This research work was carried out to
investigate the factors affecting effective distribution of vaccines
among five (5) selected health facilities in Akure South Local Government. Simple random sampling technique was used
in the collection of samples. One hundred and twenty (120) questionnaires were
administered and one hundred and ten (110) were retrieved for presentation and analysis
which was done using percentage and frequency. It was revealed that Esure,
Ilekun and Kolawole health centres did not have Solar Direct Drive (SDD) which made it difficult for them
to store vaccines. Only Oda and Danjuma health centres had SDD. Due to lack of
effective cold chain system at Esure, Ilekunn and Kolawole health centres,
lives of health workers were endangered while vials and vaccines wastages were
eminent. This was as a result of the fact that only 24% of health workers
collected vaccines with vehicles, others used other means like
motorcycles. It was recommended that
Government should make SDD available for all health centres and health workers
also need to ensure adequate monitoring of the vaccine in the freezer.
TABLE OF CONTENTS
Table of contents
List of tables
Background of the study 2-4
Statement of the problem
Aims of the study 5
Objectives of the study 5
Significance of the study
Definition of terms 7
2.0 Literature review 8-9
2.1 Vaccination 9
2.2 Importance of vaccines 10-11
2.3 Types of vaccine 11-16
immunization coverage 2020 16-19
Cold Chain 19-20
chain system 20
of maintaining the cold chain 20-22
2.8 Vaccine vial
monitor (VVM) 22-23
related factors contributing to low immunization coverage 23
2.10 Distribution and supply 23-25
3.0 Research methodology 25
3.1 Study design 25
3.2 Study area 25-26
3.3 Study population 26
3.4 Sample size determination 26
3.5 Sampling technique 27
3.6 Study Instrument 28
3.7 Method of data collection 28
3.8 Data Analysis
3.9 Ethical consideration
4.0 Data presentation and analysis 29-35
conclusion and recommendations
5.1 Summary 36
5.2 Discussion of findings 36-38
5.3 Conclusion 38
5.4 Recommendations 39
Table 1: Age range of the respondents 29
Table 2: Health Centres of the respondents 30
3: Cadre of the respondents 30
iv: Sex of the respondents 31
v: Are there factors affecting effective distribution of vaccine in your health
vi: Presence of effective cold-chain system 32
vii: Response on whether the government has roles in effective vaccine
Table viii: Respondents means of transporting
vaccine from the cold chain store to
their health facility. 33
ix: Respondents vaccines usually transported weekly 33
x: Respondents response on the vaccines vials transported at once. 34
xi: Respondents response on how they preserve their vaccines 34
xii: Respondents response on how often they collected vaccines from the central
xiii: Respondents response on the need of center 35
Vaccine is preparation that is used to stimulate the body’s
immune response against diseases (CDC, 2021). Vaccines are usually administered
through needle injections, but some can be administered by mouth or sprayed
into the nose (CDC, 2021). “The impact of vaccination on the
health of the world’s peoples is hard to exaggerate. With the exception of safe
water, no other modality has had such a major effect on mortality reduction and
population growth” (Plotkin and Mortimer, 2017). The development of safe and
efficacious vaccination against diseases that cause substantial morbidity and
mortality has been one of the foremost scientific advances of the 21st century.
Vaccination, along with sanitation and clean drinking water, are public health
interventions that are undeniably responsible for improved health outcomes
globally. It is estimated that vaccines have prevented 6 million deaths from
vaccine-preventable diseases annually (Ehreth, 2003).
2055, the earth’s population is estimated to reach almost 10 billion (United
Nations Department of Economic and Social Affairs, 2019), a feat that in part
is due to effective vaccines that prevent disease and prolong life expectancy
across all continents. That said, there is still much to be done to ensure the
financing, provision, distribution, and administration of vaccines to all
populations, in particular those which are difficult to reach, including those
skeptical about their protective value and those living in civil disruption.
Agencies including the World Health Organization (WHO), United Nations
Children’s Fund (UNICEF). Vaccines reduce risks of getting a disease by working
with your body’s natural defenses to build protection. When an individual gets
a vaccine, their immune system responds. We now have vaccines to prevent more
than 20 life threatening diseases, helping people of all ages live longer,
healthier lives (WHO, 2021). Immunization currently prevents 2-3 million deaths
every year from diseases like diphtheria, tetanus, pertussis, influenza and
measles (WHO, 2021).
A study conducted in Kenya in the year 2014 showed that out
of 300 sub-county vaccine stores across the country only 55% had an adequate
cold chain storage (Ministry of Health Kenya, 2019). This had implications on
vaccine availability, as depots could not hold sufficient stocks. The report
also revealed that although the national immunization program outsourced
transport services for vaccine distribution between national and regional
vaccine stores, there was no reliable transportation between regional and sub
country vaccine depots as well as to the public health facilities. The mandate
for transport and distribution to sub county and public health facilities lies
with the county governments. The factors that affected vaccine availability
included insufficient knowledge of forecasting, monitoring and resource
management. Others were high staff turnover and wastage (Kenya National Bureau
of Statistics, 2014).
