaccine-preventable diseases (tuberculosis, poliomyelitis,
diphtheria, tetanus, pertussis and measles) through routine infant immunization (T. Hyde et al,
2012). Since 2000, national-level Expanded Program on Immunization (EPI) have seen their
vaccine portfolio grow from 6 basic antigens to the 12 now recommended by the World Health
Organization (WHO) for all countries (Hyde et al., 2012). The new vaccine introductions have
put strains on vaccine supply chains around the world. Many low and middle income countries
have been forced to restructure their entire vaccine supply, logistic and reporting systems
components in order to get all the vaccines to their populations in a timely manner.
The diseases that children are immunised against are Measles, Tuberculosis, Pneumonia,
Diarrhoea, various respiratory infections and others. It is the duty of the Division of Vaccine
and Immunisation to ensure that all children in Kenya are fully vaccinated. It also checks and
ensures that vaccines are well maintained and monitors any responsive effects from the
immunizations. It dispenses vaccines to various health center and also introducing new
vaccines.
In the last decade, we have seen a surge in interest and funding for new vaccine development
and introduction to many developing countries (Kaufmann, Miller & Cheyne, 2011). This
developments have become increasingly clear impacting the immunization and public health
in those countries, both in a positive and negative way. Third world countries are now
beginning add new vaccines and antigens to their standard immunization programs. M. Zaffran
et al. (2013) says the introduction of a new vaccine has the potential to reduce morbidity and
mortality associated with pneumonia, cancer and other diseases at the same time, access to all
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vaccines hinges on the ability of the already strained vaccine supply and logistic systems in
this countries.
In Kenya, the new vaccine landscape has been increasing with the Rotavirus vaccine introduced
in July 2014 and there are plans to introduce Inactivated Polio Vaccine, Human papilloma
Virus, Measles Rubella and switch to Bivalent oral polio vaccine (Chopra & Meindle, 2009).
The Rotavirus vaccine uptake was variable with slow uptake in some counties and rapid uptake
in other counties in terms of time and uptake. This was due to the existing inefficiencies in the
current supply system threatening the vaccine accessibility, quality and availability. With the
higher cost of these new vaccines, such programs are under considerable pressure to increase
performance through improved forecasting, wastage minimization and implementing efficient
vaccine management systems. Supply and logistic innovations are urgently needed to address
the current supply system bottlenecks.
The main challenge is difficulty in monitoring vaccines from the moment they leave the
national and regional stores. In the current system, this is almost impossible as keeping track
of how the vaccines are being used is a Herculean task. Kenya’s spending on vaccines is set to
grow from $14 million annually to $53 million due to the introduction of the diarrhoea vaccine
and a medically beneficial polio vaccine (Mvundura et al, 2015). This calls for an automated
and more sensitive system that provides increased visibility and analysis of vaccine stock data,
consumption data, and interventions that are possible with current resources at levels. Currently
this is done in excel based tools, already shared with national.
Another challenge faced is the concern about the security and potency of these vaccines. It is
difficult to uniquely identify vaccines. There is also lack of visibility on the working conditions
of cold chain equipment. This is at the sub-county and the health facility levels. There is need
to design a system that assures users of the originality and potency of vaccines through the use
of batch numbers. Also, decisions made by users in different levels of the system need to be
tracked.
It is against this background that the problem statement addressed in the current study was
formulated.
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1.2 Problem Statement
The Division of Vaccine and Immunization is facing increasing difficulty monitoring vaccines
and other commodities distribution once they have been distributed from the national stores.
The existing vaccine supply chain structure operates primarily as a “push system” where the
DVI calculates required vaccine quantities for each region and allocates stock to the region
stores. The system in place is only usable to users at the national level and the regional levels
and deals with the issuance and reception of vaccines and tracking of cold-chain equipment.
Some of the capabilities missing are the ability for users to track vaccine stocks, vaccine
utilization and monitoring cold chain system.
With the introduction of new vaccines, more challenges have been anticipated with this
additions posing serious threat to the already over strained vaccine supply chain system in
Kenya. Access to all this vaccines will have surpassed the current ability of the existing supply
and logistic system to distribute, track and store the vaccines at proper temperatures, condition
and quality and ensure they reach their destinations in a timely manner.
Thus, it was essential that an improved and efficient vaccine stock management tool to be
developed to reduce wastage, stock outs, overstocking and expired stock. The developed
solution was available to users at all levels thus it facilitated vaccine stock tracking throughout
the vaccine supply chain. The developed solution was expected to collect information from the
various stores, transfer it to the national level, and notify the regional stores on stock availability
at the national level. The system would provide analytic information with the data gathered.
There are various problems that have been brought by using the current system. It was hard to
make any forecast on future stock needs, resulting in the Division of Vaccines and
Immunization being unable to make proper planning. Lack of keeping track of the vaccine
stock created a loophole for malicious people to take advantage and probably misuse these
vaccines. The system could not monitor Cold Chain equipment and temperature at the sub-
county and health facility levels.
