scholarly journals Adherence to Cold-Chain Management Guidelines and Influence on Stability of Live Attenuated Vaccines: Results from an Observational Study in Kisumu County, Kenya.

2020 ◽  
Vol 2 (1) ◽  
pp. 1-13
Author(s):  
Moses Olunga Okomo John ◽  
Dickens S. Omondi Aduda ◽  
Bernard Guyah
Keyword(s):  
Cold Chain ◽  
P Value ◽  
Unique Contribution ◽  
Adherence Level ◽  
Cross Sectional ◽  
Chain Management ◽  
Live Attenuated Vaccines ◽  
Ethical Frameworks ◽  
Management Procedures ◽  
Improved Stability

Purpose: Guidelines provide ethical frameworks to streamline processes for best outcomes. Live-attenuated vaccines in routine immunization programs in Kenya have challenges of instability despite the availability of guidelines. Diseases preventable by these vaccines are reported in Kisumu County more than others in the region. This observation is suspected to be associated with lapses in adherence to cold-chain management procedures. This study, hence purposed to assess whether there was any association between instability of vaccines and staff adherence level to the guidelines.Method: Using analytical cross-sectional design with repeated observations, data was collected from 120 out of 170 public and non-governmental health facilities in the Kisumu County at three intervals, between October 2018 and March 2019. In each health facility, immunization manager on duty was interviewed and observations made on compliance with cold-chain protocols using a checklist. Data was summarized descriptively and regression used to identify key points of adherence levels. Qualitative information was analyzed thematically to identify evolving themes.Result: In 40% of the facilities, staff did not transfer vaccines when the need arose; 8.3% did not defrost fridges; while 45.8% did not dispense vaccines at VVM stage 2. Transferred vaccines accounted for improved stability of both OPV (95%C.I; 3.1 – 16.8, OR 7.2, p value< 0.001) and measles-rubella vaccines (95% C.I, 2.1 – 10.4, OR, 4.7, p=value <0.001). Dispensing vaccines at VVM stage 2 ahead of FEFO had better stability of OPV (95%C.I, 6.0 - 49, OR17.2, p=value <0.001) and measles-rubella vaccines (95%C.I 3.3-17.4; OR7.6, p=value <0.001) respectively. Defrosted fridge enhanced stability of OPV (95% C.I, 1.1 – 15.5; OR 4.17, p=value 0.033), measles-rubella (95% C.I, 1.3 – 12.3, OR 4, p-value 0.0017) and ROTA vaccine (95% C.I 1.9 – 21.5; OR 6.3, p= value 0.003).Unique contribution to practice and policy: Lapses in transferring vaccines, defrosting of fridges and use of VVM to dispense vaccines significantly destabilized live attenuated vaccines worth linking to the outbreaks of Rota diarrhea and measles outbreaks in Kisumu. Due to inadequate staff adherence level to guidelines, new innovations meant to help improve stability of vaccines, inadequately improved the situation, so calls for strengthened capacity building to staff.

scholarly journals A cross-sectional survey on cold chain management of vaccines in Cebu, Philippines

2018 ◽  
Vol 16 (2) ◽  
pp. 1167 ◽  
Author(s):  
Patrisha L. Maglasang ◽  
Ma L. Butalid ◽  
Maria F. Pastoril ◽  
Antonius N. Pratama ◽  
Elizabeth Y. Tan
Keyword(s):  
Cold Chain ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Chain Management

scholarly journals Evaluation, Awareness, Practice and Management of Cold Chain at the Primary Health Care Centers in Coastal South India

1970 ◽  
Vol 32 (1) ◽  
pp. 19-22 ◽  
Author(s):  
S Rao ◽  
S Naftar ◽  
S Baliga ◽  
B Unnikrishnana
Keyword(s):  
South India ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Cold Chain ◽  
Cross Sectional ◽  
Chain Management ◽  
Primary Health ◽  
The Status ◽  
Primary Health Care Centers ◽  
Maintenance Process

