The status of vaccine availability and associated factors in Tshwane government clinics

Abstract

Background. Vaccines have greatly contributed to the control of vaccine-preventable diseases and to human development. Efforts by many countries to introduce new vaccines are a significant move towards achieving the sustainable development goal for health. However, effective vaccine supply chains that ensure an uninterrupted supply of vaccines are pivotal to attaining universal access to life-saving vaccines and sustainable development. The introduction of new vaccines puts a strain on supply chains; South Africa (SA) is no exception, as there are indications of vaccine stock-outs in clinics. Objective. To establish the status of vaccine availability and associated factors in government health facilities of Tshwane Health District in Gauteng Province, SA. Methods. A cross-sectional study was conducted in a sample of randomly selected government clinics in the Tshwane health district of Gauteng Province. Data were collected using a structured measurement instrument in participating clinics. Data were analysed using Excelbased software (Microsoft, USA). Results. A total of 31 clinics participated. In the preceding 12 months, clinics had experienced vaccine stock-outs, especially of the three newer vaccines: pneumococcal conjugate vaccine, rotavirus and Pentaxim. These were also out of stock for a long duration; for over 2 weeks in a majority of clinics. The causes of vaccine stock-outs were: poor management of stock, district depot out of stock, unreliable deliveries, lack of pharmacy assistants and limited fridge capacity. Further burdening the situation is the ineffective emergency-ordering system. Conclusion. Significant shortages of vaccines, which are essential drugs, occur in Tshwane government clinics. Vaccine supply chain issues and vaccine shortages should be treated as a priority at all levels of the healthcare system; therefore, a similar study should be conducted at national level. It is recommended that the vaccine supply chain should be restructured and overhauled with the use of advances in technology and could be linked with current initiatives such as MomConnect.

A scoping review of interventions for vaccine stock management in primary health-care facilities

“…This in turn affects the motivation of health-care workers who may end up resenting the responsibilities of vaccine stock management because they often also have other duties including clinical duties. 9,32 When adequate data are not available, it affects the placing orders and could lead to shortages. 31 In addition, findings from this review have underscored the importance of assigning a specific person at health facility level to manage vaccine stock, as highlighted in the studies by Gilbert et al 4 and Prosser et al 22 .…”

“…It is due to these underlying factors that several countries experience vaccine shortages with the introduction of new vaccines. [9][10][11] Vaccine stock-out is said to occur when there is complete absence of a particular vaccine or different vaccines. 12 The frequency and duration of stock-outs are indicators commonly used to measure vaccine availability.…”

The effects of coronavirus disease 2019 pandemic on the South African health system: A call to maintain essential health services

“…South Africa has existing ARV and vaccine stock-out challenges because of supply chain constraints. 8,9,10,11 Prioritise the worst-performing provinces on ARVs, vaccines and other essential medicines stock-outs.…”

“…6 , 7 South Africa has existing antiretroviral (ARV) and vaccine stock-out challenges because of supply chain constraints. 8 , 9 , 10 , 11 In addition, gaps have been identified around low routine immunisation coverage resulting in outbreaks of vaccine preventable diseases, such as measles, in South Africa. 12 Anecdotal reports show that there is a decline in access to ART from March 2020 by those already initiated on ART.…”

“…6,7 South Africa has existing antiretroviral (ARV) and vaccine stock-out challenges because of supply chain constraints. 8,9,10,11 In addition, gaps have been identified around low routine immunisation coverage resulting in outbreaks of vaccine South Africa had its first coronavirus disease 2019 (COVID-19) case on 06 March 2020 in an individual who travelled overseas. Since then, cases have constantly increased and the pandemic has taken a toll on the health system.…”