Background. Despite the relevance of cold chain management in maintaining the potency of vaccines, gaps still exist in the ability of healthcare practitioners to maintain the cold chain system effectively. Thus, the current study sought to assess healthcare providers’ knowledge, attitudes, practices, and challenges regarding cold chain management. Methods. A concurrent mixed methods study was conducted at twelve facilities in the Sekyere Central District of Ghana. Eighty-six (86) participants took part in a survey that assessed their “cold chain management” knowledge and attitudes. Twelve (12) cold chain sites within the district were also observed in respect of their cold chain management practices. Eleven key informants were additionally interviewed to explore their challenges on cold chain management. Quantitative data were analyzed using descriptive (frequencies, percentages, means, standard deviations, ranges) and inferential statistics (Spearman’s rho correlation). Qualitative data were inductively analyzed into themes which described participants’ challenges on cold chain management. Results. Majority of the participants scored ≥70% on knowledge (68.6%) and attitudes (67.4%) toward cold chain management. However, there was a very weak positive and statistically insignificant relationship between participant’s knowledge and attitudes toward cold chain management (, ). Regarding cold chain management practices, majority of the facilities had their vaccine vial monitors attached to the vaccines (8/12, 66.7%), had functional fridge tags (8/12, 66.7%), and an appropriate refrigerator to store vaccines (7/12, 58.3%). However, the study observed that 91.7% (11/12) of the facilities did not have policies and guidelines on cold chain management while all 12 facilities (100%) did not have a contingency plan in place for equipment. With regards to the cold chain management challenges, participants raised concerns about inadequate personnel, erratic power supply, logistical constraints, and transportation difficulties. Conclusion. Although majority of the participants had good knowledge and attitude towards cold chain management, there was a weak association between them. This implies that good knowledge may not necessarily influence good attitudes towards cold chain management and vice versa. The extent to which facilities support cold chain management practices was suboptimal. Participants encountered a number of challenges which prevented them from managing the vaccine cold chain system effectively. We recommend continual professional education for cold chain practitioners, provision of adequate human and material resources for cold chain management, and enhanced monitoring and evaluation of cold chain activities. Future studies should quantitatively measure individual participants’ knowledge, attitudes, practices, and challenges on cold chain management so that we can establish the relationships that exist between these components.

中文翻译：

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加纳某地区医疗保健提供者的冷链管理：一项混合方法研究

背景。尽管冷链管理在维持疫苗效力方面具有相关性，但医疗保健从业人员有效维持冷链系统的能力仍然存在差距。因此，本研究旨在评估医疗保健提供者在冷链管理方面的知识、态度、实践和挑战。方法. 在加纳 Sekyere 中心区的 12 个设施同时进行了混合方法研究。八十六 (86) 名参与者参加了一项评估他们“冷链管理”知识和态度的调查。还观察了该地区十二（12）个冷链站点的冷链管理实践。还采访了 11 位关键线人，以探讨他们在冷链管理方面面临的挑战。使用描述性（频率、百分比、平均值、标准差、范围）和推论统计（Spearman 的 rho 相关性）分析定量数据。定性数据被归纳分析为描述参与者在冷链管理方面的挑战的主题。结果. 大多数参与者对冷链管理的知识（68.6%）和态度（67.4%）得分≥70%。然而，参与者的知识和对冷链管理的态度之间存在非常微弱的正向和统计学上不显着的关系（, ）。关于冷链管理实践，大多数设施的疫苗瓶监视器都附在疫苗上（8/12，66.7%），有功能性冰箱标签（8/12，66.7%），以及合适的冰箱来储存疫苗（7 /12, 58.3%)。然而，研究发现，91.7% (11/12) 的设施没有冷链管理政策和指南，而所有 12 家设施 (100%) 都没有制定设备应急计划。对于冷链管理的挑战，与会者提出了人员不足、电力供应不稳定、后勤限制和运输困难的担忧。结论. 尽管大多数参与者对冷链管理有良好的知识和态度，但他们之间的关联性较弱。这意味着良好的知识不一定会影响对冷链管理的良好态度，反之亦然。设施支持冷链管理实践的程度不是最理想的。参与者遇到了许多阻碍他们有效管理疫苗冷链系统的挑战。我们建议对冷链从业者进行持续的专业教育，为冷链管理提供充足的人力和物力，加强对冷链活动的监测和评估。未来的研究应该定量测量个体参与者的知识、态度、实践、