Speaker
Description
Background: Vaccination has saved millions of lives and prevented countless childhood illnesses. However, maintaining vaccine potency through effective cold chain management is essential before administration. In Ethiopia, only 27.5% of facilities demonstrate good vaccine cold chain practices, with knowledge gaps and lack of on-the-job training identified as key barriers. This evaluation explored the implementation status and challenges of Effective Vaccine Management (EVM) in public hospitals of South Wollo Zone.
Objective: To evaluate the quality of EVM practices in public hospitals of South Wollo Zone, Northeast Ethiopia, in 2025.
Methods: A convergent parallel mixed-methods case study was conducted from March 03 to April 19, 2025. The evaluation assessed three dimensions: Availability (input), Compliance (process), and Satisfaction (outcome), using 39 indicators weighted at 35%, 40%, and 25%, respectively. Quantitative data were collected through resource inventory, document review, 20 non-participatory observations, and structured interviews with 738 caregivers. Additionally, eight key informant interviews were conducted with program implementers to explore barriers and enablers. Quantitative data were analyzed using SPSS v25, and qualitative data were thematically analyzed.
Results: Availability of EVM resources was rated very good (87.89%). All hospitals had functional vaccine refrigerators, carriers, ice packs, and trained technicians. However, only 66.7% had functional vaccine freezers, and just 33.3% had temperature-controlled units. Compliance also scored very good (88.33%), with strong adherence to national cold chain protocols. Yet, only 51.1% of providers checked vaccine temperature upon receipt, and hand hygiene was observed in just over half of the cases. Satisfaction was moderate (61.7%), influenced by caregiver age, marital status, education, waiting time, income, and provider behavior.
Conclusion and Recommendation: The EVM program in South Wollo Zone shows strong performance in resource availability and provider compliance but moderate caregiver satisfaction. Gaps in temperature checks, hygiene practices, and client experience highlight the need for targeted improvements. Strengthening pre-service and in-service training, ensuring consistent resource allocation, and enhancing service delivery quality are recommended to sustain vaccine integrity and build public trust in immunization services.