Introduction: Vaccination is one of the most effective disease prevention strategies and potency of vaccines is dependent on effective management of cold chain at all levels of vaccine handling. The objective was to assess the status of cold chain at the primary health centers and to assess the knowledge and practices of medical officers at these centers regarding cold chain management.Materials and Methods: This cross sectional study was conducted at 70 primary health centers of Dakshina Kannada District of Coastal South India. Cold chain equipment and maintenance process was noted following direct observation on uninformed visits. Data regarding the knowledge and practices of cold chain management was obtained by interviewing the medical officers using structured pretested questionnaire.Results: Ice lined refrigerators and deep freezers were available in 69 (98.6%) and 67(95.8%) of centers. Dial thermometer was present in all the centers. Cold boxes, frozen packs and automated voltage stabilizers were available in 68(97.2%) centers. Improper vaccine storage was observed in 7 (10%) centers. Majority of medical officers had knowledge and correct practices in fields like ideal equipment, OPV administration, vaccine requiring diluents but only 47 (61.8%) medical officers had correct practice of defrosting the deep freezers.Conclusions: The availability of equipment is near universal. Improper vaccine storage practices and poor knowledge in some fields of cold chain management may adversely affect the quality of administered vaccine. Relevant training for those handling the cold chain is recommended.Key words: Cold Chain; India; Primary health center; Temperature monitoring   DOI: http://dx.doi.org/10.3126/jnps.v32i1.5946  J. Nepal Paediatr. Soc. Vol.32(1) 2012 19-22

scholarly journals IS DISTANCE e-LEARNING OPTION ACCEPTABLE BY NIGERIANS AMIDST COVID-19 PANDEMIC?

2021 ◽  
Vol 7 (1) ◽  
pp. 11
Author(s):  
Zubaida Hassan ◽  
Aisha Shitu Sa’id ◽  
Hassan Adamu Mohammed
Keyword(s):  
Descriptive Statistics ◽  
Learning Activities ◽  
P Value ◽  
Learning Approach ◽  
Formal Learning ◽  
Unique Contribution ◽  
Cross Sectional ◽  
Internet Infrastructure ◽  
E Learning ◽  
Cross Sectional Design

Purpose: In Nigeria, the current COVID-19 Pandemic stands-still virtually all formal learning activities, especially in Government owned institutions. Therefore, the aim of this study was to assess the perception and readiness of Nigerians on adapting Distance e-Learning option during and even after the COVID-19 Pandemic. Methodology: The study applied a quantitative cross-sectional design approach. A closed-ended e-questionnaire was designed using google form and distributed in a snowball fashion-wise via online platforms. Three categories of the audience were targeted: teachers, students and parents. Descriptive statistics were used to analyze responses. ANOVA was used to analyze the collective decision across the three categories. Findings: The findings revealed that there is no difference amongst the three groups in their final decisions on willingness to adapt (F (0.187), p-value 0.83), and kick-start distance learning (F (0.469), p-value 0.63). Poor internet infrastructure and unstable electricity supply were some of the challenges identified. Unique contribution to Theory, Practice, and Policy: The study highlights the willingness of Nigerians in adapting distance e-learning approach as a viable alternative to traditional face-face learning amidst COVID-19 Pandemic and beyond. Administrative involvements are crucial to actualizing this educational dream of Nigerians.

scholarly journals The Implementation of Immunization Cold Chain Management in Surabaya City

2021 ◽  
Vol 9 (1) ◽  
pp. 62
Author(s):  
Alfilia Lusita ◽  
Fariani Syahrul ◽  
Ponconugroho Ponconugroho
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Secondary Data ◽  
Cold Chain ◽  
Success Rates ◽  
Cross Sectional ◽  
Chain Management ◽  
Primary Health ◽  
The City

Background: Immunization success rates can be determined by several factors. The factors that can cause occurrences of immunization preventable disease (PD3I) cases include the quality of the cold chain and invalid doses of immunization medicines. Purpose: The aim of this research was to analyze the implementation of cold chain management in the city of Surabaya. Methods: This research was conducted as a descriptive study with a cross-sectional research design. The population consisted of all primary health care centers in the city of Surabaya, and the data used were secondary data, guided by interviews with informants. Results: The majority of cold chain management personnel were found to have a medical education background of 98.42%, and primary health care workers have received cold chain-related training (100%). All primary health care equipment has a 100% cold chain. The completeness of cold chain reporting was 93.51%, and the accuracy of the cold chain reporting was 71.52%. Regarding the quality of the equipment, some vaccine refrigerators were found 12% of vaccine refrigerators were found not to be in optimal condition, and 14% of temperature monitoring devices was not activated. Conclusion: The implementation of cold chain management in public health center and the availability of equipment in the Surabaya City are going well, although there are still some problems such as undisciplined reporting and inadequate quality of tools for cold chain implementation as well as the discovery of vaccine refrigerators easily leaks, and their temperature can rise easily.

scholarly journals Evaluation of vaccine storage and cold chain management practices during intensified mission Indradhanush in community health centers of Tikamgarh district of Madhya Pradesh

2019 ◽  
Vol 6 (2) ◽  
pp. 823
Author(s):  
Ram K. Panika ◽  
Pankaj Prasad ◽  
Sunil Nandeshwar
Keyword(s):  
Community Health Centers ◽  
Management Practices ◽  
Cross Sectional Study ◽  
Cold Chain ◽  
Voltage Stabilizer ◽  
Cross Sectional ◽  
Chain Management ◽  
Record Keeping ◽  
Shake Test ◽  
Immunization Services