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1.4 Specific Objectives
The objectives of the project were:
a) To visit the central vaccines store to understand the vaccine stock management
techniques
b) To identify the current challenges faced in the vaccine supply chain in Kenya.
c) To design a system architecture that tracks vaccine utilization all the way from the sub-
county level to the national level.
d) To develop a system that manages and monitors the vaccine supply chain and cold chain
systems with the capacity to make forecasts on future needs.
1.5 Justification
With the current system, there are great challenges faced by its users, and with the government
set to introduce more vaccines, tracking vaccine stocks will be a Herculean task. However, with
the new developed system, this is made much easier. The major beneficiaries is the government
under the Ministry of Health. The government has time and time again had to go through
financial strain in order to buy vaccines which are left unaccounted for. With the new system,
the government is able to have an updated and accurate inventory.
Other beneficiaries of this system are the various users at the county and sub-county levels,
who make orders and have to wait; not knowing what time the stock will be brought to their
depots. This created lots of uncertainties, resulting in cases of inadequate stock in the depots,
in case the stocks fail to arrive in time. With the new system, they are able to get prompt
messages once their orders are approved, and in the case of rejection be provided with an
opportunity to reorder.
Also, administrators at different levels are able to keep count of their cold chain systems in a
much efficient way, and also keep track of the system’s users. Currently, this is quite difficult
with some of the users having provided details in the wrong format e.g. a user putting a random
word in place of his/ her phone number.
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1.6 Scope
The developed system is a web-based application going to be used by the Division of Vaccines
and Immunization Kenya. This system covers national, regional, county and sub-county levels
of the country. However, the system at the moment is not able to cover the health facilities at
the grass-root level. This means that the user at the sub-county level have to go to the health
facilities and get information of the vaccines needed and the quantity required. The user at the
sub-county level then place an order to the county depot on the vaccines needed.
The user at the county level then assess the order placed, and either approves or rejects. After
approval, the user at the sub-county level receives a prompt message to inform him of that.
However, if the order gets rejected, the user is prompted with a message giving the reasons the
order was rejected, and be able to reorder. Reports are generated to act as proof of any
transaction that goes through the system. Currently, these functionalities are not in existing
system.
With the information collected by the system on matters such as dates in which vaccines are
ordered and the quantity ordered, the system provides crucial information to be used for
analysis purposes. Therefore, forecasts are easily made so as to make early arrangements to
avoid any future crisis.
On managing cold chain systems, the system has an inventory detailing all the systems
uniquely. This provides an opportunity to easily track any missing systems, and easily detect
malfunctions. At the moment, the system only has records of the cold chain systems but has
not uniquely identified them.
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2 Chapter Two: Literature Review
2.1 Introduction
This chapter reviews published information, trends and guidelines in vaccine supply chain and
cold chain systems.
Over the years, mankind has dedicated himself in finding better solutions to various health
issues. According to a book written by the World Health Organization (W.H.O), immunization
is one of the most cost-effective of all health interventions and also crucial in the road to attain
the Millennium Development Goals (MDGs). Research carried out by the WHO also made an
estimate that if vaccination operations were to be widely and efficiently carried out, two million
more deaths among children under the age of five years can be averted (WHO Publications,
1985).
Immunization programs have severally added new vaccines to the original six vaccines. These
original vaccines are:
a) Measles
b) Polio
c) Tuberculosis
d) Diphtheria
e) Tetanus
f) Pertussis
New vaccines added include hepatitis B, mumps, pneumococcal disease, rotavirus, yellow
fever etc. (CHAI Documents, 2015).
Globally, governments use different ways to manage and disseminate vaccines to their people.
In the United States of America, the US Department of Health and Human Services implements
a well efficient system which deals with Vaccine Inventory Management, Storage Unit
Temperature Monitoring, Cold Chain Management as well as Staff Organization. . When it
comes to, Vaccine Inventory Accounting, the system is able to keep track of received vaccine
stocks, amount of current stock, amount already administered to children; amount wasted or
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expired and is also able to forecast which vaccines need to be reordered. An inspection and
update on vaccine stocks is done on a weekly basis.
In Africa, various countries, including Kenya have embraced similar systems to manage their
vaccines. According to a research carried out by the World Health Organization in Kenya,
Moldova, North Korea and other countries showed that approximately 50% of all vaccine doses
are wasted either before or after leaving the stores (Zaffran, 2013). This can be attributed to
supply chain management issues such as accidental freezing, expiry, breakage and even theft.
This poses a major challenge in economical circles since a lot of money is used to compensate
for these loses. In Kenya, the Division of Vaccines and Immunization has a system put in place
whose functions are to ensure vaccine stocks are well managed and monitored. (Ministry of
Public Health and Sanitation, 2013) This system however has a few challenges that need to be
rectified.
