Vaccine Management Knowledge and Practice of Health workers in Yemen
Vaccine management comprises of estimation of vaccine
needs, ordering, storage, distribution, monitoring vaccines use and limiting vaccine
wastage. Yemen has been in conflict situation for over 7 years and remains one of
the world’s worst humanitarian crises, with an estimated 23.4 million people in
need of humanitarian assistance. This descriptive cross-sectional study to assess
the vaccine management knowledge and practice in Yemen was carried out among health
workers in 6 governorates. 536 health workers at different levels provided responses
to the online questionnaire which were imported into the Statistical Package for
Social Sciences (SPSS) platform for relevant descriptive and inferential analysis.
Chi square test was used to determine statistical significance of observed difference
in knowledge and vaccine management practice against relevant socio-demographic
and work-related variables. The level of significance was set at p value <0.05.
The study showed that 429(80%) had good knowledge while 63(11.8%) and 44(8.2%) had
fair and poor knowledge of vaccine management respectively. More than two-thirds
of respondents only receive vaccines 411(76.7%), 124(23.1%) receive and distribute
vaccines. Vaccine distribution included use of refrigerated vehicles (15.2%), cold
boxes (32.8%) and vaccine carrier (41.6%) both with conditioned ice packs. A total
of 432(63.8%) have experienced vaccine stock-out and mostly for 1-2weeks (75.6%).
Association between age and vaccine management knowledge was statistically significant
with p-value of 0.006. The vaccine management knowledge and practice as shown from
the findings of the study are commendable. However, there is need to address the
artificial stock-out of vaccines to avoid missed opportunities.
Osei, E., Ibrahim,
M., & Kofi Amenuvegbe, G., 2019, Effective Vaccine Management: The Case of a
Rural District in Ghana. Advances in preventive medicine, 2019, 5287287.
 Pollard, A.J., Bijker, E.M., 2021, A guide to vaccinology:
from basic principles to new developments. Nat Rev Immunol 21, 83–100, https://doi.org/10.1038/s41577-020-00479-7.
 World Health Organization. Regional Office for Africa.,
2017, Mid-Level Management Course for EPI Managers: Block III: Logistics: Module
8: Vaccine management, https://apps.who.int/iris/handle/10665/260479.
 Ameen, H., Salaudeen, A.G., Musa, O. et al., Predictors
of vaccine management practices among primary healthcare workers (PHCWs) in Ilorin,
North Central Nigeria. Research Journal of Health Sciences, 4. 2016-148.
 WHO., & UNICEF., 2016, WHO/UNICEF joint statement:
Achieving immunization targets with the comprehensive effective vaccine management
(cEVM) framework. https://apps.who.int/iris/handle/10665/254717.
 Wasiu, O.A., & Oluwatosin, A.A., 2020, Knowledge and
practice of vaccination logistics management among primary health care workers in
Nigeria: Orcid Icon Pages 1490-1495. https://doi.org/10.1080/21645515.2020.1827609.
 Mohammed, S.A., Workneh, B.D., & kahissay, M.H., 2021,
Knowledge, attitude and practice of vaccinators and vaccine handlers on vaccine
cold chain management in public health facilities, Ethiopia: Cross-sectional study.
Plos One 16(2): e0247459. https://doi.org/10.1371/journal.pone.0247459.
of Public Health & Population, Yemen., 2016, Comprehensive Multi-year Plan (cMYP)
 United Nation
Children Fund (UNICEF)., Sept. 2022, Yemen draft country program document. https://www.unicef.org/executiveboard/documents/Yemen-draft-country-programme-document-srs-2022.
J., & Biswas, T., 2013, How to calculate sample size for different study designs
in medical research? Indian Journal of Psychological Medicine, 35(2), 121–126.
 World Health
Organization (WHO)., 2005, Vaccine Management Assessment. http://apps.who.int/iris/bitstream/handle/10665/69616/WHO_IVB_05.02_eng.pdf?sequence=1.
D., Ejeta, F., Aferu, T. et al., 2022, Adherence to WHO vaccine storage codes and
vaccine cold chain management practices at primary healthcare facilities in Dalocha
District of Silt’e Zone, Ethiopia. Trop Dis Travel Med Vaccines 8, 10. https://doi.org/10.1186/s40794-022-00167-5.
 World Health
Organization., 2016, Global Routine Immunization Strategies and Practices (GRISP):
a companion document to the Global Vaccine Action Plan (GVAP). https://apps.who.int/iris/handle/10665/204500.
 Daud, Norwati.,
2014, Knowledge, Attitude and Adherence to Cold Chain among General Practitioners
in Kelantan, Malaysia. https://internalmedicine.imedpub.com/knowledge-attitude-and-adherence-to-cold-chain-amonggeneral-practitioners-in-kelantan-malaysia.php?aid=6257.
