Cold chain status at immunisation centres in Ethiopia

Area of Science:

• Public Health
• Vaccinology
• Supply Chain Management

Background:

• Child immunisation is a cost-effective intervention for reducing premature mortality.
• Vaccine efficacy is critically dependent on maintaining the cold chain throughout handling.
• Effective cold chain management is essential at all levels of vaccine distribution.

Purpose of the Study:

• To evaluate the current state of the cold chain at peripheral vaccine stores in Ethiopia.
• To identify deficiencies in cold chain infrastructure and practices.
• To inform interventions for improving vaccine storage and handling.

Main Methods:

• A cross-sectional survey was conducted in rural and urban administrative areas of Ethiopia.
• Sixty-four health institutions providing static vaccination services were assessed.
• Data collection involved interviews with healthcare workers and direct observation of cold chain equipment and records.

Main Results:

• A significant proportion of vaccine storage centres (37%) lacked complete temperature records.
• Thermometers were absent in 6.3% of centres, and 10.9% had readings outside the optimal range.
• Improper vaccine storage in refrigerators (73.4%) and lack of trained personnel/maintenance budgets were prevalent.

Conclusions:

• There is a substantial risk of vaccine potency loss at peripheral stores, even if vaccines are potent upon arrival.
• Recommendations include targeted training for cold chain handlers and improved refrigerator maintenance.
• Implementing cold chain monitoring devices is crucial for ensuring vaccine efficacy.