Assessing effective vaccine management in West Shewa Zone, Ethiopia

Abstract

Background: Immunization is a high-impact, low-cost intervention, responsible for averting an estimated two to three million deaths each year. Despite improvements in immunization rates, children in Ethiopia do not have equal access to these services. A well-functioning immunization supply chain is crucial to reducing disparities and improving vaccination coverage. Objective: To assess the performance of the immunization supply chain in West Shewa zone, Ethiopia. Methods: We conducted a mixed-method, cross-sectional study using assessment tools designed by the World Health Organization (WHO). A total of 43 stores (1 sub-national store, 14 district stores and 28 health facilities) were randomly selected and assessed on eight performance criteria for effective vaccine management (EVM). Data were analyzed using a software developed by the WHO and EVM scores were consolidated for each store level and the entire zone. Each criterion was compared against the WHO’s recommended minimum score of 80% to evaluate the strength of the immunization supply chain. Forty-three key informants were purposively chosen to participant in the qualitative portion of the study. Interviews were transcribed, translated into English and analyzed using OpenCode software. Results: The average scores for the zone across all performance criteria ranged from 43% to 75% - below the WHO-recommended minimum standard. The West Shewa sub-national store achieved the minimum score for temperature monitoring (90%) and building, cold chain equipment and transport (82%), and the district stores achieved the minimum score for storage capacity (80%). Health facilities scored poorly in five out of the eight measures of performance compared with higher-level stores. Overall, the zonal average was highest for storage capacity (75%), temperature monitoring (74%) and vaccine management (73%), and lowest for stock management (55%), information systems and management (48%) and maintenance of building, cold chain equipment and transport (43%). Conclusion: Our study found that the immunization supply chain in West Shewa zone was poor. In-service training, computerized vaccine stock management systems and the installation of solar refrigerators may improve the immunization supply chain in this region.