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Prosser W, Danfakha N, Thurston B, Gueye A, Matan S, Tidiane C, Kitts E, Alkassoum I, Agui Y, Brah-Bouzou A, Dembo H, Garba M. Thinking outside of the [cold] box: implementing a human-centered design approach to understand barriers and craft solutions to cold chain equipment maintenance in Niger. J Pharm Policy Pract 2023; 16:146. [PMID: 37974256 PMCID: PMC10652434 DOI: 10.1186/s40545-023-00654-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Vaccines require cold chain equipment (CCE) to ensure quality and potency, yet the risk of CCE failing is well-documented, often due to lack of equipment maintenance. While general barriers to a reliable CCE maintenance system are known, little has been done to understand the barriers from the cold chain technician's perspective. This human-centered design (HCD) study in Niger sought to better understand the gap in the current maintenance approaches from the technicians' perspectives and to collaboratively identify forward-thinking solutions. METHODS The research team collected data through semi-structured and open-ended in-depth consultations. Rapid qualitative research was followed by co-creation workshops with study participants to identify solutions. RESULTS The research team conducted 20 in-depth consultations in two regions with participants directly involved in the management of the cold chain. Fourteen people participated in the online co-creation workshop, and 20 people participated in the in-person workshop. Insights were organized in three main areas: (1) the lack of system agility and ability to optimize resources constrain performance of the maintenance system; (2) cold chain is often an afterthought within the overall context of immunization services and should instead be prioritized; and (3) knowledge sharing across the system and key stakeholders is ad hoc with limited understanding of roles and responsibilities. During the co-creation workshop, participants identified four main concepts as potential solutions: (1) create an on-line platform to connect people and to share knowledge across regions; (2) develop practical CCE technical resources; (3) use gamification and friendly competition to motivate staff to value maintenance; and (4) create a real-time maintenance tracking system. DISCUSSION This study took a unique HCD approach to engage people directly involved in CCE maintenance to more deeply understand challenges with the current system and create space to identify innovative solutions that are tailored to the context. The results demonstrate that stakeholders can identify potential solutions that have not been part of the typical approaches to a maintenance system. This HCD approach has implications for all global health challenges and demonstrates a methodology that can encourage key stakeholders to think about problems and solutions differently.
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Affiliation(s)
| | | | - Brittany Thurston
- ThinkPlace/Senegal, Dakar, Senegal
- ThinkPlace, ThinkPlace, London, UK
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Chu JO, Jeong HS, Park JP, Park K, Kim SK, Yi H, Choi CH. Capsule-based colorimetric temperature monitoring system for customizable cold chain management. CHEMICAL ENGINEERING JOURNAL (LAUSANNE, SWITZERLAND : 1996) 2023; 455:140753. [PMID: 36506703 PMCID: PMC9721202 DOI: 10.1016/j.cej.2022.140753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/08/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic and the resulting supply chain disruption have rekindled crucial needs for safe storage and transportation of essential items. Despite recent advances, existing temperature monitoring technologies for cold chain management fall short in reliability, cost, and flexibility toward customized cold chain management for various products with different required temperature. In this work, we report a novel capsule-based colorimetric temperature monitoring system with precise and readily tunable temperature ranges. Triple emulsion drop-based microfluidic technique enables rapid production of monodisperse microcapsules with an interstitial phase-change oil (PCO) layer with precise control over its dimension and composition. Liquid-solid phase transition of the PCO layer below its freezing point triggers the release of the encapsulated payload yielding drastic change in color, allowing user-friendly visual monitoring in a highly sensitive manner. Simple tuning of the PCO layer's compositions can further broaden the temperature range in a precisely controlled manner. The proposed simple scheme can readily be formulated to detect both temperature rise in the frozen environment and freeze detection as well as multiple temperature monitoring. Combined, these results support a significant step forward for the development of customizable colorimetric monitoring of a broad range of temperatures with precision.