1.1 BACKGROUND OF THE STUDY.
The Expanded Programme on
Immunization (EPI) has proved its place as a corner stone in the Primary Health
Care (PHC) strategy. Not only is it a cost-efficient intervention that prevents
common childhood diseases, it also provides an entry-point into communities for
other Reproductive and Child Health (RCH) interventions, such as vitamin A
supplementation and growth promotion (CDC, 2016). Global coverage dropped from
86% in 2019 to 83% in 2020, an estimated 23 million children under the age of
one year did not receive basic vaccines, which is the highest number since
2009. In 2020, the number of completely unvaccinated children increased by 3.4
million, only 19 vaccine introductions were reported in 2020, less than half of
any year in the past two decades. 1.6 million more girls were not fully protected
against human papillomavirus (HPV) in 2020, compared to the previous year (WHO,
During 2020, about 83% of infants worldwide (113 million
infants) received 3 doses of diphtheria-tetanus-pertussis (DTP3) vaccine,
protecting them against infectious diseases that can cause serious illness and
disability or be fatal. While immunization is one of the most successful public
health interventions, coverage has plateaued over the last decade. The COVID-19
pandemic and associated disruptions have strained health systems, with 23
million children missing out on vaccination in 2020, 3.7 million more than in
2019 and the highest number since 2009.(WHO, 2021). Immunization programmes depend
greatly on efficient and effective supply chain systems to store, transport and
distribute these vaccines and health commodities, which ensures that the right
products are available at the right place, at the right time and in the right
condition in order to provide efficient health services to the communities (Chiodini, 2014).
The Effective Vaccine Management
(EVM) initiative, launched in the year 2010 by World Health Organization (WHO)
and United Nations Children’s Fund (UNICEF) is a comprehensive assessment of
the vaccine supply chain system of immunization programmes in low and
lower-middle income countries. The focus of the initiative is to uncover the
shortcomings in the performance of immunization supply chain so as to provide
basis for improvement (WHO & UNICEF, 2014). EVM initiative assesses nine
criteria of vaccine management performance from the national through to the
service delivery points and benchmark this performance against global set
standards. The nine criteria for satisfactory vaccine supply chain are; (i)
vaccine arrival procedures ensure that every shipment from the manufacturer
reaches the national store in right condition; (ii) temperature
monitoring—vaccines and diluents are stored and distributed within recommended
temperature ranges; (iii) cold storage, dry storage, and transport
capacity—warrant the sufficiency of storage and transportation of all vaccines
and supplies needed for the immunization programme; (iv) buildings, cold chain
equipment, and transport systems are appropriate; (v) maintenance of buildings,
cold chain equipment, and vehicles; (vi) stock management systems; (vii)
vaccine distribution between each level in the supply chain; (viii)
implementation of appropriate vaccine management policies are adopted; and (ix)
satisfactory information systems and Supportive management functions, (WHO
& UNICEF, 2014.,Diamenu et al., 2015).
Each of the nine criteria is
assessed at each level of the supply chain from the national through to the
service delivery level by observation, inspection of infrastructure and
records, and by interview of health staff involve in vaccine handling and
management (WHO & UNICEF, 2014). In Nigeria, where this study was based, routine
vaccination coverage for all recommended vaccines has remained poor though
there has been a gradual rise in vaccination coverage from 21% of eligible
children (0–11 months of age) in 2003 to 25% a decade later. (Nigeria
Demographic and Health Survey, 2013).
1.2 STATEMENT OF
The potency of vaccine needed to be maintained right from the
manufacturer to users. Some health facilities do not have effective storage facility
to maintain the potency of these vaccines, some of these the areas where the
health center are located do my have adequate lightning, some of the staffs
were not carry out their duty effectively due to poor payment of their salaries.
Government pays less attention to those health facilities that need assistance.
Therefore, there is need to assess the factors that affecting vaccines
distribution in Akure South Local Government Area.
1.3 AIM OF THE STUDY
This study aims to study the factors affecting effective
distribution of vaccines among five (5) selected health facilities in Akure
South Local Government.
1.4 OBJECTIVES OF
The Objectives of the study are to;
· To examine the vaccine distribution process in selected
health care facilities so as to identify possible loopholes in the process.
· To access the roles of health workers in effective
distribution of vaccines in those selected health facilities.
· To examine the adequacy of the roles of government in
effective vaccine distribution.
· What are the vaccine distribution process in selected health
care facilities so as to identify possible loopholes in the process?
· What are roles of health workers in effective distribution of
vaccines in those selected health facilities?
· What are the adequacy of the roles government in effective
OF THE STUDY
It is comprehensively clear that vaccines' potency needs to
be maintained, and effectively distributed. This study will help to identify
factors affecting vaccine distribution, and find solution to those identified
factors problems. This study will also help the general public to assist the
neighboring health centers around them. This will also make the health workers
and governments to identify their roles in achieving effective vaccine
distribution. It will also serve as foundational knowledge for other
1.7 DEFINITION OF
Disease: Is a disorder of
structure or function in a human, animal, or plant, especially one that
produces specific symptoms or that affects a specific location and is not
simply a direct result of physical injury.
Health: refers to a state of complete
emotional and physical well-being. Healthcare exists to help people maintain
this optimal state of health.
Health facilities: are places that provide health
refers to public health conditions related to clean drinking water and
treatment and disposal of human excreta and sewage.
Vaccine: Is a substance given
to stimulate the body's production of antibodies and provide immunity against a
disease without causing the disease itself in the treatment, prepared from the
agent that causes the disease (or a related, also effective, but safer disease),
or a synthetic substitute.
Vaccination: is a
simple, safe, and effective way of protecting people against harmful diseases,
before they come into contact with them.
Vaccine-preventable diseases (VPDs): are diseases caused by bacteria and viruses that can be
prevented by vaccines.
whole number of people living in a country, city, or area.
the process by which an individual's immune system becomes fortified against an
Measles: Is a highly contagious
illness caused by a virus that replicates in the nose and throat of an infected
child or adult.
Centre of Disease Control (CDC): Is a national public health agency of the United States.
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