ASSESSMENT OF THE FACTORS AFFECTING SUPPLY CHAIN VACIN

IMPLEMENTION IN CASE OF PHARMACEUTICAL FUND IN

ETHIOPIA HAWASSA BRANCH

AWADA BUSINESS AND ECONOMICS COLLEGE

DEPARTMENTS OF LOGISTIC AND SUPPLY CHAIN
MANAGEMENT

A Research Proposal submitted to Department logistic and supply chain

management

BY;

NAME ID NO

1. BLEN FIKRE SOSCR/0980/13

ADVISOR: YIRGA (MSc)

February, 2024

HAWASSA, ETHIOPIA

i
 TABLE OF CONTENT
Content
page

TABLE OF CONTENT......................................................................................................................................................i
ABSTRACT......................................................................................................................................................................iii
CHAPTER ONE................................................................................................................................................................1
1. INTRODUCTION.........................................................................................................................................................1
1.1 Background of the study..........................................................................................................................................1
1.2 Statement of the problem.........................................................................................................................................3
1.3 Research questions...................................................................................................................................................4
1. 4 Objective /Aim of the study................................................................................................................................4
1.4.1 General objective...............................................................................................................................................4
1.4.2 Specific objectives.............................................................................................................................................4
1.5 Significance of the study..........................................................................................................................................5
1.6 Scope for the study...................................................................................................................................................v
1.7 Organizations of the paper........................................................................................................................................v
1.8. Definition of terms..................................................................................................................................................6
CHAPTER TWO...............................................................................................................................................................7
2. LITRATURE REVIEW.............................................................................................................................................7
2.1 Theoretical Literature...............................................................................................................................................7
2.1.1 Supply Chain implementation concepts and key issues....................................................................................7
2.1.2 Function of the Supply Chain implementation...................................................................................................7
2.1.3 Importance of the vaccine supply chain............................................................................................................8
2.1.4 Problems in the vaccine supply chain and logistics...........................................................................................8
2.1.5 Problems in the vaccine supply chain and logistics...........................................................................................9
2.3 Empirical Literature Review..................................................................................................................................11
2.3 Conceptual framework...........................................................................................................................................12
CHAPTER THREE.........................................................................................................................................................13

i
3: RESEARCH METHODOLOGY.................................................................................................................................13
3.1 Research design......................................................................................................................................................13
3.2 Data Sources..........................................................................................................................................................13
3.2.1 Secondary Sources of Data..............................................................................................................................13
3.2.2 Primary Sources of Data..................................................................................................................................13
3.3 Sampling Techniques and Size...............................................................................................................................14
3.3.1 Data Collection techniques.................................................................................................................................15
3.4 Method of data analysis..........................................................................................................................................15
4. WORK PLAN..............................................................................................................................................................16
4.1. BUDJET BREAK DOWEN..................................................................................................................................17
REFERENCES................................................................................................................................................................ 19

ii
ABSTRACT

This study will identified how Pharmaceuticals Fund and supply chain vaccine implementation
Agency, Ethiopia has developed its cold chain supply systems of vaccines and how it is able to
maintain cold chain for temperature sensitive vaccines, considering the challenges of; transport
systems, storage facilities, packaging, technical capacity. The main objective of the study will
conducted to identify the factors affecting supply chain vaccine implementation in
Pharmaceutical Fund and Supply Agency of Ethiopia. Descriptive survey design will considers.
The data will be collected by use of self-administered questionnaires.

This study will be focused on the factors affecting supply chain vaccine implementation in
incase of pharmaceutical fund in ethiopia Hawassa branch further research Proposal will be
carried out to cover the whole country health facilities to assess the magnitude of the problem.

Key words: The factors affecting supply chain vaccine implementation

iii
 CHAPTER ONE

1. INTRODUCTION
1.1 Background of the study
Supply chain implementation (SCI) is the means, by which firms engaged in creating, Distributing,
and selling products, can join forces to establish a supply network With an unbeatable competitive
advantage-has emerged as one of the most Powerful business- improvement tools around (Deveshwar
et al ,2010). Companies all over the world are Pursuing supply chain as the latest methodology to
reduce costs; increase Customer satisfaction, better utilizes assets, and builds new revenues
(Deveshwar et al, 2010)
The supply chain vaccine implementation is becoming more crucial for the survival of a world-class
enterprise. Nowadays many organizations become a part of at least one supply chain. They have to
perform equally well, in order to achieve better performance. This also requires elimination of
interface between many techniques across applications and individual departments (Premaratne,
2005).
A supply chain implementation and logistics system provides excellent customer service: by fulfilling
the six rights, ensuring that the right goods, in the right quantities, in the right condition, are delivered
to the right place, at the right time, for the right cost (The Logistics Handbook, 2006). Each person
who works in supply chain implementation management systems (SCIMS) must remember that s/he
selects, procures, stores, or distributes products to meet customer needs.
A vaccine is biological preparation that improves immunity to a particular disease. A vaccine typically
contains an agent that resembles a disease causing microorganism. The agents stimulates the body’s
immune system to recognize the agent as foreign, destroy it and ―remember it, so that the immune
system can more easily recognize and destroy any of these micro-organisms that it later encounters
(strive-4-five, 2005). World Health Organization (WHO) has noted that twenty five percent of all
vaccine products reach their destination in a degraded state (Monicah, 2015).

