Table 3.
Knowledge, attitudes and practices regarding vaccine vial usage and vaccine wastage among vaccinators at 54 selected health facilities and their supervisors at 11 selected local government areas (LGAs) of Nigeria, 2011.
Indicator | Vaccinator (N = 54); % responding “yes”, (95% CI) | LGA supervisor (N = 11); % responding “yes”, (95% CI) |
---|---|---|
General vaccine wastage-related knowledge and attitudes: | ||
I am familiar with the multi-dose vial policy (MDVP) | 55 (0, 100) | 100 (100,100) |
MDVP knowledge: I can reuse an open vial of an eligible vaccine if stored in appropriate cold chain conditions | 33 (5, 61) | 100 (100,100) |
MDVP knowledge: I can reuse an open vial of an eligible vaccine if vaccine vial monitor is in stage 1 or 2 | 43 (9, 78) | 64 (3, 100) |
MDVP knowledge: I can reuse an open vial of an eligible vaccine for up to 28 days | 11 (0, 29) | 35 (0, 96) |
I received vaccine wastage targets from supervisor | 12 (0, 25) | 91 (68,100) |
Vaccine supply has been affected by vaccine wastage | 82 (42, 100) | 38 (6,70) |
There was wastage due to vaccine storage space constraints | 0 (0, 1) | NA |
High wastage rates were a reason for recent vaccine stockouts | 98 (93, 100) | NA |
I have attended a vaccine management training | 2 (0, 5) | NA |
General vaccination-related practices: | ||
In general, a vial is opened as soon as an eligible child comes to the facility | 46 (0, 100) | 76 (42, 100) |
In general, a vial is opened only on certain days or when a certain number of children are present at the facility | 54 (0, 100) | 24 (0, 59) |
Measles-containing vaccination-related knowledge: | ||
Re-constituted measles-containing vaccine (MCV) can be kept for up to 6 h | 85 (65, 100) | NA |
Measles-containing vaccination-related practices: | ||
An MCV vial is opened as soon as an eligible child comes to the facility | 2 (0, 5) | 6 (0, 20) |
An MCV vial is opened only on certain days or when a certain number of children are present at the facility | 98 (95, 100) | 77 (48, 100) |
I wait for children to gather to a minimum number before opening a MCV vial | 60 (25, 95) | NA |
General vaccine wastage-related practices: | ||
I forecast vaccine needs based on target population | 33 (3, 64) | NA |
I forecast vaccine needs based on previous number of vaccines used | 53 (11, 94) | NA |
I request vaccine from LGA when needed (pull approach) | 97 (92, 100) | NA |
I make an effort to reduce wastage | 79 (63, 96) | 79 (35, 100) |
Vaccines were wasted due to cold chain failure at least once in the last six months | 35 (0, 78) | NA |
Vaccine vials were lost/damaged at least once in the last six months | 39 (24, 54) | NA |
I calculate wastage rates monthly for each vaccine | 9 (0, 20) | 83 (51, 100) |
I calculate open vial wastage rates monthly for each vaccine | 0 (0, 0) | NA |
I know the vaccine wastage rate targets | 12 (0, 25) | 91 (68, 100) |
I know the variables needed to calculate wastage | 16 (0, 31) | 38 (0, 100) |
I monitor cold chain temperatures twice daily | 18 (6, 30) | NA |
I discard opened, usable polio vaccine vial at the end of session | 47 (5, 89) | NA |
The national policy for when to open a vial is different than the practice in my LGA | NA | 36 (5, 67) |
The practice in this LGA on use of the multi-dose vial policy is different than the official policy | NA | 7 (0, 22) |
Main reasons why wastage occurs at your facility(s) | ||
Spillage of vaccine | 57 (30, 86) | 12 (0, 31) |
Inability to get all doses from vial | 34 (6, 64) | 28 (0, 64) |
Discard 6 h after reconstitution | 31 (11, 5) | 47 (0, 100) |
Exposure to high temperature | 16 (0, 34) | 35 (6, 64) |
Breakage of vial | 11 (0, 25) | 0 (0, 0) |
Exposure to freezing | 5 (0, 18) | 6 (0, 17) |
Discarding an open vial with usable vaccine | 1 (0, 4) | 9 (0, 25) |
Definitions: NA = statement not applicable or asked to this level; LGA = local government area; CI = Confidence interval; MCV = measles-containing vaccine; MDVP = multi-dose vial policy. For the MDVP, an eligible vaccine was described as those vaccines which could be stored past the 6-h mark after opening of the vial and vaccine was still in the vial.