Nestory Bonaventura, Anasel Mackfallen, Nyandwi Jean Baptiste, Asingizwe Domina
EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania.
J Pharm Policy Pract. 2022 Nov 30;15(1):95. doi: 10.1186/s40545-022-00496-y.
Effective vaccine management is essential to maintain the quality of vaccines, minimise wastages, and prevent missed opportunities for vaccination at service delivery points.
This study aims to assess vaccine management practices among vaccinators at health facilities in the Morogoro region, Tanzania.
A descriptive cross-sectional study design involved health workers from 77 health facilities offering vaccination services. The study population consisted of vaccine handlers and vaccinators working in public health facilities in the Morogoro region. The vaccine management practices were assessed using data collected from ledgers and the Vaccine Information Management System (VIMS). The temperature records were downloaded from the Fridge-tag® 2 and Coldtrace5 devices.
The findings indicated that 65 (84%) health facilities had functional refrigerators and are using power from 26 (34%), 28 (36%), and 23 (30%) of grid electricity, solar, and Liquefied Petroleum Gas (LPG), respectively. Besides, 27 (35%) health facilities have an alternative energy source as a backup. In general, healthcare workers had a good knowledge of cold chain management, including the World Health Organization recommended storage temperatures for vaccines. Furthermore, vaccine stockout was found in 12 (15.6%) health facilities for at least one antigen and 4 (5.1%) health facilities for all five antigens under observation. This current study also revealed that the average calculated vaccine wastage rates for DTP, Measles-Rubella and Rotavirus vaccines were 7%, 19%, and 15%, respectively. More than half of health workers did not perform monthly temperature data reviews. In addition, poor performance led to high wastage rates, including the Rotavirus vaccines, and a change in VVM to discard points. Finally, a small number of 5 (6.5%) health facilities consecutively reported temperature exposure beyond + 8 Celsius (between 5.9 and 281 h).
Healthcare workers' vaccine and cold chain management knowledge were good for temperature data reading and documentation. However, the practices were poor for some health facilities. The gaps observed in this study inform health managers and policymakers toward establishing interventions to improve health workers' knowledge and practice, including mentorships, supervision, and training to guarantee that each child in all communities reaps the benefits of immunisation services.
有效的疫苗管理对于维持疫苗质量、减少浪费以及防止服务提供点出现疫苗接种机会错失至关重要。
本研究旨在评估坦桑尼亚莫罗戈罗地区医疗机构中疫苗接种人员的疫苗管理实践。
一项描述性横断面研究设计涉及来自77个提供疫苗接种服务的医疗机构的卫生工作者。研究人群包括在莫罗戈罗地区公共卫生机构工作的疫苗处理人员和疫苗接种人员。使用从账本和疫苗信息管理系统（VIMS）收集的数据评估疫苗管理实践。温度记录从Fridge-tag® 2和Coldtrace5设备下载。
研究结果表明，65个（84%）医疗机构拥有功能正常的冰箱，分别使用来自电网电力、太阳能和液化石油气（LPG）的电力，占比为26个（34%）、28个（36%）和23个（30%）。此外，27个（35%）医疗机构有替代能源作为备用。总体而言，医护人员对冷链管理有较好的了解，包括世界卫生组织推荐的疫苗储存温度。此外，在12个（15.6%）医疗机构中发现至少一种抗原出现疫苗缺货情况，在4个（5.1%）医疗机构中发现所观察的所有五种抗原均缺货。本研究还显示，百日咳、白喉、破伤风联合疫苗（DTP）、麻疹 - 风疹疫苗和轮状病毒疫苗的平均计算疫苗浪费率分别为7%、19%和15%。超过一半的卫生工作者没有每月进行温度数据审查。此外，表现不佳导致浪费率较高，包括轮状病毒疫苗，以及疫苗效期监测标记（VVM）丢弃点的变化。最后，少数5个（6.5%）医疗机构连续报告温度暴露超过 +8摄氏度（5.9至281小时之间）。
医护人员在疫苗和冷链管理方面的知识对于温度数据读取和记录来说是良好的。然而，一些医疗机构的实践情况较差。本研究中观察到的差距为卫生管理人员和政策制定者提供了信息，有助于他们制定干预措施，以提高卫生工作者的知识和实践水平，包括指导、监督和培训，以确保所有社区的每个儿童都能从免疫服务中受益。