1
2
This is according to The Medicines and Health care Products Regulatory Agency (MHPRA) is
due to temperature rises above desired parameters thereby contributing forty-three percent of
reported non-compliant cases worldwide vaccine-preventable diseases are responsible for
about twenty five percent of the ten million deaths occurring annually for children under five
years of age (Monicah, 2010). Global warming makes temperature control issues a growing
challenge in the cold chain supply (Bishara, 2007). Vaccination is one of the most effective
ways to prevent the outbreak of an infectious disease. This medical intervention also brings
about many logistical challenges. Some of the challenges of vaccine supply chain are that
Vaccines are biological products that can be damage by high temperatures, Freezing
temperatures, and excessive light. They are generally effective for a limited period of time at
room temperature (Evelot.et al, 2017).
Inappropriate transportation and improper storage of vaccines might lead to a decrease
in vaccine effectiveness. For example, according to the product information sheets,
inactivated polio vaccine diphtheria- tetanus-pertussis vaccine (DTP), diphtheria and tetanus
toxoids vaccine, hepatitisB vaccine(HepB),and tetanus toxoid vaccine (TT) are seriously
damaged at temperatures less than 0°C (Duijzer,2011). HepB vaccine freezes at temperatures
less than-0.5°C (Path, 2011). Once potency has been lost through exposure to excessive heat
or freezing temperatures, returning the vaccine to the correct storage temperature will not
cause the vaccine to regain its potency. If potency is lost through heat exposure, the vaccine’s
appearance will not change (Duijzer et al, 2017).Without performing a laboratory test, it is not
possible to know whether a vaccine has lost its potency or not. The supply chain of vaccines
in Ethiopia now is performed by pharmaceuticals fund and supply agency (PFSA) in
collaboration with UNICEF. So far this organization faces different challenges during the
logistics of vaccines.

3
1.2 Statement of the problem
The role of supply chain vaccine implementation is to ensure effective vaccine
storage, handling, and stock management; rigorous temperature control in the cold
chain; and maintenance of adequate logistics management information systems
(Bishara, 2007).The importance of the cold chain is crystal clear to the government
and key stakeholders within the industry based on their impact on health, very little
effort is done to control the effects of supply chain logistics such as transport, storage,
packaging, technical capacity and many other sensitive activities that help keep such
products safe and in good quality (Bishara, 2007).
This is confirmed by who asserts that supply chain vaccine implementation items like
vaccines are particularly sensitive materials which, if not manufactured and shipped
under stringent controls, can become ineffective or even hazardous to the consumer
due to reduced potency. Vaccines must be stored correctly from the time they are
manufactured until the time they are administered to children. The exposure of
vaccines to heat or cold can reduce the vaccines potency, thus increasing the risk of
children not being protected against vaccine-preventable diseases (Monicah, 2015)

There are three basic problems that affect supply chain of vaccines. The first problem
is transportation of vaccines; the temperature will not maintain in the required level
because of lack of cold chain transport mechanism. The second is the distribution of
vaccines; ensuring that every health facility has an adequate supply of all vaccines in
the routine and supplementary immunization schedules (Bishara, 2007). A ‘stock out’
is said to occur when a facility has insufficient vaccines on hand to perform
scheduled services. Stock outs mean that immunization sessions must be cancelled or
children who arrive not receive vaccinations.
There are multiple causes of stock outs including overall shortages of vaccines in the
system (for example, if insufficient stock comes in to the national level), delays or
mistakes in ordering at different levels, over allocation of stock to some facilities
(which means there is not enough to get to other facilities), travel delays or lack of
transport, and incorrect forecasts of demand (Richard, 2014).
The WHO guidelines are that vaccines should not be exposed to temperatures of less

3
than -0.5°C for more than one hour, or temperatures of more than 8°C for more than
10 hours. These conditions are referred to as alarm conditions (Richard, 2014).
The ultimate goal of Pharmaceuticals Fund and Supply Agency is to ensure the
uninterrupted availability of quality vaccines from manufacturer to service
delivers, so that opportunities to vaccinate are not missed because vaccines are
unavailable. To ensure an uninterrupted supply of quality vaccines to patients the
regulatory environment needs to reflect the complexity of new vaccine and Good
Manufacturing Practice (GMP).The overall full immunization coverage 23.4% in
Ethiopia is considerably low as compared to the national target set 66 % (Yihunie,
et.al, 2011). The study will assess the factors that affect supply chain management of
vaccines in Pharmaceuticals Fund and Supply Agency (PFSA) of Ethiopia.

