Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Independent Consultant, Pretoria, South Africa.
Vaccine. 2020 May 22;38(25):4111-4118. doi: 10.1016/j.vaccine.2020.04.019. Epub 2020 Apr 30.
Poor stock management has been identified as one of the causes of vaccine stock-outs in health facilities. This study assessed the occurrence of vaccine stock-outs and vaccine stock management practices in primary health care facilities in OR Tambo district of the Eastern Cape province, South Africa.
Descriptive cross-sectional study design was used in this study to assess both the stock management practices and the availability of vaccines in the facilities. The study was conducted in 64 primary health care facilities across all sub-districts in OR Tambo. Data were collected using a questionnaire administered by the researcher, record checks and through observation. The occurrence of stock-outs of six tracer vaccines on the day of the visit and in the preceding 24 months were assessed. The data were captured into REDCap tool and analysed using STATA version 14.
Most standard stock management procedures were not adhered to, as these procedures were mostly handled by health care workers who either required formal training or refresher training on vaccine management. Cold chain capacity was not adequate and some vaccines were exposed to freezing. Both stock cards and the stock visibility solution (SVS) device were used in all the facilities for vaccine stock management. Less than half of the facilities visited 27 (44%) filled their stock cards regularly. Delays in receiving supplies from the pharmaceutical depot were commonly reported by facilities, which contributed to stock-outs. A total of 49 (77%) health facilities had at least one stockout for at least one vaccine on the day of the visit. Furthermore, BCG and OPV were the most affected vaccines in 37 (58%) and 28 (44%) of facilities, respectively.
Interventions for improving vaccine availability should be considered, especially those targeting human resources and the entire stock management system.
不良的库存管理被认为是卫生机构疫苗缺货的原因之一。本研究评估了南非东开普省奥塔姆博地区初级保健设施中疫苗缺货情况和疫苗库存管理做法。
本研究采用描述性横断面研究设计，评估设施中的库存管理做法和疫苗供应情况。该研究在奥塔姆博所有分区的 64 个初级保健设施中进行。研究人员通过问卷调查、记录检查和观察收集数据。评估了在访问当天和前 24 个月内六种示踪疫苗的缺货情况。数据被捕获到 REDCap 工具中，并使用 STATA 版本 14 进行分析。
大多数标准库存管理程序没有得到遵守，因为这些程序主要由需要正式培训或疫苗管理进修培训的卫生保健工作者处理。冷链能力不足，一些疫苗暴露于冻结状态。所有设施均使用库存卡和库存可见性解决方案（SVS）设备进行疫苗库存管理。在被访问的设施中，只有不到一半的设施 27（44%）定期填写库存卡。设施经常报告从制药仓库接收供应品延迟的情况，这导致了缺货。在访问当天，共有 49 家（77%）卫生设施至少有一种疫苗缺货。此外，BCG 和 OPV 分别是 37 家（58%）和 28 家（44%）设施中受影响最严重的疫苗。
应考虑采取干预措施来提高疫苗的可获得性，特别是针对人力资源和整个库存管理系统的干预措施。
