Assessment of medicines cold chain storage conformity with the requirements of the World Health Organization in health facilities of the Eastern Province of Rwanda

BACKGROUND: Despite the prominent evidence of cold chain monitoring in the health system to reduce wastage and maintain product potency, there are still inefficiencies in the storage and transportation of cold chain products. This study assessed medicine cold chain storage conformity in health facilities in the Eastern Province of Rwanda. METHODS: A cross-sectional and prospective with quantitative and qualitative approaches study was approved, and 44 health facilities (public, faith-based and private) were selected using both convenience, stratified, and purposive sampling techniques. Temperature data loggers were mounted in refrigerators to measure the Mean Kinetic Temperature (MKT). RESULTS: The overall performance of cold chain storage conformity of refrigerators assessed was 54 (73.0%). The conformity found in refrigerators of pharmacy stock in public health facilities was 22 (56.0%), in vaccination program was 25 (100.0%), and in private retail pharmacies was 7 (70.0%). The MKT measured fit the required cold chain storage at this rate. Most refrigerators used in pharmacy stock (27.0%) were aged between 8 and 10 years, while those used in vaccination programs were less than 4 years. Regular calibration of refrigerator and temperature monitoring device (TMD) was 39.0% and 24.0%, respectively. Most respondents, 44 (80.0%), knew the proper cold chain storage. However, few identified the impact of storing cold chain products with vaccines at 16 (29.1%). The transportation of cold chain products from two central medical stores assessed showed inefficiencies as only one of them uses temperature data loggers during transportations of the products mentioned above. CONCLUSIONS: The medicines cold chain storage conformity investigated in seven districts of the Eastern Province in Rwanda was better than reported previously in other LMICs. However, cold chain storage for pharmacy stock often did not meet the requirements. The observed drawback represented a serious risk to public health. Calibrating cold chain equipment, regular maintenance, and commissioning new cold chain equipment should be done to improve cold chain storage.