H., Hadgu, T., Ayele, B. et al., 2022, Knowledge of vaccine handlers and status
of cold chain and vaccine management in primary health care facilities of Tigray
region, Northern Ethiopia: Institutional based cross-sectional study. Plos
One. 17. e0269183. 10.1371/journal.pone.0269183. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269183.
B., Bekele, D., & Esmael, A., 2018, Cold Chain Status and Knowledge of Vaccine
Providers at Primary Health Care of Units Bale Zone, Southeast Ethiopia: Cross-sectional
Study. Immunome Research. 14,152. https://www.readcube.com/articles/10.4172/1745-7580.1000152.
J. Y., Habtamu, Y.N., Behailu, T. D. et al., 2019, Knowledge of Health Professionals
on Cold Chain Management and Associated Factors in Ezha District, Gurage Zone, Ethiopia,
Scientifica, vol. 2019, Article ID 6937291, 7 pages. https://doi.org/10.1155/2019/6937291.
 Ebile Akoh,
W., Ateudjieu, J., Nouetchognou, J.S. et al., 2016, The expanded program on immunization
service delivery in the Dschang health district, west region of Cameroon: a cross
sectional survey. BMC Public Health 16, 801. https://doi.org/10.1186/s12889-016-3429-7.
J.C., Bjune, G., 2007, Cold chain management: Knowledge and practices in primary
health care facilities in Niassa, Mozambique. Ethiopian Journal of Health Development,
21(2): 130-135. https://www.ajol.info/index.php/ejhd/article/view/10040.
 Ameen H.A;
Salaudeen A.G; Bolarinwa O.A. et al., 2014, Vaccine Storage and Handling Practices
among routine immunization service providers in a metropolitan city of North-Central
Nigeria. Journal of Community Medicine and Primary Health Care. 26 (2) 18–28.
 PATH Optimize.,
Aug.2013, Preventing in cold boxes and vaccine carrier. https://media.path.org/documents/TS_opt_handout_freeze_safe.pdf.
H.A., Amhare, A.F., & Bogale, A.A., 2019, Assessment of factors affecting vaccine
cold chain management practice in public health institutions in east Gojam zone
of Amhara region. BMC Public Health 19, 1433. https://doi.org/10.1186/s12889-019-7786-x.
of Public Health & Population, Yemen., July 2013, Effective Vaccine Management
Assessment (EVM) report.
J., 2010, Vaccine Vial Monitor (VVM) Availability and Use in the African, Eastern
Mediterranean, Southeast Asian, and Western Pacific Regions. Ferney: PATH, World
Health Organization; https://media.path.org/documents/TS_opt_vvm_avail_use.pdf.
U., Ozgüler, N. K., Wolfson, L. J., & Kurzatkowski, W., 2010, Validation of
the shake test for detecting freeze damage to adsorbed vaccines. Bulletin of the
World Health Organization, 88(8), 624–631. https://doi.org/10.2471/BLT.08.056879.
 Das, B.,
Bora, P., 2019, Effect of mobile-based supportive supervision on cold chain point
management and routine immunization service delivery. International Journal of
Medical Science and Public Health, 8 (1). 1-5. https://www.bibliomed.org/?mno=302642932.
 Iwu, C.
J., Ngcobo, N., McCaul, M. et al., 2020, Vaccine stock management in primary health
care facilities in OR Tambo District, Eastern Cape, South Africa. Vaccine, 38(25),
of Public Health & Population, Yemen. (2019). Immunization forecast for 2020.
of Public Health & Population, Yemen. (2020). Immunization forecast for 2021.
of Public Health & Population, Yemen. (2021). Immunization forecast for 2022.
 United Nation
Children Funds (UNICEF)., July 2022, Immunization regional snapshots. Immunization regional snapshots - UNICEF
of Public Health & Population, Yemen., 2019, Quarterly Vaccine stock take report
of Public Health & Population, Yemen., 2020, Quarterly Vaccine stock take report
of Public Health & Population, Yemen., 2019, Routine Immunization data for 2019.
of Public Health & Population, Yemen., 2020, Routine Immunization data for 2020.
of Public Health & Population, Yemen., 2021, Routine Immunization data for 2021.
O., Suwattana, O., Harun-Or-Rashid, M., & Sakamoto, J., 2011, Healthcare workers’ knowledge and practices regarding expanded program on immunization in Kalasin,
Thailand. Nagoya Journal of Medical Science, 73(3-4), 177–185. https://pubmed.ncbi.nlm.nih.gov/21928699/.
 Sinha, A.,
Verma, A., Chandrakar, A. et al., 2017, Evaluation of cold chain and logistics management
practice in Durg district of Chhattisgarh: pointer from Central India. International
Journal of Community Medicine and Public Health, 4(2). 390. https://www.ijcmph.com/index.php/ijcmph/article/view/582.