An Assessment of the Cold Chain System in Immunization Centres

An Assessment of the Cold Chain System in Immunization Centres in Enugu North Local Government Area of Enugu State

Abstract

Introduction: Vaccine preventable diseases remain the most common causes of childhood mortality with an estimated three million deaths each year. Immunity to vaccine preventable diseases only result when active and effective vaccines are used. Active and effective vaccines can be sustained by harnessing the essential elements in the cold chain namely the vaccines, manpower, and equipment. Objectives. This study was conducted to determine the knowledge of health workers in immunization centers in Enugu North LGA as regards vaccine storage and handling, to determine number of trained personnel, number of equipments, their conditions and maintenance as well as fund availability and to determine whether or not the cold chain is interrupted using the VVM of oral polio vaccines. Methods. This study is a cross-sectional descriptive survey of all the public health facilities that offer static immunization in Enugu North LGA. All the twenty seven health facilities that offer immunization services in the LGA were reviewed using both qualitative and quantitative approach to determine the cold chain status at those centers. Results. The result showed that 65(46 .1 %) of the respondents received pre service training while 76 (53.9%) of the respondents have received in-service training on cold chain management. Only 48 (34.0%) of the respondents could identify OPV as the most heat sensitive, 70 (49.6%) could identify OPT as the most sensitive to freezing and as many as 126 (89.4%) could cite the appropriate temperature range for vaccine storage. There is significant relationship between inservice training and knowledge of vaccine storage by health workers. Equipments used in the main tenance of cold chain were found lacking in some centers, 22 (81 .5%) of the facilities inspected do not have maximum and minimum thermometer, 14 (51 .9%) of the facility do not have vaccine stock control books, and refrigerators were available but not functional in 1 (3.7%) of the centers visited. Vaccine carriers were found not available in1 (3.7%) of the centers. 10(37.0%) of the centers do not have stand by generator while in 6 (22.20/0) of the centers generators were available but not functional. In about 9 (33.3%) of the facilities visited their vaccines were stored on the refrigerator door shelves while 5 (18.5%) of the facilities stored other things like sachet water and soft drinks along with their vaccines and diluents. In all the centers the OPV inspected using the VVM were found to be within the normal calor change. In 11 (40 .7%) of the centers their VVM was in stage one while 16 (59.3 %) has their VVM in stage two . Conclusion. The quality of vaccine cold chain in the twenty seven health facility visited were generally good but efforts need to be directed at the availability of equipments and maintenance, regular supervision and monitoring of the vaccine cold chain and regular in-service training to update the knowledge of health workers.