First, the system is only usable at the regional level. With the introduction of the new
constitution, a total of 47 counties were made. The system should be able to provide users as
far as the sub-county levels place their orders. This is done after the users at the sub-county
levels have received estimates on the number of vaccine stocks needed at the health facilities
in their respective counties. A situation analysis done by the Division of Vaccines and
Immunization identified that its programme was facing several setbacks.
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division has a series of stores which vaccines are stored in refrigerators and have a distribution
network which utilizes cold boxes.
With the introduction of new beneficial vaccines (ROTA and IPV), the country is bound to
experience significant strain on an already overloaded vaccine supply and logistics systems. It
follows that we can easily resolve part of the challenge by; implementing supply systems that
support efficient and effective vaccine delivery and that enable better and timely decision-
making. This means there is more need than ever to have a robust system than while ensuring
effectiveness provides increased accountability and traceability.
The current stock outs about 56% in all facilities affect over 200,000 children monthly, with
immunization drop out as large as 25%, we are risking loss of lives for over 50,000 children
(CHAI Documents, 2015). We can save lives all these children by streamlining vaccine
delivery, through technology as part of other interventions.
There has been increased concerns about security and potency of vaccines, in Kenya. There
currently exists little information on the working status of the cold chain at sub-county stores
and health facilities, and their capacity to store vaccines. There is need to build a system that
ensure verifiability of vaccines against batch numbers, to allow retrieving vaccines, so as not
to harm our children.
With the decentralization health there is need for relegation of decision making from National
to County Level, this decision making needs to be evidence based. A vaccine information
system will provide the necessary information for these actions.
Availability of quality, real time data on vaccine supply and demand at the national, regional,
and lower levels would be critical to supporting improved efficiencies in how vaccines are
managed.
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DVI calculates required vaccine quantities for each region and distributes to the region stores
(Figure 1). The counties and sub counties levels the submit stock order to their respective
regional stores
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d) Use of the push system as opposed to the recommended pull system is causing over or
under stocking of vaccines in some facilities as it is not based on individual performance
e) Unreliable minimum and maximum stock levels as they were not related to facility
coverage data
f) Vaccine wastage not included and factored in vaccine forecasts
The most effective supply chain system should include financial planning, forecasting,
distribution and procurement processes to create a seamless end-to-end system. Modern
inventory systems and supply chains can provide precision and transparency.
When supply-chain managers have access to reliable information about customers’ needs,
production information and delivery schedules, there is less need for large inventories.
There are two different well known types of stock management systems. These are:
a) “Push” or Allocation systems
b) “Pull” or Requisition systems
In the push or allocation systems, distribution decisions are made by higher-level facilities. The
quantities distributed are usually based on usage and stock reports without receiving
requisitions.
In the pull systems, the lower level facilities are responsible for ordering supplies. Decisions
on quantities distributed are made by lower level managers in charge of supply.
Minimum/maximum (min/max) inventory control system is recommended in stock
management systems. Using a min/max inventory control system help managers to prevent
both over-stocking and stock outs.
Minimum stock level is the level below which stocks should never drop without having placed
an order.
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Maximum stock level is set to guard against oversupply, it consists of the minimum stock plus
that amount of stock which is normally used between orders
The new system was designed and developed with the following objectives in mind:
The system prevalent challenges at that time was fraught with errors and there was no control
on critical issues like alerts on expiry medicine, supply of medicine by vendors, whether drugs
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have reached the reordering level etc. The system led to lots of time wastage and requires
continuous monitoring to ensure that each transaction is accounted for and makes inventory
record keeping a more cumbersome process for the operator. Not more than one person was
able to access data at the same time unless they keep multiple copies of reports and the resultant
paper work takes lot of space and often searching the relevant information becomes a tedious
exercise.
A computerized system is a good option for businesses dealing with many different types of
stock. Other useful features include:
Stock and pricing data integrating with accounting and invoicing systems. All the systems draw
on the same set of data, so you only have to input the data once. Sales Order Processing and
Purchase Order Processing can be integrated in the system so that stock balances and statistics
are automatically updated as orders are processed.
a) Automatic stock monitoring, triggering orders when the re-order level is reached.
b) Automatic batch control if you produce goods in batches.
c) Identifying the cheapest and fastest suppliers.
d) Bar coding systems which speed up processing and recording. The software will print
and read bar codes from your computer.
e) Radio Frequency Identification (RFID) which enables individual products or
components to be tracked throughout the supply chain. See the page in this guide on
using RFID for inventory control, stock security and quality management (Info
Entrepreneurs, 2010).
It involves the equipment and people needed to keep vaccines at the correct temperature
(between +2°C to +8°C) during transport and storage from the time they are manufactured up
until they are administered.
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The cold chain must never be broken. Vaccines are sensitive to heat and extreme cold and must
be kept at the correct temperature at all times.
