<ns3:p>Delivery of health products from provinces or districts to health facilities, including temperature-sensitive vaccines, is one of the most effective interventions to ensure availability of supplies and save lives in low- and middle-income countries. Currently, routes are hand drawn by logisticians that are adjusted based on vehicle availability and quantity of products. Easy-to-use supply chain tools are needed that planners can use in real-time to create or adjust routes for available vehicles and road conditions. Efficient and optimized distribution is even more critical with the COVID-19 vaccine distribution.</ns3:p><ns3:p> </ns3:p><ns3:p> We develop a Route Optimization Tool (RoOT) using a variant of a Vehicle Routing and Scheduling Algorithm (VeRSA) that is coded in Python, but reads and writes Excel files to make data input and using outputs easier. The tool takes into account cold chain distribution, is easy-to-use, and provides routes quickly within two minutes. RoOT can be used for routine operations or in emergency situations, such as delivery of new COVID-19 vaccine. The tool has a user-centric design with easy dropdown menus and the ability to optimize on time, risk, or combination of both.</ns3:p><ns3:p> </ns3:p><ns3:p> Training of logisticians in Mozambique indicate that RoOT is easy to use and provides a tool to improve planning and efficient distribution of health products, especially vaccines. We illustrate using RoOT in an emergency situation, such as a cyclone.</ns3:p><ns3:p> </ns3:p><ns3:p> RoOT is an open-source tool for optimal routing of health products. It provides optimized routes faster than most commercial software, and is tailored to meet the needs of government stakeholders. Currently, RoOT does not allow multi-day routes, and is designed for trips that can be completed within twenty-four hours. Areas for future development include multi-day routing and integration with mapping software to facilitate distance calculations and visualization of routes.</ns3:p>