Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring With Data Review Teams for Vaccine Management

Lutukai, Mercy; Bunde, Elizabeth A.; Hatch, Benjamin; Mohamed, Zoya; Yavari, Shahrzad; Some, Ernest; Chweya, Amos; Kania, Caroline; Ross, Jesse; Keddem, Carmit; Chandani, Yasmin

doi:10.9745/ghsp-d-19-00157

Cited by 10 publications

(6 citation statements)

References 11 publications

(9 reference statements)

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“…In terms of documentation of twice-daily manual temperature records, it was observed that tools were not consistent in completing them and this was comparable to findings from the study conducted by Lutukai et al [ 30 ]. Not only understaffing and unavailability of a functional temperature monitoring tool may be possible, but also the unavailability of a temperature recording chart was observed.…”

Section: Discussionsupporting

confidence: 83%

Evaluation of vaccine storage and distribution practices in rural healthcare facilities in Kenya

Sinnei

Karimi

Maru

et al. 2023

J of Pharm Policy and Pract

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Background Vaccines require cold chain storage conditions, and good distribution practices throughout the supply chain to maintain their quality and potency. However, in the last mile of the vaccines supply chain, these requirements may not be guaranteed resulting in reduced effectiveness which could lead to an upsurge in vaccine preventable morbidity and mortality. The aim of this research was to evaluate vaccine storage and distribution practices in the last mile of vaccine supply chain in Turkana County. Methods A descriptive cross-sectional study was conducted from January 2022 to February 2022 across seven sub-counties in Turkana County, Kenya, to assess vaccine storage and distribution practices. The study sample size was 128 county health professionals across 4 hospitals, 9 health centers, and 115 dispensaries. The respondents were selected using simple random sampling within the facilities strata. Data were collected using a structured questionnaire, adapted, and adopted from a standardized WHO questionnaire on effective vaccines management and administered to one healthcare personnel working in the immunization supply chain per facility. Data were analyzed using excel and presented as percentages in table forms. Results A total of 122 health care workers participated in the study. Most respondents (89%, n = 109) had utilized a vaccine forecasting sheet, but only 81% did have an established maximum–minimum level inventory control system. Many of the respondents had sufficient knowledge of ice pack conditioning although 72% had adequate vaccine carriers and ice packs. Only 67% of respondents had a complete set of twice-daily manual temperature records at the facility. Most refrigerators complied with the WHO specifications but only 80% of them had functional fridge-tags. The number of facilities that had a routine maintenance plan was below average while only 65% had an adequate contingency plan. Conclusion Rural health facilities have suboptimal supply of vaccine carriers and icepacks for effective storage and distribution of vaccines. In addition, some vaccine fridges lack functional fridge-tags for proper temperature monitoring. Routine maintenance and contingency plans remain a challenge to ensure optimal service delivery.

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Section: Discussionsupporting

confidence: 83%

Evaluation of vaccine storage and distribution practices in rural healthcare facilities in Kenya

Sinnei

Karimi

Maru

et al. 2023

J of Pharm Policy and Pract

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“…Various studies in Africa and other parts of the world identified weaknesses in cold chain management that influence vaccine wastages, including shared knowledge among health providers, breakdown of the cold chain systems, power interruption, and quality of refrigerators [9,[32][33][34]. In this study, the vaccine wastage level was lower than those reported in other studies conducted in India, which reported a wastage of DTP and MR to be 32.1% and 32.2%, and 25.4%, and 21.7%, for Kangra and Pune districts, respectively [35].…”

