Factors contributing to wastage of Measles-Rubella and Bacillus Calmette–Guérin vaccines at health facilities: case study of Rombo DC, Tanzania

Abstract

The multi-dose lyophilized vaccines (Measles/Rubella and Bacillus Calmette–Guérin vaccines) have limited time for use after reconstitution and hence have an avoidable wastages which make vaccinators to hesitate to open the vial for few clients. In line with this the study sought to assess the rate of vaccine wastage at the facility and further examine the influence of vaccinators and vaccine handlers’ education, attitude and practices on MR and BCG vaccines wastage. To achieve the intended objectives a structured questionnaire and vaccine stock monitor in tool were used to gather data from the vaccinator and vaccine handlers in 34 vaccination facilities in Rombo district, Kilimanjaro Tanzania. The data collected covered one year, a period before Covid19 pandemic and during Covid –19 pandemic (July 2019 to June 2020). The average vaccine wastage mean was 32.03% and 59.53% for MR and BCG vaccine respectively, likely wise the average wastage for un-open was 0.52% and 2.12% for MR and BCG vaccines respectively. Where for opened vial wastage was 27.28% and 57.09% for MR and BCG vaccines respectively. Before Covid-19 the average wastage was 23.09% and 57.94% for MR and BCG vaccines while during Covid-19 the average wastage was 32.51% and 60.47% respectively. Most of the service providers were knowledgeable and they had positive attitude on MR and BCG vaccine wastage, stock management and usage strategies to reduce wastage. The study also revealed a positive relationship between knowledge and practice where increased knowledge lead to proper practices which in turn reduces vaccine wastage. The vial size was the main contributing factors for MR and BCG vaccine wastages at the health facilities. Rescheduling days for vaccination was a strategies for reducing vaccine wastage fearing open vaccines for few clients. Attitude was observed to negatively relate to vaccine wastage that is a positive attitude to managing vaccine results into decrease in vaccine wastage and vice versa. The study recommends for improved knowledge of the vaccinators and vaccine handlers for them to be able to perfect their practices which include proper scheduling of the vaccination dates and number of the clients.