1.3 Research questions

1. What are the factors affecting supply chain vaccine implementation in incase of
pharmaceutical fund in Ethiopia Hawassa branch?
2. How can determine vaccine availability and stock out level

3. How to manage the storage condition, transportation and distribution of

vaccines to different branches and health facilities?

4. How to reduce the factors affecting supply chain vaccine implementation.

1. 4 Objective /Aim of the study

1.4.1 General objective

The general objective of the research proposal will be conducted to identify the
factors affecting supply chain vaccines implementations in Pharmaceuticals Fund in
Ethiopia Hawassa branch.

1.4.2 Specific objectives

1. To identify the factors affecting supply chain vaccine implementation in incase

of pharmaceutical fund in Ethiopia Hawassa branch?
2. To identify how vaccines are stored, transported and distributed in
pharmaceuticals fund in ethiopia Hawassa branch

4
3. To determine the availability of vaccines for immunization

4. To determine the level of knowledge of the pharmacy personnel on storage

and handling of vaccines.

1.5 Significance of the study

The study will be identifying the factors affecting supply chain vaccine
implementation in incase of pharmaceutical fund in Ethiopia Hawassa branch. The
findings and recommendations of the study will be useful for pharmaceutical fund
and supply agency to implement supply chain management of vaccines. The result of
the study will benefit UNICEF, FMOH, PFSA, regional health bureaus and
stakeholders to (1) understand the factors affecting supply chain vaccine
implementation in incase of pharmaceutical fund Hawassa branch. (2) Get
information about the progress made so far and see the possible future direction of
supply chain vaccine implementation (3) identify areas that need more attentions and
collaboration in the vaccine supply chain implementation and management system.

1.6 Scope for the study

The research proposal will delimit on pharmaceuticals fund and supply chain vaccine
implementation of Ethiopia Hawassa branch. The study was not included health
facilities, i.e. hospitals and health centers. The study was addressed: storage,
transportation, distribution and cold chain of vaccines. The study included those
Pharmacists and Druggists working in pharmaceuticals fund in Ethiopia Hawassa
branch.

1.7 Organizations of the paper

This research proposal will be organized in to three chapters chapter one contains
background of the study, statement of the problem, basic research proposal questions,
objective of the study, definition of terms, significance of the study and
delimitation/scope of the study, chapter two deals with the literature review, chapter
three deals with research design and methodology finally work plan, budget break
down and reference.

5
1.8. Definition of terms

The terms listed below have multiple interpretations, but here they are defined as follow for the
purpose of this proposal.
1. Supply chain a supply chain encompasses everything from the delivery of source materials
from the supplier to the manufacturer through to its eventual delivery to the end user.
2. Vaccine: is a biological preparation that improves immunity to a particular disease.
3. Implementation is the execution or practice of a plan, a method or any design, idea, model, specification,
standard or policy for doing something. As such, implementation is the action that must follow any
preliminary thinking for something to actually happen

6
 CHAPTER TWO

2. LITRATURE REVIEW

2.1 Theoretical Literature

2.1.1 Supply Chain implementation concepts and key issues

Supply chain is a system of suppliers, manufactures, distributors, retailers and customers where
material typically flows downstream from suppliers to customers and information flow in both
directions. SCM involves managing a connected series of activities including planning,
coordinating and controlling movement of goods from supplier to customer. Therefore there are
decisions to be made strategic, tactical and operational. The decision making levels in supply chain
are strategic (5 to 10 years), Tactical (3 months to 2 years) and operational (day to day) (Charu &
Swatantra, 2004).The common key issues that face SCI activities are distribution network
configuration, inventory control, supply contracts, distribution strategies, supply chain integration
and strategic partnering, outsourcing and procurement strategies, information technology and
decision support systems, and customer value (Encyclopedia, Charu & Swatantra, 2004).

