Assessment of vaccine management performance in health facilities of Mwanza Region, Tanzania

Abstract

Background and rationale: Effective Vaccine Management (EVM) initiative provides the platform needed to monitor and assess the vaccine supply chain system to identify strengths and weaknesses of the system at all levels to enhance the development of continuous improvement plan to strengthen the system. This study was conducted to determine the vaccine management performance, and factors hindering the effective performance in health facilities as well as exploring key challenges from district managers on vaccine management practices in health facilities.

Objective: To assess vaccine management performance in health facilities of Mwanza Region, Tanzania.

Methods: This descriptive cross-sectional study was carried out in 102 health facilities providing immunization services from eight districts of Mwanza Region in Tanzania. The World Health Organization (WHO) effective vaccine management assessment tools were used to collected data. Both quantitative and qualitative approaches were used. Eight of the thirteen criteria and four of the six facility and management functions assessment criteria of the effective vaccination management assessment instrument were evaluated to see if the WHO benchmark of 80% was fulfilled. In addition, observational checklists were used to obtain further information on vaccine management practices. The qualitative data were collected through key informant interviews. The quantitative data were analysed using the existing WHO criteria for analysing effective vaccine management assessment data. Deductive thematic analysis was also used to analyse the qualitative data.

Results: The finding shows that the overall score for vaccine management performance was 53% which is below the WHO acceptable minimum score of 80%. None of the health facilities had reached the benchmark but only 67% had an average performance (>=50% - <80%). The highest health facility score was 76% and the lowest was 27%. Among the categories assessed, the highest score was on information technology with 72% followed by human resource capacity with 53% and the lowest was on standard operating procedures with a score of 43%. The major challenges that contributed to low performance were lack of training, low knowledge about vaccine management practices, unavailability of standard operating procedures (SOPs), and limited financial resources to support operations for vaccine management practices. The skills gap, incomplete stock records and management, as well as DISSERTATION _ GREEN SADRU iv low availability of SOPs were the key challenges reported that affected vaccine management practices.

Conclusion: Effective vaccine management performance was low across all health facilities in all districts under the study. Increasing personnel capacity and ensuring availability of resources to support operations were reported as key interventions in improving vaccine management practices. Hence effectively working on continuous improvement plan with key highlighted actions is highly recommended to all actors from national level to sub-national level managers and healthcare workers as frontline vaccine handlers.