Knowledge Of Health Workers About Cold Chain System
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Knowledge Of Health Workers About Cold Chain System
Chapter one
INTRODUCTION
The cold chain combines science, technology, and process. It is a science since it needs knowledge of the chemical and biological processes associated with perishability. It is a technology because it uses physical techniques to maintain optimal temperature conditions throughout the supply chain.
It is a process because a number of steps must be taken to manufacture, prepare, store, transport, and monitor temperature-sensitive products. The cold chain has global, regional, and local consequences.
Global, Specialisation allows for the delivery of vaccines and other pharmaceutical or biological temperature-sensitive items to large facilities. Agricultural activities enable the transportation of temperature-sensitive food products to distant markets.
Regional. Supports production specialisation and distribution economies of scale. This could include massive cold storage facilities serving regional grocery markets or specialised laboratories swapping temperature-sensitive components. Local Timely distribution of vaccine to beneficiaries during an immunisation session.
The cold chain refers to the transportation of temperature-sensitive products along a supply chain using thermal and refrigerated packing methods, as well as the logistical planning to ensure the integrity of the shipments. (Cyril Chaput, PhD 2000).
Cold chain products can be delivered using a variety of modes, including refrigerated vehicles and railcars, refrigerated cargo ships, and air cargo.
In health care services, the term “cold chain” refers to the process of keeping vaccines at the optimum suggested temperature from the manufacturer through transit, storage, and handling, beginning with manufacturing and finishing with administration to the client. It is used to assist extend and protect the shelf life of items. The optimal temperature range for refrigerated vaccines is +2°C to +8°C. Furthermore, some vaccines require photoprotection.
The term “cold chain and logistics” refers to the system of people, regulations, procedures, vehicles, fuel, equipment, and technologies that collaborate to ensure that vaccinations are safe and effective.
Because most vaccines have specific temperature needs, a good cold chain and logistics management system prevents both excessive heat and cold from causing vaccine damage from manufacturing to use (WHO February 2008).
A decade ago, most underdeveloped countries’ vaccines cost roughly one dollar per child. Today, with the addition of combination vaccines against hepatitis B and hemophilia’s influenza type B, as well as other recently approved vaccines and an increase in the rate per dollar, a completely immunised infant costs $15 or more (UNICEF 2013).
Background of the study
Ushongo Local Government Area is one of the 23 local government areas of Benue state, formed in May 1989 from Kwande Local Government Area by then-President General Ibrahim Badamosi Babangida.
It is located between latitudes 70 and 71 in the eastern section of Benue state, with a total population of 268529 according to the 2006 population census.
It is bordered by Gboko Local Government Area to the north and northwest, Buruku Local Government Area to the northeast, Kwande Local Government Area to the east, Vandeikya Local Government Area to the south, and Konshisha Local Government Area to the west.
The local government headquarters are in Lessel, which is located on the Gboko-to-Ihugh route, approximately 135 kilometres from Makurdi, the state capital. Her land area is 1228 km.2.
The postal code for the area is 982. The local government’s name is taken from Ushongo Hill, which is located in Ushongo Town, Mbayegh Council Ward.
It is important to note that Ushongo local government area was fortunate to be a UNICEF-assisted local government from 2006 to 2015.During this time, UNICEF, NPHCDA, WHO, and BSMH provided tremendous support to the national immunisation program (NPI). The Ushongo local government’s cold chain system was expanded with the addition of 13 solar and 9 refreegilators.
Two are stored in the LGA cold store, and one is in each comprehensive health centre in the eleven council wards of the local government. This is to serve a total population of 10742 children aged 0 to 11 months, or 4% of the total population, 53706 children aged 0 to 59 months, or 20% of the total population, 13426 pregnant women, or 17% of the total population, and 59068 women of childbearing age, or 22% of the total population.
In addition, given the high cost of vaccinations and their susceptibility to heat, a smooth and effective cold chain system is required.Furthermore, NGOs (GAVI), governments at various levels, donor agencies such as WHO and UNICEF, stakeholders, and all relevant bodies are doing their utmost to improve children’s health care, including immunisation services.
Nonetheless, according to the 2018 cold chain inventory, ten (10) of Ushongo Local Government Area’s 14 solar refrigerators are no longer operational, while four (4) are partially operational.
Another issue is that shortly after the 2015 measles campaign, an outbreak of measles occurred in four council wards, affecting 47 children in the age range, 32 (68%) of whom had been vaccinated with measles, but there was no sera conversion, indicating that the vaccine was ineffective in 2016.
Similarly, 59 children in the local government failed BCG when a post-program evaluation was conducted in 2018 due to vaccine failure due to insufficient potency.
The final straw for Brock, the female camel, was the implementation of a measles vaccination campaign in December 2017, which was postponed and shifted to February 2018 due to a lack of good and adequate icepacks to implement the program, until icepacks were borrowed from a neighbouring local government area.
