Assessment Of The Effectiveness Of Vaccine Cold Chain System In Ilorin West L.G.A Kwara State, Nigeria

Project and Seminar Material for Public Health

Assessment Of The Effectiveness Of Vaccine Cold Chain System In Ilorin West L.G.A Kwara State, Nigeria


Abstract


To ensure the optimal potency of the vaccine storage and handling, need or there is a careful attention adequate electricity power and refrigerator are often lacking in developing countries, where storage handling and heat stability of vaccine are consequently of great concern, where new product have been developing for safe transport and storage while the reliability of vaccine supply has been increased by the introduction of improved management techniques, extensive training ensure that everyone involved in the cold chain system is familiar with all its facet. However, the evaluation in Indian Malaysia Nepal the united republic Tanzania and Tunisia show that these were still weak points in the cold chain system performances and that more attention should be paid to it especially in peripheral facilities the importance of monitoring the cold chain has been given little consideration in temperature countries although adequate refrigerator is often taken for granted, errors in vaccine handling may occur more commonly than is generally assumed.


Chapter One


Introduction

1.1 Background of the Study

A cold chain is defined as a temperature control apply chain( l]. cold chain is also an uninterrupted series of storage and distribution activities which maintain a given temperature range(1).According to WHO cold chain is used to help extend and ensure the shelf life of products such as fresh agricultural products,, chemicals and pharmaceutical drugs etc. it ensures that there are minimum temperature fluctuations for good in transit from place of production to the point of consumption(1).

Otis regarded as a temperature-controlled supply chain that involves equipment in view of the different temperature needed for different vaccine and medicines. Cold chain is the process that ensure vaccine are stored at recommended temperature range of 2.0 C to 8.0C from the point of manufacturer to the point of administration (immunization Advisory center)put no reported cold chain as the system used to keep and distribute vaccine in perfect condition.

Cold chain in network is regarded as the backbone to ensure that the right quality of vaccine reaches the target population. Manufacturing plant, vaccine distribution and then to provider office (immunization clinic) and end with the administration of the vaccine to the recipient (1).

Vaccine are immunogens consisting of weakened or dead pathogenic cell injected in order to stimulate the production of antibodies it’s use to improve immunity to particular disease(1). The prevention of disease by the immunization is a conventional public health measure is known as today the best disease low-cost community based way of protecting children against the major killer disease over a 2 million death that are preventable through immunization. Each year and worldwide(2).this vaccine preventable disease remain the most common cause of childhood mortality with on estimated 3million death each yea(2). .development of effective vaccine has reduced the incidence of much serious infectious disease, early year immunization services in developing countries prevent about 490.000children from becoming paralyzed by poliomyelitis. Over 3million death are similarly prevented from measles, neonatal tetanus, pertussis (5). The achievement is partly attributable to the training of staff in the proper storage and transport of vaccine and partly to improvement in the cold chain. Immunization to vaccine preventable disease only result when active and affective vaccine can be sustainable by harnessing the essential elements in the cold chain system namely the vaccine, manpower, equipment and transportation. The cold chain refers to the continued of safe handling practice including material equipment and procedure that maintain vaccine within a temperature range from the time they are manufactured to the time they are administered to the person being immunized the cold chain still remains a highly vulnerable element of any immunization program. Both in developing and developed countries. The cold chain management including all of the means use to ensure a constant temperature between +2.c +8.c for that is not heat stable e.g. vaccine (2).


1.2 Statement of Problem

The development of vaccines for the prevention of infectious diseases is one of the most significant accomplishments of public health in the last century. The efficacy of a vaccine in preventing disease depends largely on the quality of the immunizing agent. Failure to adhere strictly to recommended specifications for vaccine handling and storage can render vaccines useless. Inactivation of a vaccine may become evident only after immunized individuals acquire the disease the vaccine was designed to prevent (3). The identified cases are often considered primary or secondary vaccine failures, thereby obscuring the role that improper vaccine handling may have played in the failure.

