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Example of survey form Optimize Project SC costing

Example of survey form Optimize Project SC costing 2025

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The document is a questionnaire designed to gather comprehensive information about health centers' vaccine supply chain logistics, including cold chain functions, energy sources, population data, vaccine inventory, human resources involved in vaccine logistics, and transportation methods. It aims to optimize the costing tool for vaccine supply chain management by collecting detailed data on storage capacities, wastage rates, and operational practices related to vaccine distribution.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the interviewee's name, title, and health center details in the designated fields at the top of the form.
In the 'Health Facility General Information' section, select the appropriate options for cold chain functions and routine vaccine supply methods. Mark only one box where indicated.
Provide information regarding energy sources available for cold chain equipment. Choose from options like grid electricity and bottled gas, ensuring to mark only one box for each.
Fill out the population data section with relevant statistics for each year listed. Ensure accuracy as this data is crucial for analysis.
Complete the vaccine data section by entering details about doses in stock and received for each vaccine listed. Pay attention to wastage rates as they impact overall efficiency.
For human resources, list health workers involved in vaccine logistics, detailing their responsibilities and how often they perform these tasks.
Finally, review all entries for accuracy before submitting your completed form through our platform.

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