Health workers at all levels are often responsible for maintaining the cold chain while vaccines
are stored in the vaccine stores at the province and county levels, or while they are being
transported to township and villages, and while they are being used during immunization
sessions or rounds. More and more often it is becoming the logistician’s responsibility to
manage the cold chain as a part of the supply chain (Logcluster, 2004).
The need to monitor cold chain systems arises because they suffer weaknesses which include:
There are two types of Functional testing, Positive and negative functional testing. In positive
functional testing applications functions are tested with valid input and also verifying that the
outputs are correct. In negative functional testing the testing involves exercising application
functionality suing a combination of invalid inputs.
An information system can be said to be ideal if it meets this characteristics (Zaffran etal,
2013):
• Integrated and interoperable with other health information systems.
• Built on reliable data collected at the place where the events occur and aggregated or
disaggregated as needed.
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• Flexible, adaptable, and compatible with different contexts, programs, and changes over time
as needs evolve.
• Driven by the needs of end-users, managers, planners, recipients of health services, and other
stakeholders.
• Affordable and sustainable so decision-makers can evaluate the wider cost implications of
adopting an information system across the health system.
• Reliable and secure from unauthorized use.
• Built upon a consistent design framework with standards, common data, common software
applications, and technologies that are properly supported by clear design and user
documentation.
• Designed and used for evidence-based decision-making.
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3 Chapter Three: Research Methodology and Design
3.1 Introduction
The main objective of this research was to develop a vaccine management tool for the Division
of Vaccine and Immunization Kenya. This chapter outlines the methodology, data collection
and analysis techniques that were used in carrying out the research to get information prior to
the design and development of the system. A research method is the arrangement of conditions
for collection and analysis of data in a manner that aims to combine relevance to the research
purpose with economy in procedures (Selltiz., Wrightsman & Cook, 1976).
Due to the nature of this study, a qualitative approach was therefore used. [Figure number]
presents a conceptual research design of this study.
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3.3 Data Collection
Both Primary and Secondary Data were collected and analysed during the study. The primary
data were gathered through face to face and guided interviews and participatory observation at
the national central vaccine store in Kitengela and the secondary data gathered from different
books, journals and related publications.
3.3.1 Observation
Observation involves the systematic viewing of people's actions and the recording, analysis
and interpretation of their behaviour. We visited the national central vaccine store in Kitengela
where we involved ourselves in having formal and informal discussions with the users and
system administrators to obtain useful inputs while developing the system. This was considered
to be the best way of obtaining information that could not be captured in the interviews.
3.3.2 Interview
An interview is a structure conversation between people in which one person has the role of
researcher and aims to discover the truth or the unknowns. Interviews are preferable to
questionnaire where questions are either open-ended or complex, or where the logical order of
questions is difficulty to predetermine and it is the favoured approach where better reliability
of data is desired (Gray, 2009).
We researcher used this tool purposely to get information that could not be obtained through
participatory observations. Through interviews, it was possible to ask interviewees (system
users and program administrators) supplementary questions on the research problem.
The system development thus borrowed much from the existing literature on similar interests.
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The system development methodology aims to produce a high quality software that meets
customer expectations, reaches completion within times and cost estimates. It contains
definitions, guidelines, and templates for the various project management activities needed to
deliver successful projects.
The vaccine stock management tool was developed following the agile methodology approach
to achieve its intended objectives. This helped the development team keep focus on process
adaptability and customer satisfaction by rapid delivery of working software product in
iterative builds.
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Client interaction is the backbone of Agile methodology, and open communication with
minimum documentation are the typical features of Agile development environment. This
worked well for us as we were having regular meetings with the project co-ordinators from the
Clinton Health Access Initiative offices.
3.5 Deliverables
The following are the expected deliverables of the system:
b) System documentation
a) Manage stock
b) Cold Chain
c) Reports
d) Documents
e) Configurations
3.6 Conclusion
In this chapter, the research methods selected for the research were discussed. This research
primarily uses document analysis, interview and observation for facts finding purposes. The
systems development methodology selected is agile methodology as it offers numerous benefits
which are well suited for rapid development web-based applications. There was also a review
of the deliverables that were aimed at in the conducting of this research.
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4 Chapter Four: System Analysis and Design
4.1 Introduction
In order to carry out an extensive system design, use case diagrams, data flow diagrams and
system sequence diagrams were used. We also did an analysis of the system development
requirements is carried out in this chapter. The main challenge was to develop a system that
will enable the access to all vaccines and the new ones in development without posing great
challenges on the system’s ability to distribute, track and keep accurate inventory of the
vaccines at proper temperatures, conditions and quality in a timely manner.
a) System generates reports that show details of any transaction that occurs in the system.
b) EPI Logisticians can make vaccine orders via the system at all levels.
c) National MET users can manage cold chain spare parts inventory at national levels.
d) The system should be able to register new users at all levels and assign them specific
roles and permissions.
e) The system should allow system user to generate reports as when required.