Background: Vaccination is one of the most effective disease prevention strategies and potency of vaccine is dependent on effective management of cold chain at all levels of vaccine handling. An effective cold chain maintenance system is the backbone of success of any immunization program. This study was done to assess the cold chain management and vaccine storage practices in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was carried out using a structured questionnaire.Results: Dedicated room/space for dry storage not available in any of 03 CHCs. Dedicated table for conditioning of icepacks, dedicated clean clothes for wiping of icepacks after conditioning and power back up was available, ILR and DF were connected to separate functional voltage stabilizer and thermometers were placed correctly only in 66.6% CHCs. ILRs and DFs were properly placed, cabinet temperature of ILR and DFs was maintained in normal range in all the three (100%) CHCs. Record of power failure, records of defrosting/cleaning was maintained in temperature log book and cold chain handlers had knowledge of shake test in only 33.3% CHC.Conclusions: Proper vaccine storage and management of cold chain system is essential for immunization. In order to improve quality of immunization services there is a need of space, temperature monitoring and regular defrosting with record keeping and regular training of cold chain handlers to keep their knowledge and skills updated. Monitoring and supervision of cold chain points by DIO should be on regular basis. 

scholarly journals Assessment of factors affecting vaccine cold chain management practice in public health institutions in east Gojam zone of Amhara region

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hewan Adam Bogale ◽  
Abebe Feyissa Amhare ◽  
Alemtsehay Adam Bogale
Keyword(s):  
Logistic Regression ◽  
Storage Temperature ◽  
Health Workers ◽  
Management Practice ◽  
Cold Chain ◽  
Knowledge Gap ◽  
Amhara Region ◽  
Cross Sectional ◽  
Chain Management ◽  
Health Institutions

Abstract Background Maintaining quality of vaccines is one of the main challenges of immunization programs in Ethiopia. The objective of this study is to assess the factor affecting vaccine cold chain management practice in immunization health institutions in East Gojam zone of Amhara region, Ethiopia. Method An institutional based cross-sectional study was conducted from March to April 2017 in ten districts of East Gojam zone of Amhara Region. Descriptive statistics and Logistic regression analysis were carried out to identify factors related to the practice of cold chain management. Result Among 60 health institutions, only 46(76.7%) had functional refrigerators. Twenty-one (35%) had a functional generator for backup service and 28(46.6%) had a car/motorbike for transportation of vaccines in case of refrigerator/power failure. Twenty-nine (48.3%) had known the correct vaccine storage temperature (2 °C – 8 °C) in the refrigerator and the results of this study revealed that only 23(38.3%) of respondents had sufficient knowledge about vaccine cold chain management. The finding of this study also revealed that 35(58.3%) had appropriate vaccine cold chain management practice and the rest 25(41.7%) had inappropriate practice. Logistic regression showed us the knowledge gap and profession were significantly associated with vaccine cold chain management practice at P < 0.05. Conclusion This study indicates that there was a knowledge gap of health workers who are working on cold chain management. There is an urgent need to improve knowledge and practice on cold chain management through improved supervision and training at a different level of health care system.

scholarly journals FACTORS INFLUENCING CONTROL OF BLOOD PRESSURE LEVELS AMONG HYPERTENSIVE ADULT PATIENTS IN SELECTED HOSPITALS, KAKAMEGA COUNTY, KENYA

2021 ◽  
Vol 6 (2) ◽  
pp. 42-71
Author(s):  
Thomas Ong'ondo Ng'ambwa ◽  
Prof. Lt Col (Rtd) John Martin Okoth ◽  
Dr. Tecla Psusma Sum
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Health Care Providers ◽  
Blood Pressure Level ◽  
Adult Patients ◽  
P Value ◽  
Unique Contribution ◽  
Care Providers ◽  
Cross Sectional ◽  
Factors Influencing