Section: Discussionmentioning

confidence: 99%

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

Nestory

Anasel

Nyandwi

et al. 2022

J of Pharm Policy and Pract

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Background Effective vaccine management is essential to maintain the quality of vaccines, minimise wastages, and prevent missed opportunities for vaccination at service delivery points. Objectives This study aims to assess vaccine management practices among vaccinators at health facilities in the Morogoro region, Tanzania. Methodology A descriptive cross-sectional study design involved health workers from 77 health facilities offering vaccination services. The study population consisted of vaccine handlers and vaccinators working in public health facilities in the Morogoro region. The vaccine management practices were assessed using data collected from ledgers and the Vaccine Information Management System (VIMS). The temperature records were downloaded from the Fridge-tag® 2 and Coldtrace5 devices. Results The findings indicated that 65 (84%) health facilities had functional refrigerators and are using power from 26 (34%), 28 (36%), and 23 (30%) of grid electricity, solar, and Liquefied Petroleum Gas (LPG), respectively. Besides, 27 (35%) health facilities have an alternative energy source as a backup. In general, healthcare workers had a good knowledge of cold chain management, including the World Health Organization recommended storage temperatures for vaccines. Furthermore, vaccine stockout was found in 12 (15.6%) health facilities for at least one antigen and 4 (5.1%) health facilities for all five antigens under observation. This current study also revealed that the average calculated vaccine wastage rates for DTP, Measles–Rubella and Rotavirus vaccines were 7%, 19%, and 15%, respectively. More than half of health workers did not perform monthly temperature data reviews. In addition, poor performance led to high wastage rates, including the Rotavirus vaccines, and a change in VVM to discard points. Finally, a small number of 5 (6.5%) health facilities consecutively reported temperature exposure beyond + 8 Celsius (between 5.9 and 281 h). Conclusions Healthcare workers’ vaccine and cold chain management knowledge were good for temperature data reading and documentation. However, the practices were poor for some health facilities. The gaps observed in this study inform health managers and policymakers toward establishing interventions to improve health workers' knowledge and practice, including mentorships, supervision, and training to guarantee that each child in all communities reaps the benefits of immunisation services.

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“…Mercy Lutukai, Elizabeth A Bunde, Benjamin Hatch, Zoya Mohamed, Shahrzad Yavari , Ernest Some , Amos Chweya , Caroline Kania , Jesse C Ross , Carmit Keddem , Yasmin Chandani (2019) said that Monovalent live Rotavirus vaccine (RV1) is given orally in two doses a minimum 4 weeks apart. It is provided as a lyophilized powder that is reconstituted just before administration.…”

Section: Practices By Health Work In Rotavirus Preventionmentioning

confidence: 99%

Assessing the Knowledge, Attitude and Practices among Health Workers on Rotavirus Diarrhoea Prevention in Rukiga District

Davis,

Francis

2023

EJHS

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Purpose: Rotavirus has been identified as the most common pathogen associated with severe diarrhoea. Rotavirus infection is the leading cause of diarrhea in children under five and it is highly contagious. It poses an exception to typical diarrheal disease management rules. While improved access to clean water and better sanitation and hygiene practices are vital to preventing most diarrheal diseases, they have done little to disrupt infection. The virus may cause severe, dehydrating diarrhea in young children and, in untreated cases, lead to death. The aim of this study is to determine the knowledge, attitude and practices regarding Rotavirus Prevention and its vaccination among medical workers in Rukiga district Methodology: A total of 263 health workers were selected through random sampling. A structured and validated questionnaire was used. Questions about knowledge, attitude and practices were collected and verified on scale. Descriptive statistics were presented; multivariable regression analysis was done to determine the correlation of knowledge, attitude level, and practices with socio demographic variables such as age, sex and education. The p value≤0.05 considered was statistically significant. Findings: 118(47.14%) had adequate knowledge, 164(66.138%) positive attitude and 102(41.1%) appropriate practices on the Rotavirus diarrhoea prevention. Knowledge, attitude level and practices were increased significantly with increasing age, sex and education. After controlling for variables in the multivariable regression model, age, sex and education were the significant factors in determining the scores on knowledge, attitude and practices. About the knowledge. Age (β=4.15, p<0.001), sex (β=3.012, p=0.001) and education level (β=14.04, p<0.038), then attitude, age (β=4.32, p<0.001), sex (β=0.015, p=0.003) and education level (β=0.021, p<0.001) while for practices, age (β=0.021, p<0.001). Similarly, sex (β=0.022, p<0.001), education level (β=0.136, p=0.006). Generally, there was inadequate knowledge, positive attitude and inappropriate practices amongst the respondents on Rotavirus diarrhoea prevention in Rukiga District. Recommendations: Rukiga District needs to train, mentor and coach the health workers on prevention of Rotavirus including vaccination in order to have increased knowledge level, positive attitude and appropriate actions.

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Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring With Data Review Teams for Vaccine Management

Abstract: Using technology to make data visible to stakeholders and giving those stakeholders a framework for analyzing that data for decision making improves cold chain management of vaccines in Kenya.

Cited by 10 publications

References 11 publications

Evaluation of vaccine storage and distribution practices in rural healthcare facilities in Kenya

Evaluation of vaccine storage and distribution practices in rural healthcare facilities in Kenya

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

Assessing the Knowledge, Attitude and Practices among Health Workers on Rotavirus Diarrhoea Prevention in Rukiga District

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