2.1.2 Function of the Supply Chain implementation

Supply chain implementation (SCI) is becoming more crucial for the survival of a world- class
enterprise. Nowadays many organizations become a part of at least one supply chain. They have to
perform equally well, in order to achieve better performance (Premaratne, 2005). As a result,
organizations increasingly find that they must rely on effective supply chains, or networks, to
compete in the global market and networked economy.
The functions of the supply chain are to resolve the major business challenges of the organizations
and for developing capabilities to manage value, volume, volatility, velocity, variety, variability,
visibility and vertuality of the organizations. Visibility is a core capability for managing the total
supply chain from source to customer. Visibility or transparency ensures that parties within the
total supply chain know what the current pipelines look like (Hines, 2004).
Matters are complicated by the fact that equipment and supplies usually cannot go directly from
their source to the end user; they frequently must be held as inventory at one or more intermediate
7
points along the way (Desalegn, 2015).
There are only four reasons for holding inventory: transportation efficiency, safety stocks, storage
capacity and anticipation of a program that is growing or changing (USAID|DELIVER PROJECT,
2009). Hence, reducing cost of operations, improving inventory, lead times and customer
satisfaction, increasing flexibility and cross- functional communication, and remaining competitive
appear to be the most important objectives to implement SCI strategies (Tummala, Cheryl, &
Melanie, 2006).

2.1.3 Importance of the vaccine supply chain

Vaccination has been widely accepted as one of the most cost-effective public health interventions
for disease prevention (David, 2016). Despite high immunization coverage rates and vaccine
effectiveness there are still a number of reported outbreaks, some of which could be prevented by
better vaccine management practices. For example, measles and polio outbreaks have been
observed in several countries where measles and polio were previously under control, including In
Italy, Japan, Laos, and Namibia (path, 2011). The continuing number of reports of vaccine-
preventable disease outbreaks raises concerns about vaccine quality.
Vaccines are biological products that can be damaged by high temperatures, freezing
temperatures, and excessive light (path, 2011).
They are generally effective for a limited period of time at room temperature. Inappropriate
transportation and improper storage of vaccines might lead to a decrease in vaccine effectiveness.
For example, according to the product information sheets, inactivated polio vaccine, diphtheria-
tetanus-pertussis vaccine (DTP), diphtheria and Tetanus toxoids vaccine, hepatitis B vaccine
(HepB), and tetanus toxoid vaccine (TT) are Seriously damaged at temperatures less than
0°C.HepB vaccine freezes at temperatures less than -0.5°C (Path, 2011).

2.1.4 Problems in the vaccine supply chain and logistics

The transport and storage of vaccines at temperatures higher than 8°C (the optimum temperature
range for vaccine storage is 2°C to 8°C) have been reported in the United States and Australia
(WHO: 2011). Vaccine freezing has been reported in many countries. A study in Indonesia that
monitored the temperature of HepB vaccine shipped from the manufacturer to the provider) found
8
that 75% of vaccine shipments were being frozen. The highest rates of freezing Occurred during
transport from provincial to district warehouses (WHO: 2011).
A study in Bolivia that monitored the temperature of DTP- HepB- Haemophilus influenza type b
vaccine throughout its transportation from the national warehouse to 11 communities in 3
provinces reported that the proportion of time that the temperature fell to less than 0°C ranged
from 2% to 50%. Vaccine freezing occurred at all levels of the cold chain, especially from the
district warehouse to health centers. In addition, 7 of the 11 routes from provincial to district
warehouses had a temperature higher than 8°C (PATH: 2011). A study in Papua New Guinea
recorded vaccine temperatures during transportation from the national warehouse to health centers
and detected frozen vaccine vials caused by insulation between the vaccines and the icepacks that
was not sufficient to protect the Vaccines from direct contact with the ice packs (WHO:2011).

2.1.5 Problems in the vaccine supply chain and logistics

The transport and storage of vaccines at temperatures higher than 8°C (the optimum temperature
range for vaccine storage is 2°C to 8°C) have been reported in the United States and Australia
(WHO: 2011). Vaccine freezing has been reported in many countries. A study in Indonesia that
monitored the temperature of HepB vaccine shipped from the manufacturer to the provider) found
that 75% of vaccine shipments were being frozen. The highest rates of freezing Occurred during
transport from provincial to district warehouses (WHO: 2011).
A study in Bolivia that monitored the temperature of DTP- HepB- Haemophilus influenza type b
vaccine throughout its transportation from the national warehouse to 11 communities in 3
provinces reported that the proportion of time that the temperature fell to less than 0°C ranged
from 2% to 50%. Vaccine freezing occurred at all levels of the cold chain, especially from the
district warehouse to health centers. In addition, 7 of the 11 routes from provincial to district
warehouses had a temperature higher than 8°C (PATH: 2011). A study in Papua New Guinea
recorded vaccine temperatures during transportation from the national warehouse to health centers
and detected frozen vaccine vials caused by insulation between the vaccines and the icepacks that
was not sufficient to protect the Vaccines from direct contact with the ice packs (WHO:2011).

