Saidu Yauba, Ename E Harmelle, Vouking Zambou Marius, Nkwain Jude, Kamga Delphine, Tonga Calvin, Bayiha Christain, Ewane Leonard, Biloa Alain, Mbollo Marianne, Mbu Robinson, Dicko Hamadou, Nzuobontane Divine
Background: Availability of adequate number of optimal cold chain equipment is indispensable for expanded programs on immunization. Lack of this equipment can hinder a country’s progress towards its immunization coverage and equity goals. In this study, we evaluated the availability and status of vaccine cold chain equipment in Cameroon so as to facilitate planning for repairs, maintenance, replacement and expansion of cold chain infrastructure.
Methods: This cross-sectional study was conducted in Cameroon, a country that has witnessed a sizable decline in its immunization coverage in recent years. Pre-tested and validated questionnaires were used to collect data from districts and health facilities. Completed questionnaires were double entered into Census and Survey Processing System and analyzed using SPSS, version 22.
Results: Overall, 4,568 sites were surveyed, including 189 health districts and 4,379 health facilities. Of the 189 surveyed districts, 75% were equipped with WHO-prequalified vaccine refrigerators, 7% were unequipped with any refrigerator, while 3% were equipped with broken refrigerators. In addition, 12% were equipped with absorption (PIS) refrigerators and the remaining 3% with domestic refrigerators. Of the 4,379 surveyed facilities, 38% were unequipped with any refrigerator and 14% were equipped with broken refrigerators. Only 2% of facilities were equipped with WHO-prequalified refrigerators. The remaining facilities met their cold chain needs with absorption (28%) and domestic (18%) refrigerators. With regards to storage capacity gaps, 45% of health districts had capacity gaps in 2017, a percentage that is projected to reach 75% by 2021. Unlike districts, almost all facilities had cold chain capacity gaps in 2017 and this percentage is expected to reach 99% by 2021 if no intervention is implemented.
Conclusion: Our findings suggest that the cold chain system in Cameroon, particularly at facility level is severely compromised. This challenge highlights the need for urgent interventions to restore adequate and functional cold chain capacity at these levels as this will be necessary to boast immunization coverage and equity.