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肯尼亚农村医疗机构疫苗储存与分发实践的评估

Evaluation of vaccine storage and distribution practices in rural healthcare facilities in Kenya.

作者信息

Sinnei Dennis Kipkoech, Karimi Peter Ndirangu, Maru Shital Mahindra, Karengera Stephen, Bizimana Thomas

机构信息

East African Community Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

Department of Pharmacy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.

出版信息

J Pharm Policy Pract. 2023 Feb 21;16(1):25. doi: 10.1186/s40545-023-00535-2.

Abstract

BACKGROUND

Vaccines require cold chain storage conditions, and good distribution practices throughout the supply chain to maintain their quality and potency. However, in the last mile of the vaccines supply chain, these requirements may not be guaranteed resulting in reduced effectiveness which could lead to an upsurge in vaccine preventable morbidity and mortality. The aim of this research was to evaluate vaccine storage and distribution practices in the last mile of vaccine supply chain in Turkana County.

METHODS

A descriptive cross-sectional study was conducted from January 2022 to February 2022 across seven sub-counties in Turkana County, Kenya, to assess vaccine storage and distribution practices. The study sample size was 128 county health professionals across 4 hospitals, 9 health centers, and 115 dispensaries. The respondents were selected using simple random sampling within the facilities strata. Data were collected using a structured questionnaire, adapted, and adopted from a standardized WHO questionnaire on effective vaccines management and administered to one healthcare personnel working in the immunization supply chain per facility. Data were analyzed using excel and presented as percentages in table forms.

RESULTS

A total of 122 health care workers participated in the study. Most respondents (89%, n = 109) had utilized a vaccine forecasting sheet, but only 81% did have an established maximum-minimum level inventory control system. Many of the respondents had sufficient knowledge of ice pack conditioning although 72% had adequate vaccine carriers and ice packs. Only 67% of respondents had a complete set of twice-daily manual temperature records at the facility. Most refrigerators complied with the WHO specifications but only 80% of them had functional fridge-tags. The number of facilities that had a routine maintenance plan was below average while only 65% had an adequate contingency plan.

CONCLUSION

Rural health facilities have suboptimal supply of vaccine carriers and icepacks for effective storage and distribution of vaccines. In addition, some vaccine fridges lack functional fridge-tags for proper temperature monitoring. Routine maintenance and contingency plans remain a challenge to ensure optimal service delivery.

摘要

背景

疫苗需要冷链储存条件,并在整个供应链中采用良好的配送规范,以保持其质量和效力。然而,在疫苗供应链的最后一英里,这些要求可能无法得到保证,从而导致效力降低,进而可能导致疫苗可预防的发病率和死亡率上升。本研究的目的是评估图尔卡纳县疫苗供应链最后一英里的疫苗储存和配送规范。

方法

2022年1月至2022年2月在肯尼亚图尔卡纳县的七个次县进行了一项描述性横断面研究,以评估疫苗储存和配送规范。研究样本量为来自4家医院、9个健康中心和115个诊疗所的128名县卫生专业人员。在各机构层内使用简单随机抽样选择受访者。数据通过一份结构化问卷收集,该问卷改编自世界卫生组织关于有效疫苗管理的标准化问卷,并发放给每个机构中一名从事免疫供应链工作的医护人员。使用Excel分析数据,并以表格形式呈现为百分比。

结果

共有122名医护人员参与了研究。大多数受访者(89%,n = 109)使用了疫苗预测表,但只有81%建立了最高-最低库存控制系统。许多受访者对冰袋调节有足够的了解,尽管72%有足够的疫苗运输箱和冰袋。只有67%的受访者在机构有一套完整的每日两次手动温度记录。大多数冰箱符合世界卫生组织的规格,但其中只有80%有可用的冰箱标签。有常规维护计划的机构数量低于平均水平,而只有65%有足够的应急计划。

结论

农村卫生机构在有效储存和配送疫苗方面,疫苗运输箱和冰袋的供应不足。此外,一些疫苗冰箱缺乏用于适当温度监测的可用冰箱标签。常规维护和应急计划仍然是确保最佳服务提供的一项挑战。

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