4.2.2 Non-functional requirements
Non-functional system requirements describe how the system should work. Below are the non-
functional requirements:
a) The system increased reliability because reports will be generated to keep track of the
vaccine stocks. Vaccine quality can only be assured if the product is correctly stored
and handled from the point of manufacture to the point of use. The system can only
establish with certainty that quality has been maintained when detailed records are kept
and these records are reliable.
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b) Users with basic computer skills should be able to use the new system and the system
should be robust.
c) The system should be mobile responsive and run well on any screen size. The rollout
plan targets to issue out tablets to all system users.
d) Non authorised users should be denied access to the system. All system data should be
secured at all times (See Appendix B).
So as to fully understand the various functions the program should perform the following tools
were used:
a) Feasibility Studies – determining whether the product or project is worth the time
and effort. It describes features and benefits of the product, itemizes costs, resources
and staffing then describes the projects potential profits or value to the organization.
b) Flowcharts – this is the diagrammatic representation of a process. It describes a
series of steps or decisions in visual form in a manner that facilitates
communication.
c) Requirements Lists - should be organized by categories. As the list grows, this list
helps the analyst understand the customer's needs and helps limit what features are
necessary and which are not.
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4.3.1 Entity Relation Diagram
An Entity Relationship Model is a detailed logical representation of data in an organization. It
is expressed in terms of the relationships among entities and the attributes of entities and their
relationships. Figure 4 show the entity relationships in our system.
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4.3.2 Use Case Modelling
Uses cases are text based methods of describing and documenting complex processes. Use case
is a set of activities that produce some output result. They describe how the system reacts to an
event that triggers the system. Figure 5.1 and Table 5.1 show the Use Case Diagram of Vaccine
Stock Management Tool.
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Figure 4-3: Managing the National Module
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4.3.2.2 Sub County EPI Logistician Use Case
Created By: Julie Otieno Egesa Last Updated By: Julie Otieno Egesa
Date Created: 28th October 2015 Last Revision Date: 29th December 2015
Description: This Use Case describes the process by which vaccines stocks are supplied and
distributed at the Sub County level. It also sets up a stock ledger platform for
inventory management at the Sub County level
Postconditions: 1. Sub County meets the vaccines demand from the Heath facilities
2. Sub County managers maintain accurate vaccine stocks records for planning
and forecasting.
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10. Sub County manager pulls vaccine immunization reports and information
from the DHIS
Alternative 2a. In step 2 of the normal flow, if the Sub County is in a County that has a depot
Flows: 1. System will prompt Sub County manager to place the order to the County
[Alternative depot manager
Flow 1 – 2. Sub County manager accepts
County has 3. Use Case resumes on step 5
own depot]
4b. In step 2 of the normal flow, if the Sub County is in a County that has a depot
1. System will prompt Sub County manager to place the order to the County
depot manager
2. Sub County manager declines
3. Order is placed to the Region Depot manager
4. Use Case resumes on step 3 of normal flow
Exceptions: 2a. In step 5 of the normal flow, if the consignment are discover to have quality
and/or quantity discrepancies
1. Sub County manager reports the issue
2. Order is rejected and returned to the Regional Depot
3. Regional Depot updates his/her stock information
4. Use Case resumes on step 7 of normal flow]
Created By: Julie Otieno Egesa Last Updated By: Julie Otieno Egesa
Date Created: 28th October 2015 Last Revision Date: 25th February 2016
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2. Regional Manager
Description: This Use Case describes the process by which vaccines are purchased from world
vaccines distributors and donors to serve the country demands. It also sets up a
stock ledger platform for inventory management at the National level
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4.3.3 Class Diagram
The system was developed following an object-oriented analysis and design approach. The
class diagram show some of the classes of the system, their interrelationships (including
inheritance, aggregation, and association), and the operations and attributes of the classes.
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4.3.4 Database Schema
A database schema is the skeleton structure that represents the logical view of the entire
database. It defines how the data is organized and how the relations among them are associated.
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4.4 System Design
4.4.1 High Level Architecture for the Vaccine Stock Management Tool
This architectural design is an overview of the technological architecture stack on which the
Vaccine Stock Management Tool was built on. It shows a high level view of the main
components of the tool, services and how they interact and communicate with each other.
The system is based on a client – server architecture, with both the client and server providing
their respective interfaces for interaction/communication. The system is web-based and can be
accessed through a website address (see Appendix) from any device connected to the internet
(Client). The system will include a robust relational database on a secure webserver that
running Apache 2.5 (Server).
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5 Chapter Five: System Implementation and Testing
5.1 Introduction
This chapter discusses the technology tools used in developing the system, explains how the
system implementation and its core functions. It also takes a look at the system testing
techniques that were carried out on the system.
