南苏丹上尼罗州共和国冷链设备平台太阳能冰箱项目评估

Paulo Okech, Shiferaw Mitiku, Kashi Carasso, Jean Damour Habagusenga, Marie-Jeanne Mukazayire
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摘要

背景:冷链是一种温度控制的供应链,具有不间断的活动链,维持给定的温度范围,以保持和维持疫苗的质量。疫苗要经过复杂的程序和过程,需要特别注意和照顾。有效的冷链系统需要高效的端到端疫苗储存、处理和库存管理,以将疫苗保持在2°C至8°C的严格温度控制下(几乎所有疫苗)。方法:采用描述性横断面研究设计和混合(定性和定量)研究方法进行研究。通过面对面深入访谈和问卷调查的方式收集疫苗接种员和疫苗接种单位主要人员的数据。在收集数据之前,获得了国家卫生部规划和监测总局以及卢旺达大学研究委员会委员会的伦理批准。因此,在征求参与者的个人同意后收集数据。结果:本研究的主要发现表明,与2017年EPI覆盖率调查结果相比,冷链覆盖率有所提高。结果显示,扩大免疫方案冷库技术人员不足、冰箱备件缺乏、训练有素的工作人员以及疫苗预测不足是县和卫生设施一级面临的主要挑战。结论:对上尼罗州加强疫苗供应链系统做出积极贡献的主要因素是冷链覆盖率的实质性提高。然而,由于缺乏定期预防性维护、备件和扩大免疫计划技术人员,CCEOP在提高免疫覆盖率方面的作用仍然受到怀疑。研究发现,影响疫苗相关性、有效性、效率和可持续性的主要挑战主要是疫苗处理不当,原因是对冷链管理的知识不足。
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Evaluation of Cold Chain Equipment Platform Solar Fridges Project in Upper Nile State Republic of South Sudan
BACKGROUND: A cold chain is a temperature-controlled supply chain with uninterrupted chain of activities that maintain a given temperature range that keep and maintain the quality of vaccines. Vaccines move through complex procedures and processes that require special attention and care. Effective cold chain systems require efficient end-to-end vaccine storage, handling, and stock management to maintain vaccines under strict temperature control of between 2 °C and 8 °C (for almost all vaccines). METHODS: A descriptive cross-sectional study design and mixed (qualitative and quantitative) research approach is employed to conducting the research. Data were collected through face to face in-depth interviews and questionnaires from Vaccinators and key persons from IPs. Prior to data collection, ethical approval was obtained from national Ministry of Health, Directorate of planning and M&E, and the University of Rwanda, Research Committee Board. Accordingly, data were collected after seeking the personal consent sought from the participants. RESULTS: The key findings from this study showed that the cold chain coverage has been improved compared to the result obtained in EPI coverage survey conducted in 2017. The results revealed that inadequate availability of EPI cold technicians, lack of fridge spare parts, trained staff, and adequate vaccine forecasting was the major challenges at county and the health facility level. CONCLUSIONS: The main factor that contributed positively in strengthening vaccines supply chain system in the Upper Nile State was the substantive increase in cold chain coverage. However, the role of the CCEOP in improving immunization coverage is still doubted due to lack of regular preventive maintenance, spare parts, and EPI technicians. The major challenges that affect the vaccines relevance, effectiveness, efficiency and sustainability were found to be mainly poor vaccines handling, due to inadequate knowledge on cold chain management.
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