Vaccine Cold Chain Management Factors Associated with Measles Outbreak among Children below 5 Years in Oltepesi Location, Kajiado County, Kenya

Abstract

The management of cold chain is crucial in the maintenance of efficacy of immunizations by way of keeping vaccines safe and effective from the manufacturer, to delivery and finally, to the recipients. Integrity in cold chain management is therefore central in the maintenance of a quality immunization programme. According to Kenya Health Information System (KHIS), the coverage of measles immunization in Kajiado County was above 80%, but there were frequent measles outbreaks in the county. This investigation aimed to establish the cold chain management factors that led to frequent measles outbreaks in the study area despite the relatively high immunization coverage. The study investigated cold chain management gaps in transportation, storage, and in the health worker’s competence. Data was obtained from two dispensaries that conduct immunization in Kajiado North Sub County. A descriptive-analysis was used to identify factors affecting vaccine cold chain management regarding measles outbreak. Purposive sampling was used to identify facilities within the affected and non-affected areas within the location of the study. Results of the study indicated that vaccine cold chain maintenance in health facilities was deficient with the main gaps being lack of power back-up, old and poorly maintained fridges, poor storage of vaccine diluent, poor temperature monitoring, incomplete vaccine carriers and insufficient knowledge on cold chain management. Kajiado County Government should implement a range of changes to improve the quality of immunization against measles so as to reduce wastage and make savings in the health budget. Specifically, there is need to upgrade the storage fridges and transportation carrier kits; provide standby automatic power backup generators, consistently monitor vaccine storage temperatures, and invest in education and training of the health care professionals on the importance of cold chain integrity in the maintenance of a quality immunisation programme.