Abstract
Background Despite the relevance of cold chain management in maintaining the potency of vaccines, gaps still exist in the ability of healthcare practitioners to maintain the cold chain system effectively. Thus, the current study sought to assess healthcare providers' knowledge, attitudes, practices, and challenges regarding cold chain management. Methods A concurrent mixed methods study was conducted at twelve facilities in the Sekyere Central District of Ghana. Eighty-six (86) participants took part in a survey that assessed their “cold chain management” knowledge and attitudes. Twelve (12) cold chain sites within the district were also observed in respect of their cold chain management practices. Eleven key informants were additionally interviewed to explore their challenges on cold chain management. Quantitative data were analyzed using descriptive (frequencies, percentages, means, standard deviations, ranges) and inferential statistics (Spearman's rho correlation). Qualitative data were inductively analyzed into themes which described participants' challenges on cold chain management. Results Majority of the participants scored ≥70% on knowledge (68.6%) and attitudes (67.4%) toward cold chain management. However, there was a very weak positive and statistically insignificant relationship between participant's knowledge and attitudes toward cold chain management (r = 0.109, p = 0.317). Regarding cold chain management practices, majority of the facilities had their vaccine vial monitors attached to the vaccines (8/12, 66.7%), had functional fridge tags (8/12, 66.7%), and an appropriate refrigerator to store vaccines (7/12, 58.3%). However, the study observed that 91.7% (11/12) of the facilities did not have policies and guidelines on cold chain management while all 12 facilities (100%) did not have a contingency plan in place for equipment. With regards to the cold chain management challenges, participants raised concerns about inadequate personnel, erratic power supply, logistical constraints, and transportation difficulties. Conclusion Although majority of the participants had good knowledge and attitude towards cold chain management, there was a weak association between them. This implies that good knowledge may not necessarily influence good attitudes towards cold chain management and vice versa. The extent to which facilities support cold chain management practices was suboptimal. Participants encountered a number of challenges which prevented them from managing the vaccine cold chain system effectively. We recommend continual professional education for cold chain practitioners, provision of adequate human and material resources for cold chain management, and enhanced monitoring and evaluation of cold chain activities. Future studies should quantitatively measure individual participants' knowledge, attitudes, practices, and challenges on cold chain management so that we can establish the relationships that exist between these components.
Highlights
The achievement of higher vaccination coverage depends on the competent distribution of cost-effective vaccines that can be stored at the appropriate temperatures through quality cold chain management systems
Despite the training given to healthcare providers (HPs), evidence suggests that gaps in knowledge, attitudes, skills, and nonadherence to cold chain management practices negatively affect the efficient management of the cold chain system [8, 9]
The healthcare providers narrated a myriad of resource challenges which impeded the effective management of the cold chain system in the district
Summary
The achievement of higher vaccination coverage depends on the competent distribution of cost-effective vaccines that can be stored at the appropriate temperatures through quality cold chain management systems. The current study sought to assess healthcare providers’ knowledge, attitudes, practices, and challenges regarding cold chain management. Majority of the participants scored ≥70% on knowledge (68.6%) and attitudes (67.4%) toward cold chain management. Regarding cold chain management practices, majority of the facilities had their vaccine vial monitors attached to the vaccines (8/12, 66.7%), had functional fridge tags (8/12, 66.7%), and an appropriate refrigerator to store vaccines (7/12, 58.3%). Majority of the participants had good knowledge and attitude towards cold chain management, there was a weak association between them. Participants encountered a number of challenges which prevented them from managing the vaccine cold chain system effectively. Future studies should quantitatively measure individual participants’ knowledge, attitudes, practices, and challenges on cold chain management so that we can establish the relationships that exist between these components
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