title: The impact of implementing a demand forecasting system into a low-income country's supply chain.
abstract: To evaluate the potential impact and value of applications (e.g. adjusting ordering levels, storage capacity, transportation capacity, distribution frequency) of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas.
  
  
  
  Using our software, HERMES, we generated a detailed discrete event simulation model of Niger's entire vaccine supply chain, including every refrigerator, freezer, transport, personnel, vaccine, cost, and location. We represented the introduction of a demand forecasting system to adjust vaccine ordering that could be implemented with increasing delivery frequencies and/or additions of cold chain equipment (storage and/or transportation) across the supply chain during varying degrees of population movement.
  
  
  
  Implementing demand forecasting system with increased storage and transport frequency increased the number of successfully administered vaccine doses and lowered the logistics cost per dose up to 34%. Implementing demand forecasting system without storage/transport increases actually decreased vaccine availability in certain circumstances.
  
  
  
  The potential maximum gains of a demand forecasting system may only be realized if the system is implemented to both augment the supply chain cold storage and transportation. Implementation may have some impact but, in certain circumstances, may hurt delivery. Therefore, implementation of demand forecasting systems with additional storage and transport may be the better approach. Significant decreases in the logistics cost per dose with more administered vaccines support investment in these forecasting systems.
  
  
  
  Demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose when implemented with storage and transportation increases. Simulation modeling can demonstrate the potential health and economic benefits of supply chain improvements.
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently); Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Mueller
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently); Pittsburgh Supercomputing Center (PSC), Pittsburgh, PA, USA.
authors.forename: Leila A
authors.initials: LA
authors.lastname: Haidari
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently).
authors.forename: Angela R
authors.initials: AR
authors.lastname: Wateska
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently).
authors.forename: Roslyn J
authors.initials: RJ
authors.lastname: Phillips
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently).
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Schmitz
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently).
authors.forename: Diana L
authors.initials: DL
authors.lastname: Connor
authors.affiliation: Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Norman
authors.affiliation: Pittsburgh Supercomputing Center (PSC), Pittsburgh, PA, USA.
authors.forename: Shawn T
authors.initials: ST
authors.lastname: Brown
authors.affiliation: Pittsburgh Supercomputing Center (PSC), Pittsburgh, PA, USA.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Welling
authors.affiliation: Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA, USA (formerly) and Baltimore, MD, USA (currently); Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: brucelee@jhu.edu.
authors.forename: Bruce Y
authors.initials: BY
authors.lastname: Lee
mesh_terms: D003198:Computer Simulation; D004356:Drug Storage / Q000191:economics*; D005544:Forecasting; D006301:Health Services Needs and Demand; D006801:Humans; D008962:Models, Theoretical; D009548:Niger; D011203:Poverty; D012034:Refrigeration / Q000191:economics*; D014186:Transportation / Q000191:economics*; D014612:Vaccines / Q000600:supply & distribution*
chemical_list: D014612:Vaccines
keywords: Health information systems; Immunization; International health