9
The Clinton Health Access Initiative operates in many countries including Ethiopia with an aim to
save lives from preventable and treatable diseases. In Ethiopia the organization is working to
advice the ministry of health in Ethiopia on an efficient logistics and supply chain management
system for vaccine (Hajara, 2010).Currently the vaccine distribution capacity is five vaccines and
will rise to seven with the introduction of a number of vaccines like the pneumococcal vaccine
(pcv10) and Rota next year. The introduction of these vaccines will inevitable affects the
organizations, i.e. Pharmaceuticals Fund and supply Agency’s stock management and logistics in
Ethiopia since the rate of hospital visits per health center will remain constant (Hajara,2010 ).
As for all national vaccine supply chains, the vaccine’s sensitivity to heat poses a risk of waste,
especially for the health facilities. The current systems is paper based and includes the use of stock
cards which is predominant in most health centers, about 80% practice (Hajara, 2010).This system
is very inefficient and prone to errors (including transcription errors), is not regular enough to be
useful, and can’t forecast demand of inventory and makes it tedious to extract use full information
for decision making at any level of the supply chain.
Ethiopia has switched to a number of vaccines like the single dose pentavalent vaccine (a few
years ago), the pneumococcal and plans to introduce the Rota vaccine (Hajara, 2010). These
vaccines are bulky and more expensive both to purchase and store. Thus, it is essential that an
improved and efficient logistics system is put in place to reduce waste, stock outs, over stocks,
expired stock, and to improve on decision and information flow between the national cold storage,
the regional health facilities, and every level of the vaccine supply chain (Hajara, 2010).
Policy decision of Ethiopia in 2013 to transfer responsibility for vaccine supply chain to
Pharmaceuticals Fund & Supply Agency (PFSA) from Ethiopian Federal Ministry of Health
(TechNet conference, 2015), Federal agency responsible for distribution of essential medicines
and most other health commodities. The Ethiopian Existing Country Context for Vaccine
Distribution Cold Chain system for vaccines and other cold storage requiring health commodities
consists of five levels, following the FMOH administrative structures:
PFSA Central Regional Zonal Health Woreda Health
Bureau
Health Departments Health Facilities

10
2.3 Empirical Literature Review
Supply chain implementation (SCI) is a rapidly evolving area of interest to academics and business
management practitioners alike. As a result most of the industries innovations in improving
efficiency and reduce cost targeted innovations on key functions including logistics (Charu &
Swatantra, 2004). The aspects of marketing, economics, logistics and organizational behavior are
all important for developing insights into how and why different SCI arrangements emerge and for
understanding the consequences of these arrangements for industry efficiency and competitiveness
(Jill & Hobbs, 1996).Like most other industries, SCI in vaccines is now slowly evolving in
developing countries like Ethiopia.
Vaccine supply chain starting from the planning and acknowledge the specialization and
importance in accomplishing immunization programs. Vaccine supply chain in most developing
countries are designed and implemented to meet demands of specific program logistics. The
different health programs have multiple parallel SCM but all basically perform similar functional
activities i.e. primarily meeting the supply needs of their clients or customers. However, as the
health programs mature and funding from donors decline, there are interests and efforts for
integration to takeover (Jill & Hobbs, 1996). The main anticipation for integrations is SCI
knowhow improves and capacity developed.
Ethiopian government started moving to make the vaccine SCI more efficient and integrated.
However, unlike other sectors such as discrete parts in manufacturing and fast-moving consumer
goods where there has been a long history and experience with management of inventory, the
healthcare sector is behind other industry sectors in Implementing effective supply chain
implementation (SCI) practices (McKone et al., 2005;Baltacioglu et al., 2007).
The main reason for the sector’s difficulties in implementing effective SCI practices is supply
chains are much more complex compared to supply chains in other industries (Vikram, Prakash, &
Amrik, 2012). However, several factors contribute to this complexity. There are also new vaccines
continually adding to the SCM, demanding specific conditions like transportation, storage or cold
chain and distribution that challenge the supply chain and inventory management.
As a result, in vaccine SCI, getting a child vaccinated, a mother an appropriate medicine and controlling any
epidemic outbreak are all very critical while ensuring the proper management and use of medicines. That
makes supply chain in vaccine more difficult while it requires the bulk of the health resources even if funded

11
by UNICEF. Although, vertical and integrated systems each have advantages and disadvantages there are
valid technical reasons, often reflecting changes in the environment, make integrating a logistics system more
advantageous or feasible. Some of the advantages include improved transportation infrastructure, improved
data management, improve Communications system coverage, new customer service requirements and increased
storage and transportation efficiency (USAID | DELIVER PROJECT, 2009).
Literature has shown that the basis of competition in many industries in the future will revolve
around supply chain development (Das & Narasimhan, 2000).

