Assessment of cold chain management practices in immunisation centres in Kacheliba Division, Pokot County, Kenya

Abstract

Background: Immunisation contributes significantly to the achievement of MDGs. It is one of the eight elements and success stories of primary health care. Proper utilisation of Immunisation services is associated with improved child health outcomes. The WHO targets Immunisation coverage of 90% for urban areas and 80% for rural areas. Objectives: To assess the cold chain management practices that could affect potency of vaccines and its utilisation by under five year old children in Kacheliba Division. Design: A cross-sectional descriptive study. Setting: All health facilities in Kacheliba Division, Kenya. Subjects: Parents/guardians of under-five year old children and all the health facility level within Kacheliba Division. Results: Seven (87.5%) health facilities reported that they collect vaccines at intervals of more than one month. Four (50%) health institution were located 20 kilometers from the local vaccine store - Kacheliba District Hospital. Kacheliba District Hospital gets their vaccine stocks from Eldoret KEMSA depot, an estimated 90 kilometers away. Completely melted ice packs during transportation of vaccine were encountered only in one (12.5%) centre- Kacheliba mobile dispensary. Major source of power for the refrigerators was the gas (75%), and electricity (28.6%). During electricity power block out, the right temperature intervals were then generated using gas. It was found that all the eight health facilities did not have a stand by biomedical technician who maintains and repair refrigerators. Furthermore there was no budgetary allocation for the refrigerators maintenance and repair among all the health facilities. Problems related to cold chain were observed in all the eight facilities in Kacheliba Division. Inadequate air circulation was seen in seven (87.5%) facilities, water bottles were kept inside the cold boxes and fridges in three (37.5%) facilities, Food and drinks were kept in cold boxes and fridges in 4(50%) facilities and vaccines were not kept in proper compartment in three (37.5%) facilities. Conclusion: The cold chain management practices among health facilities in Kacheliba Division of Pokot County were not upto the standards set by the Kenya Extended Programmeme on Immunisation (KEPI)) Guidelines. Cold chain management should be improved through continuous medical educational programmemes and sufficient budgetary allocation.