Another issue was that in August 2018, a WHO consultant working under his supervision uncovered thousands of doses of various vaccines that had been squandered over time due to a lack of functional storage facilities, as stated by the regular immunisation officer and confirmed by the supervisor.
Statement of the Problem
It is important to note that Ushongo local government area was fortunate to be a UNICEF-assisted local government from 2006 to 2015.During this time, she received enormous support from UNICEF, NPHCDA, and BSMH for the national immunisation program (NPI). The Ushongo local government’s cold chain system has been expanded with 14 solar and 9 refreegilators.
Two are located in the LGA cold store, with one in each comprehensive health centre across the eleven council wards in the local government area. This aims to serve a total population of children aged 9-59 months.
As of 2015, there was an outbreak of measles in four council wards, affecting 47 children between the ages of 9 and 59 months, 32 (68%) of whom had been vaccinated with measles, but there was no sera detected, indicating that the vaccine was not effective.
Similarly, in 2016, out of 11234 children aged 0 to 59 months, 59 children aged 0 to 11 months across the local government failed BCG due to vaccine failure and lack of potency during post-program review.
In 2018,11516, Brock the camel’s final stroke was the implementation of a measles vaccination campaign in December 2017, which was proposed but pushed back to February 2018 due to a lack of good and adequate icepacks to implement the program, until icepacks were borrowed from a neighbouring local government area.
Another issue was that in August 2018, a WHO consultant working under his supervision uncovered thousands of doses of various vaccines that had been squandered over time due to a lack of functional storage facilities, as stated by the regular immunisation officer and confirmed by the supervisor.
It was disappointing to learn that only four of the 14 solar refrigerators were partially functional, including the most recently installed. This load is adversely affecting a significant population of children aged 0 to 59 months (53706) who will be tomorrow’s leaders, as well as pregnant women who may be eligible for various immunisation schedules.
These amounted to vaccine waste and shortage, which resulted in a squandered opportunity. Also, children are receiving immunisations that do not protect them as intended and instead make them sick. As a result, the researcher’s attention is diverted from conducting research to identify the factors at fault.
There is a need to guarantee that the right product is being used. Vaccine failures induced by the delivery of a contaminated vaccine may result in the reemergence or incidence of a vaccine-preventable illness.
Careful resource management is essential. Vaccines are expensive and may be in short supply. Loss of vaccinations may lead to the cancellation of immunisation clinics, resulting in missed opportunities to immunise.
Revaccination of persons who have previously received an ineffective vaccine is professionally uncomfortable and may lead to a loss of public trust in vaccinations and/or the health-care system.
GOALS OF THE STUDY
1. To examine the knowledge of the cold chain system among health workers (regular immunisation officers) in the Ushongo local government region.
2. Determine the general and local parameters influencing the effectiveness of the cold chain system in the Ushongo Local Government Area of Benue State.
3. To determine the negative consequences of an ineffective cold chain system on communities in the Ushongo Local Government Area of Benue State.
4. To analyse the importance, commitment, and support given to the cold chain system by the Ushongo local government council in order to establish an effective and sustainable cold chain system in the Ushongo Local Government Area of Benue State.
5. Determine the availability and operational capability of cold chain logistics in the Ushongo Local Government Area.
RESEARCH QUESTIONS:
1. Do health professionals in Ushongo local government (regular immunisation officials) understand the cold chain system and logistics?
2. Are there general and local elements influencing the cold chain system in Ushongo Local Government?
3. What are the associated issues that a broken chain or inadequate cold chain system cause in the community and Ushongo Local Government?
4. How would the Ushongo local government council demonstrate support and care for the cold chain system in order to ensure an effective and sustainable cold chain system and logistics?
5. Are there solutions to the broken cold chain system in the Ushongo local government area?
Significance of the Study
The findings of this study will assist health workers (regular immunisation officers) in the Ushongo local government in becoming aware of the elements influencing a successful cold chain system, as well as recognising solutions that can aid in addressing the highlighted concerns.
The study’s findings will also be useful to anyone who wishes to do additional research on this topic, as well as donor organisations and health-care stakeholders.
The study’s findings will assist Ushongo Local Government Council administration in understanding the issues associated with an ineffective cold chain system for the area’s residents.
The study’s findings will also assist Ushongo Local Government Council’s management in understanding her responsibilities for creating an effective cold chain system and closing the gap between an effective and ineffective cold chain system.
Limitations of the study
This study is limited to the Ushongo Local Government Area. It is also limited to 55 health personnel in the Ushongo Local Government Area, including 53 routine immunisation officers (RIO) in private and public health facilities, one cold chain officer (CCO), and one local immunisation officer. It is also limited to evaluating factors influencing the cold chain system in Ushongo local government area, Benue State.
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