Assessment of Immunisation Coverage and Cold Chain Management in Primary Healthcare Centres in Anambra State, South East Nigeria

Immunisation remains one of the most cost-effective public health interventions for reducing childhood mortality. Despite global progress, Nigeria continues to record suboptimal vaccination coverage, particularly in the South East geopolitical zone. This study assesses immunisation coverage among children aged 12 to 23 months and evaluates cold chain management practices in primary healthcare centres across three local government areas in Anambra State. A descriptive cross-sectional survey was conducted involving 280 caregivers and 15 healthcare facility managers. Data were collected using structured questionnaires and facility observation checklists adapted from WHO and UNICEF frameworks. Vaccination card verification supplemented caregiver recall to ensure data accuracy. Results indicated a full immunisation coverage rate of 62.4%, below the national target of 90%. Major barriers identified included vaccine stock-outs, irregular power supply affecting cold chain integrity, distance to health facilities, and low caregiver awareness of vaccine schedules. Cold chain equipment was functional in only 60% of assessed facilities. Healthcare workers cited inadequate training and logistical support as key operational challenges. The study recommends investment in solar-powered refrigeration systems, community health education campaigns, and routine monitoring of cold chain performance. Strengthening routine immunisation at the primary healthcare level is essential to achieving sustainable reductions in vaccine-preventable childhood diseases in Anambra State and across the South East. Keywords: immunisation coverage, cold chain, primary healthcare, Anambra State, South East Nigeria.