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Increasing the quality of immunization services is one of the strategies to reach at objective of EPI in Ethiopia. Infant and childhood mortality in Ethiopia are still among the highest in the world. Each year more than one-third of a million children die from infectious disease where the prevention and control measures are available. Majority of health facilities rated as adequate in terms of equipment and supply necessary for EPI services. But majority of health posts lack refrigerators. Below or above normal temperature in the fridge and inappropriate arrangement of vaccines in the fridge were found to be the key constraints concerning vaccine handling and cold chain management. Factors related with service provider were found to be important determinants of client satisfaction. Although it has been argued that clients do not know what the technically acceptable level of care is, it is agreed that dissatisfaction is an indication that services delivered are lacking in some aspects of provider related factors.