Published in PLOS One on 2026-06-16, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Amatullah Sana Qadeer, Nirupama AY, Winnie Paulson, Jennifer Rachel, Lipika Nanda, Ambarish Dutta, Sarit Kumar Rout
Source: PLOS One • DOI 10.1371/journal.pone.0350231
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The main objective of this scoping review is to examine the characteristics of vaccine management and delivery systems with a specific focus on cold chain management used for routine immunization in the LMICs, along with factors influencing these systems, challenges faced and the extent of digitization implemented.
A comprehensive literature search was conducted using PubMed, Scopus, Cochrane Library, and Google Scholar for studies published between 2010 and February 2025. Our study selection, data charting, and synthesis followed methodological frameworks outlined by the Joanna Briggs Institute and PRISMA guidelines for Scoping Review.
Outof 2451 identified studies, 16 eligible studies were included. The findings revealed diverse vaccine management system designs, including centralized and decentralized architecture, interoperable integrated models, and provisions for online and offline accessibility. Core features of these systems included longitudinal health records, automated inventory monitoring, and beneficiary engagement features including digital health cards. Implementation was influenced by global initiatives, project management teams and their capability, and challenges related to digitization. Factors impacting vaccine delivery included immunization sessions, stock management systems, distribution weaknesss, suboptimal practices, training gaps, and documentation. Digital transformations varied across countries, with Vietnam, Tanzania, and Zambia adopting electronic immunization registries, while India implemented the Electronic Vaccine Intelligence Network. The implementation of these digital logistics management information systems significantly improved vaccine management by reducing wastage, enhancing record-keeping, and optimizing supply chain efficiency.
To our knowledge, this scoping review is the first to provide empirical evidence on vaccine management and delivery systems and digitization in immunization in the LMICs. This review concludes that LMICs have been adapting various systems including electronic system, digitization, decentralisation of vaccine delivery, stock monitoring, individual tracking to improve immunization. Across countries, some have made notable progress, while others are at their initial stage of implementation. However, this review suggests further studies on integrated vaccine management systems and their impact for inter-country comparison.
1 Introduction
Globally, around 5 million children die each year due to preventable diseases [1]. Although notable achievement has been observed in the reduction of child mortality, the under-five mortality rates are still high, especially in the developing countries. Immunization is one of the most cost-effective community health interventions for averting infectious diseases and associated deaths [2]. Immunization program is estimated to be preventing over 3 million deaths per year globally [3]. According to the WHO and UNICEF database, currently, 14.3 million infants are not vaccinated in the world. That is 4 million more than the 2024 target needed to stay on track with Immunization Agenda 2030 goals. Data from 195 countries show that 131 countries have consistently reached at least 90% of children with the first dose of DTP vaccine since 2019, but there has been no significant movement in expanding this group. The humanitarian crisis causes slow progress in vaccination in many of the countries. Around a quarter of infants stay in 26 countries affected by conflicts and human crisis and half of these children in these countries are not vaccinated [2,4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Amatullah Sana Qadeer, Nirupama AY, Winnie Paulson, Jennifer Rachel, Lipika Nanda, Ambarish Dutta, Sarit Kumar Rout. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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