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5.3 Implementation methodology
5.3.1 Tasks
Based on the magnitude and timelines applicable to the undertaking of the project, we were
inclined towards an agile methodology approach. This was beneficial to both the clients’
coordinators (Clinton Health Access Initiative Team) and the final system users. We had the
initial meeting were the tasks and requirements were handed over to the team tasked with the
development of the task. The successive meeting were all about refining the problem statement
and reviewing the system requirements. A technology stack was chosen based on the
requirements we had already been brief on. The technology stack decisions were informed
based on security, scalability and robustness of the system during the roll out.
With an always growing list of user requirements as is case with most large projects, agile
methodology helped us maintain a list of product backlogs. The list was managed on a feature
priority basis that saw the first prototype shipped with the most basic and essential features.
There was always a review and testing done upon each release. We could build on the feedback
and keep updating the product backlogs. Then we could work on the next build, this incremental
approach saw the product get better and better with each release and a reducing item list on the
project backlog list
A basic stock management system was first implemented and after being tested and debugged
the other features and functionalities were added to the system. Every feature was individually
tested and in conjunction with the rest of the system. We followed a more pragmatic
programming techniques where all system component were highly modularised and tightly
coupled, thus they could be removed from the system and test ran on them extensively.
The components were built on each other as subsystems until a vaccine stock management tool
was produced, which matched the specification. The subsystem were divided as per modules.
The main modules in this project included:
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5.3.1.1 Manage Stock
This is the module involved in the stock management and supply of the vaccines in the system.
The main users who mostly interact with this modules are the EPI Logisticians who are in
charge of ordering, issuing and managing vaccine stock at the various vaccine stores and the
public health nurse who are responsive if the vaccine stock at facility levels. Other system users
can only view vaccine ledgers at their respective stations.
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Figure 5-2: Cold Chain Module
5.3.1.3 Reports
This interface displays the various reports that can be generated from the system based on the
users’ designations. (See Appendix B)
5.3.1.4 Documents
This interface displays the various documents, newsletters and communications that can be
downloaded from the system based on the users’ designations. (See Appendix B)
5.3.1.5 Configurations
This can only be accessed by the administrators at the national level currently. This modules is
responsible in major system customization settings and user management functions. (See
Appendix B)
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Certain basic features re-used as there were many available open source PHP vaccine inventory
management systems.
The remote temperature monitoring was also not implemented because of lack of time and
limited documentation on using a machine sensors data logs with the procured thermometers.
I will however be implementing this in the next build that will be released with the current
feedback and product backlogs.
5.4 Testing
The vaccine stock management tool was tested throughout its development lifecycle by fellow
developers attached to the Strathmore HP lab, project supervisor from Strathmore University,
program coordinators from the Clinton Health Access Initiative – Kenya and selected
individuals from the Ministry of Health.
When a feature failed the test criteria, the implementation was debugged and in some occasions
the design revised, until the cause of the error is found and resolved.
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a) Functional testing
b) Usability testing
c) Compatibility testing
The system is also compatible with the personal computers, laptops and mobile platforms. It
runs all the major operation system distributions i.e. Windows, Mac and Linux.
5.4.3 Testing Conclusion
The test results from all the types of testing conducted, we confirmed that the tool met the
qualities of a robust, highly available and user friendly.
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6 Chapter Six: Conclusions and Recommendations
6.1 Conclusions
This research study was conducted in order to provide a solution to address the vaccine supply
and stock management inefficiencies within the Division of Vaccine and Immunization
department in the Ministry of Health. The aim was to propose and develop a new vaccine stock
management tool that would replace the existing system. The current system faced/is facing
major bottleneck which include; frequent vaccine stock outs affecting the whole country, mix-
up of vaccines with diluents from different manufacturers, inaccurate stock inventories and
unreliable minimum and maximum stock levels.
The challenges were set to get even bigger with the addition of basic vaccine and antigen
recommendations by WHO from 6 to 12 for all countries. This would pose a serious threat to
an already over strained vaccine supply system in the country. Access to all this vaccines will
have surpassed the current ability of the existing supply and logistic system to distribute, track
and store the vaccines at proper temperatures, condition and quality and ensure they reach their
destinations in a timely manner. It follows that we can easily resolve part of the challenge by;
implementing supply systems that support efficient and effective vaccine delivery and that
enable better and timely decision-making
There have been many discussions and reports about this subject matter, and a number of
recommendations have been put across to the team at the Division of Vaccine and
Immunization (DVI) from the donors and GAVI alliance on solving this problem. Among them
is the adoption of a “pull” vaccine supply chain system rather than the “push” vaccine supply
chain system that is currently been used. Such a switch will not only help minimize the frequent
stock outs, but also increase transparency and accountability within the entire system.
This research therefore proposed an implementation of the “pull” vaccine supply chain system
in Kenya. The developed solution was therefore developed with such requirements in mind and
seek integrate well with the existing health systems in the sector. The developed solution is a
web based system that collates information from the various stores to the national level and
also informs the regional stores on stock availability at the national level. The system does
analysis using the stock ledger to act as an early warning system and other derivatives.
