Vaccine Wastage and its Contributing Factors in Public Health Facilities of Oromia Special Zone, Ethiopia: Explanatory Sequential Mixed Method Design

Abstract

Background: Although the availability of vaccines is crucial to achieve comprehensive and equitable immunization coverage. This study assessed vaccine wastage and its contributing factors in public health facilities in Ethiopia. Methods: A facility-based explanatory sequential mixed method was used. An institutional-based cross-sectional study design used to assess the vaccine wastage and vaccine cold chain management in all (27) health facilities offering consistence vaccination service and assessed the knowledge and attitude of 127 vaccinators and handlers. Finally, a phenomenological study design was employed among key informants and content analysis was performed using NVivo 11 plus. Results: The overall vaccine wastage rate was 22.9% while the wastage factor was 1.4. The vaccine wastage rate was found highest for Bacillus-Calmette-Guerin (55.2%), 20 dose vials (55.2%), lyophilized (44.7%) and injectable vaccine (26.0%). Only 13 (48.1%) facilities were having satisfactory cold chain infrastructure while 17 (63%) had good cold chain practices.. Distance from Woreda health office (p=0.03) and Ethiopian pharmaceutical supply agency (p=0.02), work experience (p=0.04), level of education (p=<0.001), profession (p=0.001), and attitude (p=0.04) of vaccinators and vaccine handlers were determinants of vaccine wastage. Key informants stated that factors related to logistics, immunization practices, health professional and vaccines were contributing to wastage. Conclusion: Vaccine wastage in health care facilities was above the standard. Large dose vials and opened vial policy were resulted higher wastage and hence, recommended to reduce vial size. Improving the availability of cold chain logistics, supportive supervisions and training were recommended to reduce wastage.