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Affiliation(s)
- Jin-Ok Chu
- Division of Cosmetic Science and Technology, Daegu Haany University, 1 Haanydaero, Gyeongsan, Gyeongbuk 38610, Republic of Korea
| | - Hye-Seon Jeong
- Division of Cosmetic Science and Technology, Daegu Haany University, 1 Haanydaero, Gyeongsan, Gyeongbuk 38610, Republic of Korea
| | - Jong-Pil Park
- Basic Research Laboratory, Department of Food Science and Technology, Chung-Ang University, 4726, Seodongdaero, Daedeok, Anseong, Gyeonggi 17546, Republic of Korea
| | - Kyeongsoon Park
- Department of Systems Biotechnology, Chung-Ang University, 4726, Seodongdaero, Daedeok, Anseong, Gyeonggi 17546, Republic of Korea
| | - Sun-Ki Kim
- Basic Research Laboratory, Department of Food Science and Technology, Chung-Ang University, 4726, Seodongdaero, Daedeok, Anseong, Gyeonggi 17546, Republic of Korea
| | - Hyunmin Yi
- Department of Chemical and Biological Engineering, Tufts University, Medford, MA 02155, USA
| | - Chang-Hyung Choi
- Division of Cosmetic Science and Technology, Daegu Haany University, 1 Haanydaero, Gyeongsan, Gyeongbuk 38610, Republic of Korea
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Jenkins D, Cancel A, Layloff T. Mean kinetic temperature evaluations through simulated temperature excursions and risk assessment with oral dosage usage for health programs. BMC Public Health 2022; 22:300. [PMID: 35164726 PMCID: PMC8842539 DOI: 10.1186/s12889-022-12660-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Temperature excursions occur during the transport and storage of pharmaceuticals, and often result in considerable losses for public health programs operating in countries with limited resources. After a temperature excursion has been identified, often products are discarded without any additional risk assessments. Consulting the manufacturer is the preferred approach but can be challenging depending on the responsiveness of the manufacturer. However, decisions are often required quickly depending on program needs and available stock in country. Methods To provide further guidance, simulations have been conducted based on mean kinetic temperature evaluations using accepted default kinetic parameters to assess loss of shelf-life for scenarios involving various levels of temperature excursions on a model pharmaceutical at different recommended storage conditions, shelf-life, and long-term storage conditions. Results Although an immediate loss to shelf-life occurred with excursions when the product was stored at the maximum allowed temperature, more extended excursion could be withstood before loss of shelf-life was detected when long-term storage was maintained at temperatures below the maximum storage condition for the product. With the assumption that a shelf-life loss of 2 weeks was negligible when managing program stock, a risk assessment was conducted to outline the various times that excursions at different temperatures could be considered low risk to the program. Conclusions Depending on the level of the temperature excursion and the guidance provided by the manufacturer, public health programs will have further information with this assessment to guide decisions that impact safety to the end user and resource management due to temperature excursions that can occur. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12660-9.
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Affiliation(s)
- David Jenkins
- Product Quality and Compliance, FHI 360, 2810 Meridian Parkway, Suite 160, Durham, NC, 27713, USA.
