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TITLE PAGE

ASSESSMENT OF THE EFFECTIVENESS OF VACCINE COLD CHAIN SYSTEM IN ILORIN WEST L G A KWARA STATE, NIGERIA

BY

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EE/H2013/01430
DEPARTMENT OF ----
SCHOOL OF ---
INSTITUTE OF ---

DECEMBER,2018

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APPROVAL PAGE

This is to certify that the research work, "assessment of the effectiveness of vaccine cold chain system in ilorin west l g a kwara state, nigeria" by ---, Reg. No. EE/H2007/01430 submitted in partial fulfillment of the requirement award of a Higher National Diploma on --- has been approved.

By
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Supervisor                                                  Head of Department.
Signature……………….                           Signature……………….        

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External Invigilator

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DEDICATION
This project is dedicated to Almighty God for his protection, kindness, strength over my life throughout the period and also to my --- for his financial support and moral care towards me.Also to my mentor --- for her academic advice she often gives to me. May Almighty God shield them from the peril of this world and bless their entire endeavour Amen.

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ACKNOWLEDGEMENT

The successful completion of this project work could not have been a reality without the encouragement of my --- and other people. My immensely appreciation goes to my humble and able supervisor mr. --- for his kindness in supervising this project.
My warmest gratitude goes to my parents for their moral, spiritual and financial support throughout my study in this institution.
My appreciation goes to some of my lecturers among whom are Mr. ---, and Dr. ---. I also recognize the support of some of the staff of --- among whom are: The General Manager, Deputy General manager, the internal Auditor Mr. --- and the ---. Finally, my appreciation goes to my elder sister ---, my lovely friends mercy ---, ---, --- and many others who were quite helpful.

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To ensure the optimal potency of the vaccine storage and handling, need or there is a careful attention adequate electricity power and refrigerator are often lacking in developing countries, where storage handling and heat stability of vaccine are consequently of great concern, where new product have been developing for safe transport and storage while the reliability of vaccine supply has been increased by the introduction of improved management techniques, extensive training ensure that everyone involved in the cold chain system is familiar with all its facet. However, the evaluation in Indian Malaysia Nepal the united republic Tanzania and Tunisia show that these were still weak points in the cold chain system performances and that more attention should be paid to it especially in peripheral facilities the importance of monitoring the cold chain has been given little consideration in temperature countries although adequate refrigerator is often taken for granted, errors in vaccine handling may occur more commonly than is generally assumed.

TABLE OF CONTENT
Title
Certification
Dedication
Acknowledgement
Abstract
Table of content
Chapter one
1.0  Background o f the study
1.1 Statement  problem
1.2 Significant of the study
1.3 Objective of the study
1.4 Specific objective
1.5 Research question
1.6 Scope of the study
1.7 Operational of the study

CHAPTER TWO
                             LITERATURE REVIEW
2.1 Introduction and layout of the review
2.1 Definition of cold chain system
2.2 Division of the cold chain system
2.3 Component of the cold chain system
23.1 Vaccines
2.3.1 Personal
2.3.2 Cold chain equipment
2.3.3 Cold chain refrigerator
2.3.4 Cold freezer
2.3.5 Cold box
2.3.6 Vaccine carrier
2.3.7 Ice pack
2.3.8 Form pad
2.3.9 Thermometer
2.3.10 Vehicle
2. 4 Types of vaccine
2.4.1 live attenuated vaccine
2.4.2 Inactivated vaccine
2.4.3 Subunit vaccine
2.4.4 Toxion vaccine
2.4.5 DNA vaccine
2.4.6 Conjugate vaccine
2.4.7 Recombine vaccine
2.4.5 V V M
2.6 Category of vaccine base on sensitivity
1.6.1 Heat sensitive vaccine
1.6.2 Freeze sensitive vaccine
2.6 .3 Sensitive to light
2.7 Vaccine shake test
2.8 Vaccination
2. 9 Immunization program and cold chain system in Nigeria
2.10  Appraisal of the literature review

