Feasibility of Integrating Oxytocin into Vaccines Supply Chain in Sierra Leone

Abstract

Introduction: Postpartum haemorrhage is still leading the cause of maternal mortality globally. Oxytocin is the drug of choice for the prevention and treatment of postpartum haemorrhage. Oxytocin must be maintained at a temperature similar to vaccines that is +2to +8 degrees Celsius. Most women in low-income countries are still deprived of to access quality oxytocin at service delivery point during childbirth as a result of lack of the infrastructure and poor knowledge of health workers to properly store the product. EPI program with a huge infrastructural investment on cold chain that is available even at remote settings will contribute greatly to it proper storage and hence maintained potency. Supply chain integration is the merging of both oxytocin and vaccines in the cold chain to achieve effectiveness and efficiency. Objectives: The aim of this research was to access the feasibility of integrating oxytocin into vaccines cold chain in Sierra Leone. 1. Assess the current status of the vaccine supply chain in Sierra Leone. 2. Evaluate the present status of the oxytocin supply chain in Sierra Leone. 3. Assess the feasibility to integrate oxytocin storage into the vaccine cold chain of the EPI in Sierra Leone. The study targeted 120 health facilities participants nationwide, the design of the questionnaire took a dual approach of both Quantitative and Qualitative face-to-face data collection. The study covers four regions Western Area, Southern, Northern and Eastern regions, and 14 health districts of Sierra Leone. The study sample size was determined using 10% of 1200 health facilities nationwide that conduct immunization and maternal services. The data tool used was SPSS version 20. Results: 99% of all health facilities visited stored oxytocin and vaccines in their facilities. Only 104(86.7%) health facilities (n=120) respondents stored both vaccines and oxytocin in the same refrigerator while 31.3% used other means of storage. Of the 104 respondents that store both oxytocin and vaccines together in the same refrigerator only 29.8% label their oxytocin from vaccines and 70.2% respondents‟ stores without labeling. 82.5% of respondents (n=120) believed that storing oxytocin and vaccines together is a good practice, 12.5% of respondents believe that is a bad practice and 5.0% say they don’t know if is a good or bad practice. 83.3% of health facilities (n=120) had enough storage space for both oxytocin and vaccines. 100 (83.40%) respondents supported integration at the Health facility, 13(10.80%) respondents supported integration at the district level, and 7(5.80%) support integration at the central level. From a total of 120 facilities assessed, respondents revealed that 100(83.30%) stated that the available space in the refrigerators is enough to store both oxytocin and vaccines together while 20(16.70%) said their available capacity is not enough to store both together in the refrigerator. Discussion and Conclusions: The present study found that 86.7% of the HFs respondents stores vaccines and oxytocin together in the same refrigerator which is in support to the WHO/UNICEF joint statement on integration of temperature- sensitive health products particularly oxytocin into the EPI cold chain were safe and feasible(WHO/UNICEF, 2014). The findings of this study show that integration of oxytocin into the vaccines supply chain in Sierra Leone will leverage opportunities for economies of scale and scope and promote Million Development Goals, which is inconsistent with the study done by PATH Placing Oxytocin in the Immunization Cold Chain, which highlighted Global Alliance on Vaccines Immunization’s interest on an integrated approach to health will advance efforts to achieve the Million Development Goals.