| | - Aida Cancel
- Product Quality and Compliance, FHI 360, 2810 Meridian Parkway, Suite 160, Durham, NC, 27713, USA
| | - Thomas Layloff
- Retired, formerly with Product Quality and Compliance, FHI 360, 2810 Meridian Parkway, Suite 160, Durham, NC, 27713, USA
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Cold Chain Management by Healthcare Providers at a District in Ghana: A Mixed Methods Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:7559984. [PMID: 34557551 PMCID: PMC8455184 DOI: 10.1155/2021/7559984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/06/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Abstract
Background Despite the relevance of cold chain management in maintaining the potency of vaccines, gaps still exist in the ability of healthcare practitioners to maintain the cold chain system effectively. Thus, the current study sought to assess healthcare providers' knowledge, attitudes, practices, and challenges regarding cold chain management. Methods A concurrent mixed methods study was conducted at twelve facilities in the Sekyere Central District of Ghana. Eighty-six (86) participants took part in a survey that assessed their “cold chain management” knowledge and attitudes. Twelve (12) cold chain sites within the district were also observed in respect of their cold chain management practices. Eleven key informants were additionally interviewed to explore their challenges on cold chain management. Quantitative data were analyzed using descriptive (frequencies, percentages, means, standard deviations, ranges) and inferential statistics (Spearman's rho correlation). Qualitative data were inductively analyzed into themes which described participants' challenges on cold chain management. Results Majority of the participants scored ≥70% on knowledge (68.6%) and attitudes (67.4%) toward cold chain management. However, there was a very weak positive and statistically insignificant relationship between participant's knowledge and attitudes toward cold chain management (r = 0.109, p = 0.317). Regarding cold chain management practices, majority of the facilities had their vaccine vial monitors attached to the vaccines (8/12, 66.7%), had functional fridge tags (8/12, 66.7%), and an appropriate refrigerator to store vaccines (7/12, 58.3%). However, the study observed that 91.7% (11/12) of the facilities did not have policies and guidelines on cold chain management while all 12 facilities (100%) did not have a contingency plan in place for equipment. With regards to the cold chain management challenges, participants raised concerns about inadequate personnel, erratic power supply, logistical constraints, and transportation difficulties. Conclusion Although majority of the participants had good knowledge and attitude towards cold chain management, there was a weak association between them. This implies that good knowledge may not necessarily influence good attitudes towards cold chain management and vice versa. The extent to which facilities support cold chain management practices was suboptimal. Participants encountered a number of challenges which prevented them from managing the vaccine cold chain system effectively. We recommend continual professional education for cold chain practitioners, provision of adequate human and material resources for cold chain management, and enhanced monitoring and evaluation of cold chain activities. Future studies should quantitatively measure individual participants' knowledge, attitudes, practices, and challenges on cold chain management so that we can establish the relationships that exist between these components.
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Collins J, Westerveld R, Nelson KA, Rohan H, Bower H, Lazenby S, Ikilezi G, Bartlein R, Bausch DG, Kennedy DS. 'Learn from the lessons and don't forget them': identifying transferable lessons for COVID-19 from meningitis A, yellow fever and Ebola virus disease vaccination campaigns. BMJ Glob Health 2021; 6:bmjgh-2021-006951. [PMID: 34535490 PMCID: PMC8450956 DOI: 10.1136/bmjgh-2021-006951] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/29/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION COVID-19 vaccines are now being distributed to low- and middle-income countries (LMICs), with global urgency surrounding national vaccination plans. LMICs have significant experience implementing vaccination campaigns to respond to epidemic threats but are often hindered by chronic health system challenges. We sought to identify transferable lessons for COVID-19 vaccination from the rollout of three vaccines that targeted adult groups in Africa and South America: MenAfriVac (meningitis A); 17D (yellow fever) and rVSV-ZEBOV (Ebola virus disease). METHODS We conducted a rapid literature review and 24 semi-structured interviews with technical experts who had direct implementation experience with the selected vaccines in Africa and South America. We identified barriers, enablers, and key lessons from the literature and from participants' experiences. Interview data were analysed thematically according to seven implementation domains. RESULTS Participants highlighted multiple components of vaccination campaigns that are instrumental for achieving high coverage. Community engagement is an essential and effective tool, requiring dedicated time, funding and workforce. Involving local health workers is a key enabler, as is collaborating with community leaders to map social groups and tailor vaccination strategies to their needs. Vaccination team recruitment and training strategies need to be enhanced to support vaccination campaigns. Although recognised as challenging, integrating vaccination campaigns with other routine health services can be highly beneficial if well planned and coordinated across health programmes and with communities. CONCLUSION As supplies of COVID-19 vaccines become available to LMICs, countries need to prepare to efficiently roll out the vaccine, encourage uptake among eligible groups and respond to potential community concerns. Lessons from the implementation of these three vaccines that targeted adults in LMICs can be used to inform best practice for COVID-19 and other epidemic vaccination campaigns.
