Adequate supply of cold chain facilities is essential in the delivery of life-saving routine vaccines to the last mile. However, Nigeria is still struggling to cover up the storage deficit which was accentuated during COVID-19 pandemic. ADETOLA BADEMOSI, in this piece, looks at the factors hindering the delivery of quality vaccines to remote areas in the country.
Kasimu Zakariya and Abass Haske are community health extension volunteers in Kabin Mangoro Primary Healthcare Centre (PHC), situated in Kabin Mangoro community in the Federal Capital Territory (FCT). The community comprises Gade indigenes and also accommodates the Hausas and Fulanis.
However, Kabin Mangoro is situated deep in a bushland a distance of over 67 kilometers from Abuja’s Central Business District.
A first time journey to the community leaves one bewildered. There is a long stretch of untarred road that is lonely, dusty and seems as though it leads nowhere. After riding on a motorcycle for about one hour, the village appears from a distance.
In the community exists a primary health care centre (PHC) that has nothing to depict a typical health centre. Apart from the roofing sheets blown away by the wind, the wards look unkempt, adorned with worn-out beds and dust, while cobwebs have taken over parts of the interior.
Signboard showing entrance to the community
With no basic amenities like water, good roads, electricity and telecommunications network, Kasimu, in a bid to make routine vaccines available for children in the village, has to embark on a two-hour treacherous journey on his motorcycle every two weeks.
He receives routine vaccines like the polio, diphtheria, BCG, Rota, Penta vaccines, among others, from Kuje Local Government Area (LGA) secretariat. The LGA is one of the six LGAs of Abuja.
“We usually get routine vaccines from the Kuje Local Government secretariat whenever we have immunization. It is about two hours to and from our village,” said Kasimu who also doubles as the Routine Immunization focal person at the PHC.
In an environment where electricity is unavailable and the nearest cold-chain facility is two hours away, one could not help but wonder how the facility’s vaccine freezer is being managed.
Across Africa, governments and donors have made progress in making life-saving vaccines available in African countries but getting them in good conditions to the “last mile” has been a major challenge.
Vaccine cold chain is a network of cold rooms, freezers, refrigerators, cold boxes and carriers that keep vaccines at the right temperature at every link on the long journey from the manufacturing line to the syringe.
However, findings have shown that electricity is a major challenge with cold-chain management. In some cases, other factors are insufficient backup refrigerators and cold boxes, poor temperature monitoring tools, among others
For Kasimu and Abass, maintaining these vaccines’ efficacy through every means possible is their top most priority, a reason they adopt the twice-a-month vaccination schedule.
According to Kasimu, “We only collect for the number of children we are expecting. We have our monthly target population and we immunise twice a month due to the nature of the road and other factors.
“We do immunisation every two weeks so we have to economise it.”
Despite owning a motorcycle, providing logistics to convey the vaccines from the secretariat dispensing point to the community is a Herculean task for Kasimu.
“We find it difficult to supply vaccines because of the difficulty in getting motorbikes to town. Although I have one, it is in bad shape. Sometimes, they have to send the vaccine through a bike man directly from town,” he lamented.
Vaccines are kept in cold boxes and administered to children within 48 hours. However, the leftovers are stored in the freezers donated to the Kabin Mangoro health facility in 2021.