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The adoption of the developed solution would see the following benefits; increased visibility,
accountability and traceability of stocks at all levels, packaged immunization data in ways that
ease/prompt decision making, planning /and taking real time actions and developed and
sustained use of Cold Chain Equipment and Temperature Monitoring information for planning
and actions
6.2 Recommendations
The following recommendations are offered for related research in the field of technology and
vaccines.
a) All targeted users with no computer skills should be given basic training on computer
system to ensure that they are able to work with technologies introduce to them in future
and have positive attitude towards technology.
b) There should be a series of conferences and workshops organised throughout the
country to ensure all stakeholders are aware of the current implementation and
transitions taking shape in this sector.
c) Ensure availability of internet accessibility at the facilities where the tool will used, this
will ensure the availability of the tool 24/7.
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7 References
Acharya, Kamal. "STUDENT INFORMATION MANAGEMENT
SYSTEM." Authorea Preprints (2023).
Acharya, Kamal. "Library Management System." Available at SSRN4807104 (2019).
ACHARYA, KAMAL, et al. "LIBRARY MANAGEMENT SYSTEM." (2019).
Acharya, Kamal. "Online bus reservation system project report." Authorea
Preprints (2024).
Acharya, Kamal. "Online bus reservation system project report." (2024).
Acharya, Kamal. “Online Bus Reservation System.” SSRN ElectroNIC ASIA
Journal (2024): n. pag.
Acharya, Kamal. “Student Information Management System Project.” SSRN
ElectroNIC ASIA Journal (2024): n. pag.
Acharya, Kamal. “ATTENDANCE MANAGEMENT SYSTEM.” International
Research Journal of Modernization in Engineering Technology and
Science (2023): n. pag.
Acharya, Kamal. “College Information Management System.” SSRN ElectroNIC
ASIA Journal (2024): n. pag.
Acharya, Kamal, Attendance Management System Project (April 28, 2024).
Available at
SSRN: https://ssrn.com/abstract=4810251 or http://dx.doi.org/10.2139/ssrn.4810251
Acharya, Kamal, Online Food Order System (May 2, 2024). Available at
SSRN: https://ssrn.com/abstract=4814732 or http://dx.doi.org/10.2139/ssrn.4814732
Acharya, Kamal, University management system project. (May 1, 2024). Availableat
SSRN: https://ssrn.com/abstract=4814103 or http://dx.doi.org/10.2139/ssrn.4814103
Acharya, Kamal, Online banking management system. (May 1, 2024). Available at
SSRN: https://ssrn.com/abstract=4813597 or http://dx.doi.org/10.2139/ssrn.4813597
Acharya, Kamal, Online Job Portal Management System (May 5, 2024). Available at
SSRN: https://ssrn.com/abstract=4817534 or http://dx.doi.org/10.2139/ssrn.4817534
Acharya, Kamal, Employee leave management system. (May 7, 2024). Available
at SSRN: https://ssrn.com/abstract=4819626 or http://dx.doi.org/10.2139/ssrn.4819626
Acharya, Kamal, Online electricity billing project report. (May 7, 2024). Available at
SSRN: https://ssrn.com/abstract=4819630 or http://dx.doi.org/10.2139/ssrn.4819630
Acharya, Kamal, POLICY MANAGEMENT SYSTEM PROJECT REPORT. (December 10, 2023).
Available at SSRN: https://ssrn.com/abstract=4831694 or http://dx.doi.org/10.2139/ssrn.4831694
Acharya, Kamal, Online job placement system project report. (January 10, 2023). Available at
SSRN: https://ssrn.com/abstract=4831638 or http://dx.doi.org/10.2139/ssrn.4831638
Acharya, Kamal, Software testing for project report. (May 16, 2023). Available at
SSRN: https://ssrn.com/abstract=4831028 or http://dx.doi.org/10.2139/ssrn.4831028
Acharya, Kamal, ONLINE CRIME REPORTING SYSTEM PROJECT. (August 10, 2022). Available
at SSRN: https://ssrn.com/abstract=4831015 or http://dx.doi.org/10.2139/ssrn.4831015
Acharya, Kamal, Burber ordering system project report. (October 10, 2022). Available at
SSRN: https://ssrn.com/abstract=4832704 or http://dx.doi.org/10.2139/ssrn.4832704
Acharya, Kamal, Teachers Record Management System Project Report (December 10, 2023).
Available at SSRN: https://ssrn.com/abstract=4833821 or http://dx.doi.org/10.2139/ssrn.4833821
Acharya, Kamal, Dairy Management System Project Report (December 20, 2020). Available at
SSRN: https://ssrn.com/abstract=4835231 or http://dx.doi.org/10.2139/ssrn.4835231
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Acharya, Kamal, Electrical Shop Management System Project (December 10, 2019). Available at
SSRN: https://ssrn.com/abstract=4835238 or http://dx.doi.org/10.2139/ssrn.4835238
Acharya, Kamal, Online book store management system project report. (Febuary 10, 2020).