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Affiliation(s)
- Julie Collins
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine/Public Health England, London, UK
| | - Rosie Westerveld
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kate A Nelson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hana Rohan
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine/Public Health England, London, UK
| | - Hilary Bower
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine/Public Health England, London, UK
| | | | | | | | - Daniel G Bausch
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine/Public Health England, London, UK
| | - David S Kennedy
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine/Public Health England, London, UK
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Amaral GG, Guimarães EADA, Tavares LODM, Silva BS, Cortez DN, Oliveira VCD. Adequacy assessment of immunobiological agent conservation in the Western Health macro-region of Minas Gerais State, Brazil: a descriptive study, 2017. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e20201017. [PMID: 34431956 DOI: 10.1590/s1679-49742021000300019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the adequacy of immunobiological agent conservation in vaccination rooms in the municipalities of the Western health macro-region of the state of Minas Gerais, Brazil. METHODS This was a descriptive study, based on a validated scale, with a maximum score of 15 points. A descriptive analysis and an association test between the scores obtained by the municipalities and variables of the external context were performed. RESULTS 275 out of a total of 295 existing vaccination rooms were evaluated. Immunobiological agent conservation in the West macro-region obtained an average score of 4 points (standard score, 0 to 15). There was a poor availability of immunization supplies aimed at immunobiological agent conservation, and work processes, that require improvement. Small municipalities presented better immunobiological agent conservation (p=0.011). CONCLUSION Immunobiological agent conservation in vaccination rooms in the Western health macro-region of Minas Gerais State was considered inadequate.
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Affiliation(s)
| | | | | | - Brener Santos Silva
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brasil
| | - Daniel Nogueira Cortez
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brasil
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Falcón VC, Porras YVV, Altamirano CMG, Kartoglu U. A vaccine cold chain temperature monitoring study in the United Mexican States. Vaccine 2020; 38:5202-5211. [PMID: 32586762 DOI: 10.1016/j.vaccine.2020.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 10/24/2022]
Abstract
Vacine cold chain assessments conducted in various parts of the world indicate that maintaining equipment at the temperature range recommended by the World Health Organization (WHO) is not always observed. It has been also the case that staff rather prioritize protecting vaccine from heat damage, thus often exposing vaccines to freezing temperatures. As a result, inadvertent freezing of vaccines is a largely overlooked problem all over the world. In a recent systematic review, comparison of the occurrence of freezing temperatures during storage and transport were found to be a global problem occurring both in the resource-rich as well as the resource-limited settings. A vaccine cold chain temperature monitoring study was conducted using standard WHO study protocol with the objective to document potential problems and to identify appropriate control measures. Multiple temperature monitoring devices were used in the study to evaluate user friendliness of these devices and staff attitudes towards them. In general, majority of the time, temperatures were kept between recommended temperature range of 2-8 °C. Temperature variation got wider when products moved from 3PL Laboratory to service points. The wider variation is found at the service points. High temperature excursions were observed or short periods of time while exposures to freezing temperatures were more both higher in number and duration, however, shake test with these vaccines indicated no freeze damage. 91% of staff believed that they did not have the necessary tools to detect if a vaccine had been damaged by a temperature excursion outside the 2-8 °C range, and all staff believed that inclusion of such devices (e.g. vaccine vial monitor) in the system would improve cold chain operations as they have became aware of problematic areas through this study.
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Affiliation(s)
| | - Yara Verónica Villalobos Porras
- Area of Personal Property and Specialized Equipment, OPD Jalisco Health Services, Amsterdam #1486 int 15, Arcos Vallarta, C.P 44130 Guadalajara, Jal, Mexico
| | - César Misael Gómez Altamirano
- Agreements and Committments, National Health Council, Lieja 7 Alcaldía Cuauhtémoc, Colonia Juárez, Ciudad de Mexico C.P. 06600, Mexico
| | - Umit Kartoglu
- Extensio et Progressio, 1a chemin du Pre-d'Orsat, 1245 Collonge-Bellerive, Switzerland.
