Effective Vaccine Management Initiative

EVM Assessment Tool

Country: Indonesia

Release notes

392665941.xls 1 of 6 07/22/2018
Section A: Assessment setup
Note to assesors: Before the inspection begins, obtain as much of this information as possible, including copies of previous assessments.

A1 Setup details

A1.01 Select language: EN

A1.02 Country name: Indonesia A1.03 IVB country code: INO A1.04 WHO region:

A2 National contact details

A2.01 Department/ministry: A2.02 Address:

A2.03 Primary contact: A2.04 Telephone: A2.05 Fax number:

A2.06 Email:

A3 Assessment details

A3.01 Assessment team:

A3.02 Dates of assessment: 7/17/2018 To: 8/17/2018

A3.03 Previous assessments: Type Year Outcome

392665941.xls 2 of 6 07/22/2018
Section A: Assessment setup
Note to assesors: Before the inspection begins, obtain as much of this information as possible, including copies of previous assessments.

A4 Background data checklist

Requested Obtained Requested Obtained
A4.01 Immunization schedule: A4.02 Vaccine supplier(s):

A4.03 Current UNICEF or other vaccine forecast data: A4.04 Climate data

A4.05 SOPs and manuals: A4.06 Standard forms:

A4.07 Details of stock control system(s) used: A4.08 CC equipment inventory:

A4.09 Vehicle inventory A4.10 cMYP and vaccine financing:

A4.11 New vaccine introduction plans A4.12 Previous assessments

A4.13 Maps (JPEG format preferred)

392665941.xls 3 of 6 07/22/2018
South-East Asia Region

392665941.xls 4 of 6 07/22/2018
392665941.xls 5 of 6 07/22/2018
Section B: Service provision data
Note to assesors: Before the inspection begins, obtain as much of this information as possible, including copies of service contracts.

B1 Logistics and maintenance service providers

List organizations and companies that provide a logistics service to the programme. If the service is provided by the government, specify the relevant agency/department.

Service Service provider Type of organization Is there a Contract start Contract end Describe how service provider is
contract? date date monitored

B1.1 Clearing agent services

B1.2 Cold storage services

B1.3 Dry storage services

B1.4 Transport services

B1.5 Building maintenance

B1.6 Refrigeration maintenance

B1.7 Generator maintenance

B1.8 Vehicle maintenance

B1.9

B1.10

B1.11

B1.12

Notes:

Key: PPP = Public-private partnership; 3PL = Third party logistics provider.

392665941.xls 6 of 6 07/22/2018