CHAPTER THREE
                   METHODOLOGY
3.0 Introduction
3.1 Area if the study
3.2 Crossectional Research Design
3.3 Study population
3.4 Sample size determination
3.5 Research instrument
3.6 Validation if instrument
3.7 Reliability if instrument
3.8 Inclusion criteria
3.9 Exclusive criteria
3.10 Data collection procedure
3.11 Data analyses procedure
3.12 Ethical consideration

                        CHAPTER FOUR
4.0 Presentation if result and Data Analysis
4.1 Showing the bar chat of the groups of the respondents
4.2 Educational level of the respondents
4.3 Barchart Showing Educational qualification if the respondents
4.4 Working experience if the respondents
4.5 Cold chain equipment
4.6 Multi bar chart showing the responses on cold chain equipment
4.7 Cold chain storage centre and staff
4.8 Bar chart of cold chain storage centre and staff
4.9 Cold chain vaccine storage and power supply
4.10 Cold chain Equipment management

CHAPTER FIVE
5.0 Introduction discussion of finding
5.1 Discussion of finding
5.2 Summary if finding
5.3 Limitation of the Study
5.4 Implication for the community health
5.5 Conclusion
5.6 Recommendation
5.7 To the individual community health professional
5.8 To the Government
5.9 Suggestions for the farther Study

CHAPTER ONE
BACKGROUND
A cold chain is defined as a temperature control apply chain( l]. cold chain is also  an uninterrupted series of storage and distribution activities which maintain a given temperature range(1).According to WHO cold chain is used to help extend and ensure the shelf life of products  such as fresh agricultural products,, chemicals and pharmaceutical drugs etc. it ensures that there are minimum temperature fluctuations for good in transit from place of production to the point of consumption(1).
Otis regarded as a temperature-controlled supply chain that involves equipment in view of the different temperature needed for different vaccine and medicines. Cold chain is the process that ensure vaccine are stored at recommended temperature range of 2.0 C to 8.0C from the point of manufacturer to the point of administration (immunization Advisory center)put no reported cold chain as the system used to keep and distribute vaccine in perfect condition.
Cold chain in network is regarded as the backbone to ensure that the right quality of vaccine reaches the target population. Manufacturing plant, vaccine distribution and then to provider office (immunization clinic) and end with the administration of the vaccine to the recipient (1).
Vaccine are immunogens consisting of weakened or dead pathogenic cell injected in order to stimulate the production of antibodies it's use to improve immunity to particular disease(1). The prevention of disease by the immunization is a conventional public health measure is known as today the best disease low-cost community based way of protecting children against the major killer disease over a 2 million death that are preventable through immunization. Each year and worldwide(2).this vaccine preventable disease remain the most common cause of childhood mortality with on estimated 3million death each yea(2). .development of effective vaccine has reduced the incidence of much serious infectious disease, early year immunization services in developing countries prevent about 490.000children from becoming paralyzed by poliomyelitis. Over 3million death are similarly prevented from measles, neonatal tetanus, pertussis (5). The achievement is partly attributable to the training of staff in the proper storage and transport of vaccine and partly to improvement in the cold chain. Immunization to vaccine preventable disease only result when active and affective vaccine can be sustainable by harnessing the essential elements in the cold chain system namely the vaccine, manpower, equipment and transportation. The cold chain refers to the continued of safe handling practice including material equipment and procedure that maintain vaccine within a temperature range from the time they are manufactured to the time they are administered to the person being immunized the cold chain still remains a highly vulnerable element of any immunization program. Both in developing and developed countries. The cold chain management including all of the means use to ensure a constant temperature between +2.c +8.c for that is not heat stable e.g. vaccine (2).