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Quality and reliability of vaccination documentation in the routine childhood immunization program in Burkina Faso: Results from a cross-sectional survey. Vaccine 2020; 38:2808-2815. [PMID: 32089461 DOI: 10.1016/j.vaccine.2020.02.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Accurate and timely vaccination data are important to the Expanded Program on Immunization (EPI) to assess individual vaccination status and to monitor performance and vaccine coverage (VC). Since 2013, Burkina Faso introduced several new vaccines into the routine childhood immunization schedule. However, sustained efforts for a timely update and alignment of immunization home-based (HBRs) and health facility-based records (FBRs) with the evolving schedule were not implemented. METHODS In 2016-17, we conducted a 6-week cross-sectional survey in 30 health facilities (HFs) across 10 health districts (HDs), targeting children aged < 24 months and their caregivers. Data collected included sociodemographics, availability of vaccination recording fields in HBRs, and vaccination dates. We evaluated the characteristics, completion patterns, and concordance of HBRs and FBRs to determine their reliability as data sources in estimating VC. A standard HBR was defined as one that had recording fields for all recommended 17 vaccine doses of the schedule, and discordance between HBR and FBR as having different vaccination dates recorded, or vaccination information missing in one of the records. We computed proportions and concordance statistics, and used logistic regression to explore predictors of discordance. RESULTS We recruited 619 children, including 74% (n = 458) aged 0-11 months. Half (50.6%) of HBRs were non-standard. About two-thirds (64.6%) of children were concerned with discordant information. Compared to HBRs, FBRs were generally associated with low negative predictive values (median: 0.41; IQR: 0.16-0.70). Multivariate logistic regression model showed that standard HBR was protectively associated with discordant information (OR = 0.46, 95% CI: 0.26-0.81, p = 0.010). CONCLUSION We documented a lack of standardization of HBRs and frequent information discordance with FBRs. There is a pressing need to update and standardize vaccination recording tools and ensure their continuous availability in HFs to improve data quality in Burkina Faso.
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Nkwenkeu SF, Jalloh MF, Walldorf JA, Zoma RL, Tarbangdo F, Fall S, Hien S, Combassere R, Ky C, Kambou L, Diallo AO, Krishnaswamy A, Aké FH, Hatcher C, Patel JC, Medah I, Novak RT, Hyde TB, Soeters HM, Mirza I. Health workers' perceptions and challenges in implementing meningococcal serogroup a conjugate vaccine in the routine childhood immunization schedule in Burkina Faso. BMC Public Health 2020; 20:254. [PMID: 32075630 PMCID: PMC7031928 DOI: 10.1186/s12889-020-8347-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 02/12/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Meningococcal serogroup A conjugate vaccine (MACV) was introduced in 2017 into the routine childhood immunization schedule (at 15-18 months of age) in Burkina Faso to help reduce meningococcal meningitis burden. MACV was scheduled to be co-administered with the second dose of measles-containing vaccine (MCV2), a vaccine already in the national schedule. One year following the introduction of MACV, an assessment was conducted to qualitatively examine health workers' perceptions of MACV introduction, identify barriers to uptake, and explore opportunities to improve coverage. METHODS Twelve in-depth interviews were conducted with different cadres of health workers in four purposively selected districts in Burkina Faso. Districts were selected to include urban and rural areas as well as high and low MCV2 coverage areas. Respondents included health workers at the following levels: regional health managers (n = 4), district health managers (n = 4), and frontline healthcare providers (n = 4). All interviews were recorded, transcribed, and thematically analyzed using qualitative content analysis. RESULTS Four themes emerged around supply and health systems barriers, demand-related barriers, specific challenges related to MACV and MCV2 co-administration, and motivations and efforts to improve vaccination coverage. Supply and health systems barriers included aging cold chain equipment, staff shortages, overworked and poorly trained staff, insufficient supplies and financial resources, and challenges with implementing community outreach activities. Health workers largely viewed MACV introduction as a source of motivation for caregivers to bring their children for the 15- to 18-month visit. However, they also pointed to demand barriers, including cultural practices that sometimes discourage vaccination, misconceptions about vaccines, and religious beliefs. Challenges in co-administering MACV and MCV2 were mainly related to reluctance among health workers to open multi-dose vials unless enough children were present to avoid wastage. CONCLUSIONS To improve effective administration of vaccines in the second-year of life, adequate operational and programmatic planning, training, communication, and monitoring are necessary. Moreover, clear policy communication is needed to help ensure that health workers do not refrain from opening multi-dose vials for small numbers of children.