A study conducted in Lagos, showed that 3/4 of the vaccines at the local government level were sub-potent with the situation failing to improve over the three-year study period. Studies have also reported that improper vaccine storage leading to the administration of sub-potent vaccines may have been associated with outbreaks of vaccine preventable diseases in Israel and several developing countries.

Poor handling and storage, cold chain deficiencies such as inadequate infrastructure, power shortages and poor maintenance are associated with vaccine wastage. Though there are very few countries reporting vaccine wastage to World Health Organization, WHO (19 of the 72 Global Alliance for Vaccine Initiative, GAVI eligible countries), developing countries have been found to incur cost of vaccine wastage in excess of $4 million and $6 million for pentavalent and pneumococcal vaccines respectively (4). It is noteworthy that Nigeria is among the 74% of GAVI eligible countries that do not report vaccine wastage.

Periodic assessment of vaccine handling and storage practices is instrumental in correcting wrong vaccine management practices and improving level of knowledge on vaccine management. In addition, it identifies various capacity gaps (personnel and equipment), which when duly addressed strengthens the nation’s immunization service delivery, increases vaccination coverage and ensures the administration of potent vaccines to clients. This study was therefore conducted to assess the factors associated with vaccine handling and storage practices among immunization service providers in South-Western Nigeria (4).


1.3 Significance of the Study

An assessment of effeteness of vaccine cold chain system in vaccine storage in Ilorin west LGA, would provide a lead way to prompting healthy living in the state in particular and country as a whole The finding would provide useful information that could assist relevant ministry and agencies in performing their statutory responsibilities of maintaining the quality of vaccine through optimal cold chain system. In same vein, the donor agencies and partner would leverage on the findings to determine more areas of assistant words making


1.4 Objectives of the Study

General Objectives

A assessment of effectiveness of the vaccine Cold Chain System In Ilorin West Local Government area Kwara State, Nigeria

Specific Objectives
  1. To assess the level of availability of cols chain system in Ilorin west Local government area.
  2. To assess the quality and level of effectiveness cold chain equipment in Ilorin west Local government area
  3. To assess the utilization of cold chain of monitoring devices in Ilorin west LGA

1.5 Scope of the study

The study focuses on the Assessment of the effectiveness of vaccine cold chain system in vaccine storage in Ilorin west Local Government Area of kwara state and respondents were drown among local government immunization office team management, focal Persons, routine immunization (R I) in charge, house to house team vaccinators .


1.8 Operational Definition of Terms

Cold:

Could mean a substance or weather with low temperature

Chain:

To the sense of interconnected links or rings.

System:

A composed of relationships among the organs or members

Potency:

Is the ability or capacity to perform something or to be productive

Temperature:

Is a degree of hotness or coldness of a substance

Vaccine:

Is a biological prepared that provide active acquired immunity to a particular disease. A vaccine typically contain an agent that resemble with disease causing by micro organism is often an agent weakened or killers farm of the microbe

Immunization:

Is the administration of antigen in to the body to induces immunity

Polio:

Is a acute paralysis disease cause by the poliomyelitis virus. It is cripple disease that can occur in adults but it is much commoner in children

WHO:

World Health Organization

V.P.D:

Vaccine Preventable Diseases

V.V.M:

Means Vaccine Viral Monitor – is a chemical indicator level attach to the vaccine vial with a differences 4 stage colour

EPI:

Expanded program on immunization

USAID:

United State Agency for International Development

AFP:

Acute Flaccid Paralysis

BCG:

Bacilli Calmette Guerin

NPI:

National Program Immunization

MDVPV:

Multi Dose Vial Policy Vaccine

WPV:

Wild Polio Virus.


Chapter Five


Discussion of Findings

5.0 Introduction

This chapter discusses the major findings of the research work with regards to the specific objectives. It also contains the implication for Community Health, summary, limitation of the study, recommendation, suggestions for further study and conclusion.


5.1 Discussion of Findings

The findings revealed that most of the respondents who are the professional in community health strongly agreed on the level of availability of cold chain system that those cold chain vaccine storage is the only facility in Ilorin West Local Government while others disagreed. Majority of the respondents also greed that different types of vaccines are stored in that center , that is , NPI office in Ilorin West Local Government while strongly disagree that only specific vaccines are stored in the center. The respondents agree that the equipments at the center are used maximally.

