ASSESSMENT OF THE EFFECTIVENESS OF VACCINE COLD CHAIN SYSTEM

CHAPTER ONE

INTRODUCTION

1.1     Background to the Study

A cold chain is defined as a temperature control apply chain^{( l}]. cold chain is also  an uninterrupted series of storage and distribution activities which maintain a given temperature range⁽¹⁾.According to WHO cold chain is used to help extend and ensure the shelf life of products  such as fresh agricultural products,, chemicals and pharmaceutical drugs etc. it ensures that there are minimum temperature fluctuations for good in transit from place of production to the point of consumption(1).

Otis regarded as a temperature-controlled supply chain that involves equipment in view of the different temperature needed for different vaccine and medicines. Cold chain is the process that ensure vaccine are stored at recommended temperature range of 2.0 C to 8.0C from the point of manufacturer to the point of administration (immunization Advisory center⁾put no reported cold chain as the system used to keep and distribute vaccine in perfect condition.

Cold chain in network is regarded as the backbone to ensure that the right quality of vaccine reaches the target population. Manufacturing plant, vaccine distribution and then to provider office (immunization clinic) and end with the administration of the vaccine to the recipient (1).

Vaccine are immunogens consisting of weakened or dead pathogenic cell injected in order to stimulate the production of antibodies it's use to improve immunity to particular disease(1). The prevention of disease by the immunization is a conventional public health measure is known as today the best disease low-cost community based way of protecting children against the major killer disease over a 2 million death that are preventable through immunization. Each year and worldwide(2).this vaccine preventable disease remain the most common cause of childhood mortality with on estimated 3million death each yea(2). .development of effective vaccine has reduced the incidence of much serious infectious disease, early year immunization services in developing countries prevent about 490.000children from becoming paralyzed by poliomyelitis. Over 3million death are similarly prevented from measles, neonatal tetanus, pertussis ^(5). The achievement is partly attributable to the training of staff in the proper storage and transport of vaccine and partly to improvement in the cold chain. Immunization to vaccine preventable disease only result when active and affective vaccine can be sustainable by harnessing the essential elements in the cold chain system namely the vaccine, manpower, equipment and transportation. The cold chain refers to the continued of safe handling practice including material equipment and procedure that maintain vaccine within a temperature range from the time they are manufactured to the time they are administered to the person being immunized the cold chain still remains a highly vulnerable element of any immunization program. Both in developing and developed countries. The cold chain management including all of the means use to ensure a constant temperature between +2.c +8.c for that is not heat stable e.g. vaccine (2).

1.2     Statement of Problem

The development of vaccines for the prevention of infectious diseases is one of the most significant accomplishments of public health in the last century. The efficacy of a vaccine in preventing disease depends largely on the quality of the immunizing agent. Failure to adhere strictly to recommended specifications for vaccine handling and storage can render vaccines useless. Inactivation of a vaccine may become evident only after immunized individuals acquire the disease the vaccine was designed to prevent (3). The identified cases are often considered primary or secondary vaccine failures, thereby obscuring the role that improper vaccine handling may have played in the failure.

A study conducted in Lagos, showed that 3/4 of the vaccines at the local government level were sub-potent with the situation failing to improve over the three-year study period. Studies have also reported that improper vaccine storage leading to the administration of sub-potent vaccines may have been associated with outbreaks of vaccine preventable diseases in Israel and several developing countries.

Poor handling and storage, cold chain deficiencies such as inadequate infrastructure, power shortages and poor maintenance are associated with vaccine wastage. Though there are very few countries reporting vaccine wastage to World Health Organization, WHO (19 of the 72 Global Alliance for Vaccine Initiative, GAVI eligible countries), developing countries have been found to incur cost of vaccine wastage in excess of $4 million and $6 million for pentavalent and pneumococcal vaccines respectively (4). It is noteworthy that Nigeria is among the 74% of GAVI eligible countries that do not report vaccine wastage.

Periodic assessment of vaccine handling and storage practices is instrumental in correcting wrong vaccine management practices and improving level of knowledge on vaccine management. In addition, it identifies various capacity gaps (personnel and equipment), which when duly addressed strengthens the nation's immunization service delivery, increases vaccination coverage and ensures the administration of potent vaccines to clients. This study was therefore conducted to assess the factors associated with vaccine handling and storage practices among immunization service providers in South-Western Nigeria (4).

1.3     Objective of the Study

The general objective of the study is to assessment of effectiveness of the vaccine Cold Chain System In Ilorin West Local Government area Kwara State, Nigeria

Specific Objectives of the Study

1 To assess the level of availability of cold chain system in Ilorin west Local government area.

To assess the quality and level of effectiveness cold chain equipment in Ilorin west Local government area

3 To assess the utilization of cold chain of monitoring devices in Ilorin west LGA

1.4     Research Questions

The following research questions align with the study's objectives while maintaining clarity and specificity. This study provides and answers to these questions.

1.    What is the level of availability of the cold chain system in Ilorin West Local Government Area?

2.    How effective and of what quality are the cold chain equipment in Ilorin West Local Government Area?

3.    To what extent are cold chain monitoring devices utilized in Ilorin West Local Government Area?

1.5     Significance of the study

An assessment of effeteness of vaccine cold chain   system in vaccine storage in Ilorin west LGA, would provide a lead way to prompting healthy living in the state in particular and country as a whole The finding would provide useful information that could assist relevant ministry and agencies in performing their statutory responsibilities of maintaining the quality of vaccine through optimal cold chain system. In same vein, the donor agencies and partner would leverage on the findings to determine more areas of assistant words making

1.6     Scope of the study

The study focuses on the Assessment of the effectiveness of vaccine  cold chain system in vaccine storage in Ilorin west Local Government Area of kwara state and respondents were drown among local government immunization office team management, focal Persons, routine immunization (R I) in charge, house to house team vaccinators .

1.7     OPERATIONAL DEFINITION OF TERMS

Cold: could mean a substance or weather with low temperature

Chain: to the sense of interconnected links or rings.

System: a composed of relationships among the organs or members

Potency: Is the ability or capacity to perform something or to be productive

Temperature: is a degree of hotness or coldness of a substance

Vaccine: is a biological prepared that provide active acquired immunity to a particular disease. A vaccine typically contain an agent that resemble with disease causing by micro organism is often an agent weakened or killers farm of the microbe

Immunization: is the administration of antigen in to the body to induces immunity

Polio: is a acute paralysis disease cause by the poliomyelitis virus. It is cripple disease that can occur in adults but it is much commoner in children

WHO: World health organization

V.P.D: Vaccine preventable diseases

V.V.M: Means vaccine viral monitor is a chemical indicator level attach to the vaccine vial with a differences 4 stage colour 

EPI: Expanded program on immunization

USAID: United State Agency for International Development

AFP: Acute Flaccid Paralysis

BCG: Bacilli calmette Guerin

NPI; National Program immunization

MDVPV; multi dose vial policy vaccine

WPV; wild polio virus.

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