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Affiliation(s)
| | - Mohamed F. Jalloh
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
| | - Jenny A. Walldorf
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
| | - Robert L. Zoma
- Institut National de Statistique et Démographie, Ouagadougou, Burkina Faso
| | | | - Soukeynatou Fall
- UNICEF Ouagadougou, 01 PO Box 3420, Ouagadougou 01, Burkina Faso
| | - Sansan Hien
- UNICEF Ouagadougou, 01 PO Box 3420, Ouagadougou 01, Burkina Faso
| | | | - Cesaire Ky
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | | | | | | | | | - Cynthia Hatcher
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
| | - Jaymin C. Patel
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
| | - Isaïe Medah
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Ryan T. Novak
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
| | - Terri B. Hyde
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
| | - Heidi M. Soeters
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 USA
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Yassin ZJ, Yimer Nega H, Derseh BT, Sisay Yehuala Y, Dad AF. Knowledge of Health Professionals on Cold Chain Management and Associated Factors in Ezha District, Gurage Zone, Ethiopia. SCIENTIFICA 2019; 2019:6937291. [PMID: 31281711 PMCID: PMC6590539 DOI: 10.1155/2019/6937291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/03/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Maintaining quality of vaccines has been one of the main challenges of immunization programs in Africa including Ethiopia, and this could mainly be explained by health professional's knowledge about cold chain management. There are limited studies done in Ethiopia linking the knowledge of health professionals on cold chain management, and that is why we needed to conduct this study. METHODOLOGY Institution-based cross-sectional study was conducted among all available health professionals in selected health facilities (232 health professionals). Face-to-face interview using a semistructured questionnaire was conducted to collect required information from September to October 2016. Observational checklist was used to spot availability and functionality of refrigerators. Data entry and cleaning was done using Epi Info and exported to SPSS for analysis. A multivariable logistic regression model was fitted to identify factors associated with health professional's knowledge about cold chain management. RESULT The response rate was 92.43%, and 119 (51.3%; 95% CI; 44.9%, 57.6%) health professionals had a satisfactory knowledge about cold chain management. Being trained on immunization program (AOR = 5.1; 95% CI: 2.68, 10.13), having a work experience above six years (AOR = 2.1; 95% CI: 1.8, 4.15), using EPI guidelines (AOR = 2.58; 95% CI: 1.47, 5.57), and being a BSc nurse/health officer (AOR = 2.4; 95% CI: 1.47, 14.4) had got better knowledge on cold chain management. CONCLUSION Health professionals working in the health centers and health posts had low knowledge on cold chain management. Longer work experience, in-service training, and using EPI guideline at work were factors that improved health professionals' knowledge about a cold chain management, which needs to be maintained.
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Affiliation(s)
- Zeyneba Jemal Yassin
- Ethiopian Field Epidemiology and Laboratory Training Program Resident, University of Gondar, Gondar, Ethiopia
| | - Habtamu Yimer Nega
- South Wollo Zone, Institute of Public Health Emergency Management Department, Dessie, Ethiopia
| | - Behailu Tariku Derseh
- Debre Berhan University, College of Health Sciences, Department of Public Health, Debre Berhan, Ethiopia
| | - Yetnayet Sisay Yehuala
- University of Gondar, Institute of Public Health, Department of Health Promotion and Behavioral Sciences, Gondar, Ethiopia
| | - Abel Fekadu Dad
- College of Medicine and Public Health, School of Public Health, Flinders University, Adelaide, Australia
- University of Gondar, Institute of Public Health, Department of Epidemiology Biostatistics, Gondar, Ethiopia
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