On ensuring the quality and level of effectiveness of cold chain equipment in Ilorin West Local Government, the study revealed strong agreement of the respondent that when the cold chain is well electrified it can improve efficiency. It is good to have 24 hours power supply either from the main source or alternatively through Standby Generator, in the cold chain office because the recommended temperature at the cold chain vaccine center must be maintained to retain the potency of the stored vaccines. It was also agreed that in case of any problem at the center, it must be reported promptly to the designated personnel who in turn take immediate actions by correcting the identified problems. It was also agreed that periodic services must be provided to the cold chain equipment and obsolete or non functional equipment are replaced with new ones.

The study findings revealed in terms of the assessment of the utilization of cold chain in Ilorin West Local Government, that staff should be well trained to deliver cold chain service, the staff should be trained on cold chain management to ensure efficiency and reduce unnecessary waste and damages, that when there is understanding of the protocol, routine and urgent vaccine storage can be helpful in ensuring quality cold chain system. For the monitoring devices, majority of the respondents strongly agreed that thermometer is very essential, refrigerator is the most important equipment in the cold chain system because it helps to maintain vaccine potency, that cold box can be use to distribute vaccines to all the facility levels in the ward, ice packs and vaccine carries can help maintain the potency of vaccines while generators can provide power when electricity is not available.


5.2 Summary of Findings

This study was conducted on the assessment of the effectiveness of vaccines cold chain in Ilorin west Local Government, Kwara State. The objectives of the study are to assess the level of availability of cold chain system in the study area, to assess the quality and level of effectiveness of cold chain equipment in the study area and to assess the utilization of the cold chain and of monitoring devices in the study area.

Related and relevant literatures were reviewed as it is concerned to the research. The research was a descriptive cross-sectional study design.

Target population consists of Community health Professionals in the likes of Junior Community Health Extension Workers JCHEW, Community Health Extension Workers, CHEW, Community Health Officers CHO and others. Multi stage sampling technique was used in selecting the respondents used for the study.

A total number of One Hundred and Twenty One (121) Professionals in the Study Area were selected as respondents. Thereafter, data collected from the questionnaires were presented in frequency distribution tables and charts like bar charts.

The findings revealed that the cold chain is readily available, the quality of the cold chain equipment is intact as they are being monitored to ensure effectiveness and its obvious that the cold chain system is not underutilized.


5.3 Limitation of the Study

This study limited to the assessment of the effectiveness of the vaccine cold chain system in Ilorin West Local Government only.


5.4 Implication for Community Health

  1. This will serve as source of awareness to the Community Health workers on how to ensure effectiveness of vaccines cold chain to retain the potency.
  2. This research work will serve as good source of further research commitments for Community Health officers in various fields for broader knowledge and integration of different approaches learned into ensuring quality and effective vaccines cold chain system.

5.5 Conclusion

It was obvious that the vaccines cold chain system in Ilorin West Local Government is always available for use, the level of its quality and effectiveness is always maintained as revealed by the selected Community Health Professionals responses.


5.6 Recommendation

Based on this research study, the following are recommended:

To the individual Community Health Professionals

They endeavor to update themselves on the new skill sets in the maintenance of Cold chain system to ensure quality and effectiveness of stored vaccines.

To the government

The government should ensure that basic infrastructures, like more cold chain facility are provided, prompt and constant power supply is in place to keep the potency of the stored vaccines and ensure the effectiveness of the cold chain equipments, are provided.


5.7 Suggestion for Further Study

For further studies more studies should be carried out on the following:

To conduct the research in more elaborate manner that involves a larger community with more cold chain systems.


Assessment Of The Effectiveness Of Vaccine Cold Chain System In Ilorin West L.G.A Kwara State, Nigeria


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Assessment Of The Effectiveness Of Vaccine Cold Chain System In Ilorin West L.G.A Kwara State, Nigeria


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