Factors Associated with Cold Chain Performance for Health Products in Health Facilities in Southern Benin in 2025

Introduction: The conservation of health products is critical, as they are sensitive to environmental conditions such as temperature, light, and freezing. Their storage and transport therefore require strict temperature controls [1]. Benin, like most West African countries, faces major challenges in managing the cold chain for health products, an issue that is critical to ensuring the quality and availability of vital medicines, particularly in low-income countries. Our study aimed to identify the factors associated with cold chain performance for health products in health facilities in southern Benin in 2025. Methods: We conducted an analytical cross-sectional study in 120 health facilities drawn from 17 health zones across 6 departments in southern Benin. A proportional random probability sampling method was used to select these health facilities. The association between good cold chain performance and its potential determinants was analyzed using multiple logistic regression, after adjustment for the variables included in the model. The significance threshold was set at 0.05, with a 95% confidence interval (95% CI), using Epi Info software version 7.2.2. Results: The mean performance score was 21.98 ± 4.10, with values ranging from 11 to 32, and a mode of 23. Staff training on cold chain management (aOR [95% CI] = 4.06 [1.01 - 16.35], p = 0.0485), refrigerator age ≤ 5 years (aOR [95% CI] = 4.10 [1.33 - 12.63], p = 0.0168), availability of a preventive maintenance schedule (aOR [95% CI] = 7.72 [1.78 - 33.47], p = 0.0084), and availability of a dedicated budget line (aOR [95% CI] = 5.98 [1.97 - 18.12], p = 0.0014) were statistically associated with good cold chain performance for health products. Conclusion: The results show that cold chain performance relies on a balance between human competencies, equipment quality, structured maintenance organization, and sustainable financing. The coordinated implementation of continuous staff capacity building, the progressive renewal of aging equipment, the institutionalization of preventive maintenance, and the securing of dedicated financial resources will help sustainably improve the performance of health facilities and strengthen the safety of vaccination and public health programs.