Perceptions, Challenges, and Operational Bottlenecks in Electronic Vaccine Intelligence Network Implementation: A Qualitative Study Among Immunization Stakeholders in Indore District, India.

BACKGROUND

National assessments of the Electronic Vaccine Intelligence Network (eVIN) have demonstrated reductions in vaccine stock-outs and wastage, improved cold-chain equipment performance, and strengthened data-driven stock management. However, few studies have qualitatively explored stakeholders' perspectives on its routine implementation, perceived benefits, and operational challenges.

OBJECTIVE

This study aimed to explore immunization stakeholders' perceptions of the benefits, challenges, and operational bottlenecks of the eVIN in Indore district and to identify system-level improvements for strengthening vaccine logistics and cold-chain performance.

METHODS

This descriptive qualitative study was conducted in Indore district, Madhya Pradesh, India, between January 2020 and December 2021. Using total population sampling, all key eVIN stakeholders associated with 40 cold-chain points (CCPs) were invited to participate, including district-level officials and facility-level staff. Data were collected through face-to-face semi-structured interviews, transcribed verbatim, and analyzed using reflexive thematic analysis with investigator triangulation.

RESULTS

Stakeholders perceived improvements in real-time stock visibility, distribution efficiency, continuous temperature monitoring, reduced vaccine wastage, and standardized record-keeping following eVIN implementation. Participants also identified important limitations, including dependence on accurate data entry, the lack of beneficiary-level immunization data, human resource shortages, unreliable Internet connectivity, device malfunctions, and duplication of paper and electronic records.

CONCLUSIONS

Stakeholders perceived that eVIN strengthened vaccine logistics and cold-chain monitoring in Indore district. However, persistent challenges related to workforce capacity, infrastructure, funding, and system integration continue to limit its optimal use. Addressing these gaps may improve the sustainability and effectiveness of eVIN in routine immunization services.