Available at SSRN: https://ssrn.com/abstract=4835277 or http://dx.doi.org/10.2139/ssrn.4835277
Acharya, Kamal, Paint shop management system project report. (January 10, 2019). Available at
SSRN: https://ssrn.com/abstract=4835441 or http://dx.doi.org/10.2139/ssrn.4835441
Acharya, Kamal, Supermarket billing system project report. (August 10, 2021). Available at
SSRN: https://ssrn.com/abstract=4835474 or http://dx.doi.org/10.2139/ssrn.4835474
Acharya, Kamal, Online texi booking system project report. (March 10, 2022). Available at
SSRN: https://ssrn.com/abstract=4837729 or http://dx.doi.org/10.2139/ssrn.4837729
Acharya, Kamal, Online car servicing system project report. (March 10, 2023). Available at
SSRN: https://ssrn.com/abstract=4837832 or http://dx.doi.org/10.2139/ssrn.4837832
Acharya, Kamal, School management system project report. (July 10, 2021). Available at
SSRN: https://ssrn.com/abstract=4837837 or http://dx.doi.org/10.2139/ssrn.4837837
Acharya, Kamal, Furniture Showroom Management System Project Report (March 21, 2021). Available at
SSRN: https://ssrn.com/abstract=4839422 or http://dx.doi.org/10.2139/ssrn.4839422
Acharya, Kamal, Online Vehicle Rental System Project Report (March 21, 2019). Available at
SSRN: https://ssrn.com/abstract=4839429 or http://dx.doi.org/10.2139/ssrn.4839429
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8 APPENDICES
8.1 Appendix A: Cold Chain Room
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8.2 Appendix B: System Screen Shots
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Figure 8-4: Manage Stock Module
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Figure 8-6: Cold Chain Management Module
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Figure 8-8: Admin System Configuration Module
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Figure 8-10: Unauthorized Access Error
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8.3 Appendix C: Sample System Code
<?php
class Spareparts extends MY_Controller {
function construct() {
parent:: construct();
// $this->output->enable_profiler(true);
Modules::run('secure_tings/ni_met');
}
// Modules::run('secure_tings/ni_met');
$this->load->model('mdl_spareparts');
$this->load->library('pagination');
$this->load->library('table');
$config['base_url'] = base_url().'/spareparts/index';
$config['total_rows'] = $this->mdl_spareparts->get('id')->num_rows;
$config['per_page'] = 10;
$config['num_links'] = 4;
$config['full_tag_open'] = '<div><ul class="pagination pagination-
small pagination-centered">';
$config['full_tag_close'] = '</ul></div>';
$config['num_tag_open'] = '<li>';
$config['num_tag_close'] = '</li>';
$config['cur_tag_open'] = "<li class='disabled'><li
class='active'><a href='#'>";
$config['cur_tag_close'] = "<span class='sr-
only'></span></a></li>";
$config['next_tag_open'] = "<li>";
$config['next_tagl_close'] = "</li>";
$config['prev_tag_open'] = "<li>";
$config['prev_tagl_close'] = "</li>";
$config['first_tag_open'] = "<li>";
$config['first_tagl_close'] = "</li>";
$config['last_tag_open'] = "<li>";
$config['last_tagl_close'] = "</li>";
$this->pagination->initialize($config);
$data['records'] = $this->db->get('spareparts_view',
$config['per_page'], $this->uri->segment(3));
$data['section'] = "Maintenance";
$data['subtitle'] = "Spare Parts";
$data['page_title'] = "Cold Chain Spare Parts";
$data['module']="spareparts";
$data['view_file']="list_spareparts_view";
$data['user_object'] = $this->get_user_object();
$data['main_title'] = $this->get_title();
echo Modules::run('template/'.$this->redirect($this->session-
>userdata['logged_in']['user_group']), $data);
}
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function update(){
$update_id= $this->uri->segment(3);
$data = array();
$this->load->model('mdl_spareparts');
if (!isset($update_id )){
$update_id = $this->input->post('update_id', $id);
}
if (is_numeric($update_id)){
$data = $this->get_data_from_db($update_id);
$data['update_id'] = $update_id;
}
$data['section'] = "Maintenance";
$data['subtitle'] = "Spare Parts";
$data['page_title'] = "Update Cold Chain Spare Parts and
Accessories";
$data['module'] = "spareparts";
$data['view_file'] = "update_spareparts_form";
$data['user_object'] = $this->get_user_object();
$data['main_title'] = $this->get_title();
echo Modules::run('template/'.$this->redirect($this->session-
>userdata['logged_in']['user_group']), $data);
}
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