2.3 Conceptual framework

The conceptual framework illustrates the. PFSA receive Vaccine products from the airport cold
room, transport them to PFSA storage cold chains and distribute to health facilities from their cold
storage holding facilities. The Safety of cold chain vaccines is greatly influenced by variations
during transport, storage conditions and facilities, handling and packaging (Bishara, 2007).
Supply chain strategies require a total systems view of the links in the chain that work together
efficiently to create customer satisfaction at the end point of delivery to the consumer. As a
consequence, costs must be lowered throughout the chain by driving out unnecessary expenses,
movements, and handling. The main focus is turned to efficiency and added value, or the end
user's perception of value. Efficiency must be increased, and bottlenecks removed. The purpose of
a logistics system is simple: to obtain and move goods, supplies and equipment in a timely fashion
to the places where they are needed, at a reasonable cost. Matters are complicated by the fact that
equipment and supplies usually cannot go directly from their source to the end user; they
frequently must be held as inventory at one or more intermediate points along the way (Desalegn,
2015).

12
 CHAPTER THREE

3: RESEARCH METHODOLOGY
3.1 Research design
The research will be conducted cross sectional survey design because of the following reasons.
 The research will be collected data at one point on time.

unlike longitudinal survey design that used to collect information at different point of time, cross sectional
survey design were used to collect information at one point time her first, the proposal will made
questionnaire after that I go to the field work to distribute the questionnaires finally the researcher will
returned back. The researcher does not go again to the field work like longitudinal survey design that used by
healthy students.

3.2 Data Sources

3.2.1 Secondary Sources of Data

The secondary sources of data would acquired through reviewing various studies related to the topic in order
to find out the various issues to be considered withe several written documents including journals, articles,
books and other archival documents

3.2.2 Primary Sources of Data

The information gathered from the secondary sources were substantiated by the information that was
obtained from primary sources. in this regard, a combination of both quantitative(survey) and qualitative in-
depth interviews was employed to acquire first hand information. The data were collected via structured
questionnaire, in-depth interview. for my study both structured questionnaries and indepth interview are
crucial for the following reason the frist one is in my research I,used sample survey as a methode in order to
achive this methode It were mandotry to use structured questionnaries because it is an instrument of sample
survey.the second one were I will be use indepth interview to cross check the data that was collected by using
13
sample survey regarding to the topic.

3.3 Sampling Techniques and Size

Theoretical sampling is a data collection process controlled by a theory generation process. It involves
the simultaneous collection, coding and analysis of data to identify the next stage of data collection
and where to find the participants to develop the emerging theory. It is the principal strategy for the
grounded theory approach. According to theoretical sampling, new goals for data collection are
determined by the information gathered from the previous sample. It entails seeing emerging ideas in
the data that is being produced and using those ideas to direct where, how, and from whom more data
should be gathered and with what emphasis. For example, the theoretical sampling in the study that
sought to generate a theory to explain the process by which people with diabetes learn about their
disease in Indonesia. The study was conducted in three phases, with a total of twenty-six participants.
In the first phase, participants were recruited via purposive sampling, and data from the first phase led
to further data gathering. Theoretical sampling was used to select the next data from 17 participants
based on the data analysis. Phase three was directed via theoretical sampling, with two new
participants recruited into the study. In Figure 4.5, two examples of how theoretical sampling was used
in the study have been highlighted.

14
3.3.1 Data Collection techniques

In this study, the researcher will use questionnaires from survey research as an instrument. And from in-depth
interview the researcher used In-depth interview guide as an instrument.

3.4 Method of data analysis

The collected data will be analyzed by both qualitative and quantitative analysis method. The quantitative
analysis was tables, frequencies, proportions and the qualitative analysis method were words and sentences
have used for interpretation and describing the presented table.

15
4. WORK PLAN
The process of senior proposal title selection and proposal writing will be started in the beginning of
February, 2024 /2016 E.C and expected to be completed in the end of March, 2024 /2015. Implementation of
the research proposal is intended to be started in the march 2024 /2015 and to be completed in June
2024/2016. Detail information on implementation time plan of the research work is described as follows.

The process of senior proposal title selection and proposal writing will be started in the beginning of March,
2024 /2016 E.C and expected to be completed in the end of March, 2024 /2015. Implementation of the
research proposal is intended to be started in the march 2024 /2015 and to be completed in June 2024/2016.
Detail information on implementation time plan of the research work is described as follows.