statement of Problem
The development of vaccines for the prevention of infectious diseases is one of the most significant accomplishments of public health in the last century. The efficacy of a vaccine in preventing disease depends largely on the quality of the immunizing agent. Failure to adhere strictly to recommended specifications for vaccine handling and storage can render vaccines useless. Inactivation of a vaccine may become evident only after immunized individuals acquire the disease the vaccine was designed to prevent (3). The identified cases are often considered primary or secondary vaccine failures, thereby obscuring the role that improper vaccine handling may have played in the failure.
A study conducted in Lagos, showed that 3/4 of the vaccines at the local government level were sub-potent with the situation failing to improve over the three-year study period. Studies have also reported that improper vaccine storage leading to the administration of sub-potent vaccines may have been associated with outbreaks of vaccine preventable diseases in Israel and several developing countries.
Poor handling and storage, cold chain deficiencies such as inadequate infrastructure, power shortages and poor maintenance are associated with vaccine wastage. Though there are very few countries reporting vaccine wastage to World Health Organization, WHO (19 of the 72 Global Alliance for Vaccine Initiative, GAVI eligible countries), developing countries have been found to incur cost of vaccine wastage in excess of $4 million and $6 million for pentavalent and pneumococcal vaccines respectively (4). It is noteworthy that Nigeria is among the 74% of GAVI eligible countries that do not report vaccine wastage.
Periodic assessment of vaccine handling and storage practices is instrumental in correcting wrong vaccine management practices and improving level of knowledge on vaccine management. In addition, it identifies various capacity gaps (personnel and equipment), which when duly addressed strengthens the nation's immunization service delivery, increases vaccination coverage and ensures the administration of potent vaccines to clients. This study was therefore conducted to assess the factors associated with vaccine handling and storage practices among immunization service providers in South-Western Nigeria (4).

1.2 Significance of the study
An assessment of effeteness of vaccine cold chain   system in vaccine storage in Ilorin west LGA, would provide a lead way to prompting healthy living in the state in particular and country as a whole The finding would provide useful information that could assist relevant ministry and agencies in performing their statutory responsibilities of maintaining the quality of vaccine through optimal cold chain system. In same vein, the donor agencies and partner would leverage on the findings to determine more areas of assistant words making

GENERAL OBJECTIVES
A assessment of effectiveness of the vaccine Cold Chain System In Ilorin West Local Government area Kwara State, Nigeria
1.4 Specific Objectives of the Study
1 To assess the level of availability of cols chain system in Ilorin west Local government area.
To assess the quality and level of effectiveness cold chain equipment in Ilorin west Local government area
3 To assess the utilization of cold chain of monitoring devices in Ilorin west LGA
1.7 Scope of the study
The study focuses on the Assessment of the effectiveness of vaccine  cold chain system in vaccine storage in Ilorin west Local Government Area of kwara state and respondents were drown among local government immunization office team management, focal Persons, routine immunization (R I) in charge, house to house team vaccinators .

1.8 OPERATIONAL DEFINITION OF TERMS
Cold: could mean a substance or weather with low temperature
Chain: to the sense of interconnected links or rings.
System: a composed of relationships among the organs or members
Potency:   is the ability or capacity to perform something or to be productive
Temperature: is a degree of hotness or coldness of a substance
Vaccine: is a biological prepared that provide active acquired immunity to a particular disease. A vaccine typically contain an agent that resemble with disease causing by micro organism is often an agent weakened or killers farm of the microbe
Immunization: is the administration of antigen in to the body to induces immunity
Polio: is a acute paralysis disease cause by the poliomyelitis virus. It is cripple disease that can occur in adults but it is much commoner in children
WHO: World health organization
V.P.D: Vaccine preventable diseases
V.V.M: Means vaccine viral monitor is a chemical indicator level attach to the vaccine vial with a differences 4 stage colour 
EPI: Expanded program on immunization
USAID: United State Agency for International Development
AFP: Acute Flaccid Paralysis
BCG: Bacilli calmette Guerin
NPI; National Program immunization
MDVPV; multi dose vial policy vaccine
WPV; wild polio virus.

1.9                                 PROJECT ORGANISATION
This work is divided into five chapters including this introduction. Chapter two is on the literature review and method of data collection are in chapter three. Results of findings are discussed in chapter four. The way forward is and conclusion in chapter five.

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