Socio-demographic characteristics

Out of the 61 targeted samples, 59 responded representing 96.7% response rate. Of the 59 participants interviewed 62.71% were male and 64.4% were below 40 years of age. Nurses comprised the largest proportion of the participants at 96.61% and majority were diploma holders at 77.97%. The results further revealed that majority (64.4%) of the respondents had worked for more than two years in the immunization department with only 49.15% having been trained on operational/mid-level management course on immunization.

The relationship between socio-demographic characteristics and availability of vaccines was assessed at 0.05 level of significance. This was done using Pearson Chi-square or Fisher’s exact. Statistically significant relationship was observed between availability of vaccines and working experience (p = 0.001), training (p = 0.024) as well as age of the participants (p = 0.016).

Factors affecting availability of routine vaccines

Majority (62.71%) of the facilities experienced routine vaccine shortage. Vaccine stock-out at the district deport was the main contributing factor to routine vaccine shortage at 27.12%. Other factors were under estimation of vaccine requirements (15, 25%), delay in placing order (13.56%) and faulty refrigerator (6.78%). The vaccines that were assessed had varied levels of stock to complete the supply period. The one that had the largest quantity to complete the supply period was Measles–Rubella (71.19%) followed by BCG (69.49%), Penta Valent (67.8%) and lastly oral polio vaccine (57.63%). Statistically significant relationship was observed in delay in placing order (p = 0.02) and underestimating vaccine requirement (p = 0.02).

Types of stock management practices

It was observed that all health facilities had target population for immunization displayed but only 55.93% had area catchment map with target population (Table 1). Target population method was widely used for forecasting yearly vaccine requirements at 35.59%. In addition, 23.73% of the facilities had correctly filled vaccine forecasting sheet and 89.83% ordered vaccines when the stock reached minimum levels. Majority (81.36%) of the respondents used one month as the supply period and 76.27% had correctly filled vaccine ledger book.

Table 1 Types of stock management practices

The relationship between vaccine stock management practices and availability of vaccines was assessed at 0.05 level of significance. Statistically significant associations between availability of vaccines were observed with display of area catchment map (p = 0.045), knowledge on how to calculate vaccine requirement using target population (p = 0.003) as well as status of last order (p = 0.004).

Monitoring of vaccine use and immunization operating standards and services

The monitoring of vaccine use and presence of standard operating procedure booklet were investigated and the results are shown in Table 2. Most of the respondents (93.22%) prepared monthly summary report and 83.05% used immunization monitor chart. Majority (86.44%) of the participants had the correct knowledge on the supply period required for a facility.

Table 2 Monitoring of vaccine use and immunization operating standards procedures

The relationship between monitoring vaccine use, immunization operating standards procedures and availability of vaccines was assessed at 0.05 level of significance. Statistically significant relationship was observed between availability of vaccines and monthly immunization service review meeting (p = 0.006).

Cold chain equipment

The result showed 25.42% of the equipment was installed less than 5 years ago while 35.60% was in use between 5–10 years (Table 3). The findings revealed that 86.44% of the facilities had functioning cold chain equipment. However, 11.86% experienced breakdown more than three times in one year. It further revealed that biomedical engineers were inadequate and only 20.34% of the facilities had routine cold chain equipment maintenance.

Table 3 Status of cold chain equipment and maintenancePredictors of vaccine availability

Logistic regression was used to determine the predictors of the availability of vaccines (Table 4). The test was assessed at 0.05 level of confidence. The independent variables were chosen among those exhibiting p-values less than 0.25 following Pearson chi square and Fisher’s exact tests. A bivariate analysis revealed a statistically significant association between availability of vaccines and work experience, training on immunization services, catchment area map with target population displayed in the facility, and use of target population method in vaccine forecasting. The independent predictor on multivariate analysis was work experience (AOR = 2.65, 95%CI, 1.13, 6.25, p = 0.025). Facilities where the participants had more than two years of experience in the immunization department had 2.65 odds of having all the childhood vaccines available compared to those where the experience was less than two years.

Table 4 Predictors of vaccine availability