Purpose: The study aimed to investigate the factors influencing blood pressure levels in hypertensive adult patients in Kenya's Kakamega County. The specific objectives were as follows: to assess patient factors that influence blood pressure levels among hypertensive adult patients in Kakamega County, examine health-care provider factors that influence blood pressure levels in hypertensive adult patients; determine institutional factors that influence blood pressure levels in hypertensive adult patients in Kakamega County based on the clinical recommendations for cardiovascular disease management from 2018. Methodology: The researcher used a cross-sectional analytical study design. Patients and health care providers were requested to sign a written consent before data was collected using a questionnaire and an observation checklist. Quantitative data were evaluated using descriptive and inferential statistics, statistical package for social sciences version 22, with a statistically significant p-value of 0.05. The strength of the relationship between the variables and the patient's blood pressure level was tested using multiple regression. Findings: The findings showed that the number of years a patient was told he or she had hypertension patient sensitization about the disease (p = 0.04), the patient's BMI (p = 0.01), BP stability at the time of admission (0.0001), having a treatment supporter to advise the patient when to take medications (0.04). The health care provider's age group and knowledge about the disease (p = 0.02) was all separately correlated with blood pressure control. According to the current analysis, in Kakamega County, being a male without adequate patient sensitization about the hypertension disease made patients to be more likely to have uncontrolled blood pressure levels. Unique contribution to theory, practice and policy: The study recommends a model that combines patient and health-care system variables emphasizing on patient sensitization about the hypertension disease, modifiable and modifiable risk factors should be created in attempt to have blood pressure controlled.

scholarly journals INFLUENCE OF STRATEGIC E-PROCUREMENT PRACTICE ON PERFORMANCE OF DEVOLVED SYSTEMS OF GOVERNMENT IN KENYA

2020 ◽  
Vol 5 (2) ◽  
pp. 17
Author(s):  
Carren Chepng’etich ◽  
Esther Waiganjo ◽  
Noor Ismail
Keyword(s):  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Easy Access ◽  
P Value ◽  
Unique Contribution ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Qualitative Approaches ◽  
And Performance ◽  
Acceptance Model

Purpose: The purpose of this study was to establish the influence of strategic e-procurement practice on performance of Devolved systems of government in Kenya. Methodology: The study adopted cross-sectional survey design using both quantitative and qualitative approaches.  The target population was all the 47 devolved systems of government. The sample size was the 10 counties namely; Garissa, Kisii, Nyamira, Narok, Marsabit, Murang’a, Bomet, Nairobi, Kiambu and Homa Bay specifically employees working under finance and procurement department. The study adopted stratified random sampling to pick 186 respondents from finance and procurement department. Data was collected by using questionnaires Descriptive and inferential statistics was used aided by Statistical Packages for Social Sciences version 24 to compute percentages of respondents’ answers.  Hypothesis testing was carried using multiple regression analysis and standard F tests. The results were presented using tables. Results: The  study  findings  revealed  that  Strategic e-procurement practice explained  49.6%  of the  total  variations  in  performance  of  devolved systems of government  in  Kenya.  Further,  results  indicate that  the  overall  model  was  statistically  significant as  supported  by  a  p  value  of  0.000.  This was  supported  by  an  F  statistic  of  (F=155.245, p<0.05) and  the  reported  p  value  (0.000)  which  was  less than  the  conventional  probability  of  0.05  significance  level. The standardized regression coefficient for Strategic E-procurement was 0.704. This indicates that a unit increase in the Strategic E-procurement would result in 70.4% increase in the performance of Devolved systems of government in Kenya this implied that there   is   a strong positive relationship   between Strategic E-procurement  and  performance  of  Devolved systems of government in  Kenya . Unique contribution to theory, practice and policy:  Based on the findings, the study recommends that devolved systems of government should adopted e-procurement system and automate all procurement operation procedures to enhance smooth work flow and hence improve efficiency the study further  recommends that  Devolved systems of government should adopt e-procurement for various uses such as in the standardization of services for representation in the catalog, sourcing goods and services globally, as way of reducing costs in areas such tendering processes, payment and contract management. But management should be aware and cautious that e-procurement is capital intensive in terms of acquisition and laying down the required infrastructure and highly perishable. Thus the study recommends that strategic e-procurement practice should be implemented within the legal framework of public procurement acts and regulations because it moderate has positive correlation with the performance of Devolved systems of government in Kenya. The findings are in harmony with technology acceptance model which suggest that emerging technologies cannot improve organizational effectiveness and performance if the change has not been accepted by the users. Therefore first it’s crucial for the users to accept the new technology (e-procurement) so as to reduce administrative costs, possible broadening of suppliers’ base, and easy access to preferred goods. In conclusion technology acceptance model can be used by future scholars.

scholarly journals 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

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Diriba Feyisa ◽  
Awol Jemal ◽  
Temesgen Aferu ◽  
Fikadu Ejeta ◽  
Alem Endeshaw
Keyword(s):  
Public Health ◽  
Assessment Tool ◽  
Health Facilities ◽  
Cold Chain ◽  
Temperature Sensitive ◽  
Management Performance ◽  
Cross Sectional ◽  
Southwest Ethiopia ◽  
Chain Management ◽  
Public Health Facilities

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.

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