Evaluation of Cold Chain Management Performance for Temperature-Sensitive Pharmaceuticals at Public Health Facilities Supplied by the Jimma Pharmaceuticals Supply Agency Hub, Southwest Ethiopia: Pharmaceuticals Logistic Management Perspective Using a Multicentered, Mixed-Method Approach

Abstract

Background. Effective and efficient cold chain management maximizes utilization of healthcare resources, reduces cold chain products wastage, and improves the quality of health services. It eventually guarantees that clients receive cold chain products they need at service delivery points. The objective of this study was to evaluate cold chain management performance for temperature-sensitive medicines at public health facilities in Southwest Ethiopia supplied by the Jimma Pharmaceuticals Fund and Supply Agency hub. Method and Materials. The study used an institution-based cross-sectional study design. Forty-seven (47) public health facilities in Southwest Ethiopia were evaluated using checklists adopted from the Logistic Indicators Assessment Tool, Vaccine Management Assessment Tool, and Logistic System Assessment Tool. Results. The study revealed that the mean availability of essential cold chain products was 72.1 ± 14.8% while the average stock-out rate was 26.2 ± 8.6%. The median stock-out duration was 23 ± 21 days for all visited public health facilities. Two hundred and sixty-three (43.06 ± 15.3%) of the public health facilities’ stock records were found accurate, and the wastage rate due to expiration was 9.2 ± 7.8% for all visited health facilities. Thirty public health facilities (63.8 ± 36.2%) had acceptable storage conditions. Conclusions and Recommendations. Supply chain performance at the study facilities was not adequate overall, and focused efforts need to be directed at managing the availability of critical cold chain medicines. Some cold chain management challenges demand the attention of the top management, while the rest can be addressed by operational management at the facilities through provision of appropriate training and supervision of the cold chain pharmaceutical handlers.

Adherence to WHO vaccine storage codes and vaccine cold chain management practices at primary healthcare facilities in Dalocha District of Silt'e Zone, Ethiopia

“…Vaccine storage is said to be desirable/optimal when primary healthcare storage facilities met more than 70% storage condition criterion/parameters of cold chain storage [ 41 ].…”

Vaccine management practices among healthcare workers in Morogoro, Tanzania: a cross-sectional study

“…Adequate knowledge and skills in temperature monitoring are essential for healthcare workers to review health facility temperature data, establish response actions to avoid and minimise vaccine wastages during storage, and build community confidence in immunisation services. It was found that health workers have limited knowledge of proper cold chain management, with shallow scores in identifying vaccines that are mostly affected by freezing temperatures, compared to the study conducted in Ethiopia [21] and Nigeria [32]. The lack of knowledge might be attributed to a lack of health workers training on cold chain management to enable effective performance according to guidelines.…”

“…In the Expanded Program on Immunization (EPI), the cold chain system is used for storing, transporting, and distributing vaccines and other biologicals in recommended temperatures until they reach beneficiaries [ 13 , 21 ]. However, health workers and supervisors tend to emphasise protecting vaccines from heat damage, thus creating a risk of exposure to freezing temperatures.…”

Role of Technology in the Performance Measure of Insulin Cold Chains

“…We even go beyond this by packaging the insulin in special ice-filled packages and educating the patient about how to handle the insulin until they reach home. Feyisa et al (2021) noted that various methods could help ensure the availability of insulin through appropriate CCM, and this method ensures appropriate drug storage by setting a proper temperature of fewer than 41 degrees Fahrenheit [7]. Similarly, Bastani et al (2021) said that a cold supply chain was an effective technique that allows the long-term storage and management of insulin at different levels of its availability, leading to a decline in its shortage [8].…”

“…Keeping insulin at room temperature can be detrimental to its effectiveness and efficiency, while cold supply chain management (CSCM) of insulin can improve both. CSCM is the storage or transportation of items that must be preserved at temperatures below 5 degrees Celsius (41 degrees Fahrenheit) [7]. This definition may be applied to pharmaceuticals, vaccines, biological products, blood products, cultures, tissues, organs for transplantation, and foods and dairy products.…”