Table 1: Implementation time plan

No Major Activities of the Research Implementation time plan in

2024G.C /2016E.C
Mar

April

Jun
Ma

1 Research title selection

2 Proposal writing
3 Presentation and correction of the proposal

16
 4 Submission and approval of the proposal
5 Questionnaire designing
6 Selecting respondents
7 Data collection and supervision
8 Data entry &Information processing
9 Data analysis and interpretation
10 Discussion of results
11 Submission of first draft to the advisor
12 Correction, Submission and presentation of
report

4.1. BUDJET BREAK DOWEN

In conducting this senior research budget is required to pay the cost for different services (transportation,
writing, printing and binding). To pay the cost for procurement of stationery materials. It is also used to pay
refreshment cost for attendants for focus group discussion donkey owners. Source of budget for conducting
this research work will be the researcher himself. Detail information on budget requirement plan of the senior
research is described as follows.

Table 2: Stationary material, meat sample requirement and estimated budget plan

No Item Unit Quantity Unit cost Total cost

.
1 Printing paper Pkt 500 500.00
2 Pen Pcs 10 30 300.00
3 Flash disk 16 GB No. 01 300 300.00
4 Writing pad Pcs 4 50 200.00
Total 1, 300.00

Table 3: Service requirement and estimated budget plan

17
No Types of services Unit Quantity Unit cost Total cost
1 Writing (questionnaire and report) Page 20 5 birr 100.00
2 Printing (questionnaire and report) Page 100 5 birr 500.00
3 Photocopy (questionnaire and report) Page 80 5 400.00
4 Binding Doc. 6 40 240.00
6 Transportation R. trip 20 50 100.00
7 Communication 100.00
Total 1, 440.00

Table 4: Budget requirement plan for covering personnel costs (per diem)

No Qualification No of Participants No. of days Payment/ Total cost

day
1 Data collector 3 10 100 birr 3000.00 birr
2 Focus group discussion 10 2 100 birr 2000.00 birr
3 Key informant interview 5 2 100 birr 1000.00 birr
Total 5,100.00

Table 5: Budget summery

No. Description Total (ETB)

1. Stationery 1,300.00
2 Service requirement 1,440.00
3 Per diem 5,100.00
4 Total 7,840.00

18
REFERENCES
Aarti, D., & Deveshwar, R. (2010). Challenges for supply chain management in today’s global
competitive environment. *Volume, 6*(2), 194-203.

Bishara, R. H. (2006). Cold Chain Management - An Essential Component of the Global.

Brigid E. Cakouros. (2009). The Impact of the Vaccine Supply Chain on the Socioeconomic Status of
Region in Niger.

Charu, C., & Swatantra, K. K. (2004). Managing Health Care Supply Chain: Trends, Issues and Solutions
from a Logistics Perspective. Unpublished Manuscript, University of Michigan-Dearborn, MI 48128-
1491.

Chopra, S., & Meindl, P. (2004). *Supply chain management: Strategy, planning, and operations*.
Prentice Hall.

Chopra, S., & Mendel, P. (2006). *Supply chain management: Strategy, planning, and operation* (2nd
ed.). New Delhi.

David João, Baptista, & Ribeiro (2016). Design and planning of Vaccine Supply Chains.

19
Evelot, D., Duijzer, W. V., Jaarveld, & Rommert, Dekker. (2017). The vaccine supply chain; Economic
institute report.

Federal Negarit Gazeta. (2007). Proclamation No. 553/2007, Drug Fund and Pharmaceuticals Supply
Agency Establishment Proclamation. Federal Democratic Republic of Ethiopia, Federal Negarit Gazeta,
13(64), 3939-394.

Hines, T. (2004). *Supply chain strategies: Customer driven and customer focused*. Elsevier.

Kaufmann, J. R., Miller, R., & Cheyne, J. (2011). Vaccine supply chains need to be better funded and
strengthened, or lives will be at risk. *Health Affairs (Millwood), 30*(6), 1113-1121.

Kothari, C. R. (2004). *Research methodology* (2nd ed.). New Age International.

Kumar, R. (2005). *Research methodology: A step-by-step guide for beginners* (2nd ed.). Pearson
Education.

Management Sciences for Health (MSH). (1997). *Managing drug supply* (2nd ed.). Kumarian Press.

20
ANNEX-1

HAWASSA UNIVERSITY

DEPARTMENT OF LOGISTICS AND SUPPLY CHAIN MANAGENMENT

DGREE PROGRAM

QUESTIONNAIRE

Part One: Personal information

1. Professional of in-charge/coordinator/ immunization focal person of the Supply

Chain implementation
a) Pharmacist
b) Pharmacy technician

21
 c) Medical doctor
d) Clinical officer
e) Environmental health officer
f) Nursing officer/Nurse midwife
g) Nurse assistant
h) Others (mention)…………………………………………………………………….
2. Sex
a) Male
b) Female
3. Age (in years) ……………………………………………………………………….
a) 18-24
b) 25-30
c) 31- 36
d) Above 36
4. work experience (in years)
a) Less than 1
b) 1 to 5
c) 6 to 10
d) 11 to 15 e) more than 15

Part two: basic questions

1 What type of vaccines do you stock at Pharmaceuticals Fund & Supply Agency (PFSA)?
e) Bacillus Chalmette Guerin ( BCG )
f) DTP- ( Diphtheria, Tetanus, Pertussis , Hepatitis B, Homophiles influenza B)
g) OPV (Oral polio vaccine)

h) Measles virus vaccine

i) Rabies vaccine
j) TT (Tetanus toxoid vaccine )
22
 k) all
2 Have you ever attended training on storage, distribution and handling procedures of
the Supply Chain implementation?
a. Yes (go to next Question)
b. No

23
3 Is there any record for all vaccine discarded due to incorrect Supply Chain implementation?
a) Yes (if yes ask to see)
b) No
4 What do you think are underlying factors that lead to fault in of the Supply Chain
implementation?
a) Lack of knowledge c) Lack of space
b) Unreliable temperature d) Lack of temperature monitoring device
e) Vaccine carrier
5 What reference material(s) is (are) available in your pharmacy store used as reference
during your practice?
a. EPI Guidelines for vaccine management c) Good Dispensing Manual
b. Martindale d) others (mention)

24
 6 How often do you of the Supply Chain implemented to branches?
a. Once monthly
b. Twice a year
c. Quarterly a year
d. When necessary (no specified time period)
e) All

7 How do you determine of the Supply Chain implementation position at your facility?
a. By determining only safety stock
b. By determining only maximum stock level
c. By determining only minimum stock level
d. By determining sum of stock on hand (working & safety stock) and stock
on order, minus any stock-back ordered to clients.
8 When do you say the vaccine stock is at a maximum stock level?
a) When stock is at re-order level b) When you
have safety stock
c) When the stock is sufficient to satisfy demand until the next order d) when there
is over stock

9 When do you say the vaccines stock is at safety stock level?

a. When you have vaccines maximum stock
b. When you have vaccines minimum stock
c. When you have vaccines stock on hand to prevent stock out
d. When you have vaccines emergency stock

25
 10 Do you think you need more professional training on of the Supply Chain implementation?
a. Yes
b. No
If yes, mention few areas that you need more exposure through on job training

12. What is the impact of the factors affecting supply chain vaccine implementation in your municipality?
A, positively affect B, Negatively affect C, Have no affect
13. Did the management use of the factors affecting supply chain vaccine implementation as a tool to increase
performance in your municipality?
A, Yes B, No
14. Did the management design and factors affecting supply chain vaccine implementation handling mechanism
in your municipality?
A, Yes B, No

13. What reference material(s) is(are) available in your pharmacy store used as
reference during your practice?
a) EPI Guidelines for vaccine management c) Good Dispensing Manual
b) Martindale d) others (mention)
14. If you have the Expanded Program of Immunization (EPI) Guidelines for Safe vaccine
management, have ever gone through it to find out proper ways of storage and handling vaccine
medicines at your facility up to the point of administration?
a) Yes (if yes go to next question) b) No

26
15. Did you find the EPI Guidelines fit for routine vaccines Supply Chain
implementation?
a) Yes
b) No (if No) state/mention any deficiencies that you think should be rectified to
smoothen the distribution system and handling procedures:
16. How often do you distribute vaccines to branches?
a) Once monthly
b) Twice a year
c) Quarterly a year
d) When necessary (no specified time period)
17. List all the methods that you regularly use to transport vaccine and cold chain
medicines at your facility
a) Cold chain vehicle c) vaccine carrier
b) Cold box d) all
18. How do you determine your vaccines stock position at your facility?
a) By determining only safety stock
b) By determining only maximum stock level
c) By determining only minimum stock level
d) By determining sum of stock on hand (working & safety stock) and stock on order,
minus any stock-back ordered to clients.
19. When do you say the vaccine stock is at a maximum stock level?
a) When stock is at re-order level c) When you have
safety stock
b) When the stock is sufficient to satisfy demand until the next order d) when there
is over stock

27
20. When do you say the vaccines stock is at minimum stock level?
a) When stock is at Re-order level
b) When the stock is sufficient to satisfy demand until the next order
c) When you have safety stock
d) When there is stock out
21. When do you say the vaccines stock is at safety stock level?
a) When you have vaccines maximum stock
b) When you have vaccines minimum stock
c) When you have vaccines stock on hand to prevent stock out
d) When you have vaccines emergency stock
22. What do you put in consideration when you need to prepare the vaccines order
at your facility?
a) Quantity used since last delivery
b) Storage volume within the refrigerator
c) Vaccines currently in the refrigerator
d) Disease outbreak
e) Seasonal variation f ) others………………………………

28