Report on Cold Chain Assessment of Jharkhand - 2005 - Nccvmtc.org

Cold Chain Assessment in JharkhandTotally, 213 sites were visited, which included 190 PHCs, 22 district stores and central store.The teams were advised against visiting two sites: Gawan (Giridih district) and Satgawan(Koderma district) since they were considered potentially unsafe.The forms used to record the findings were countersigned by the staff responsible for handlingthe cold chain. In most cases, the Medical Officer in-Charge (MOiC), or the LadyHealth Volunteer (LHV) or ‘Computer operator’ (an accounts-related post) was interviewed;in the absence of the cold chain in-charge, the Auxiliary Nurse and Mid-wife (ANM) or otherstaff were interviewed. Wherever possible, all staff related to the cold chain were interviewed.Based on the feedback and data collected from the field, a list of recommendations has beendrawn up.A more detailed description of the methodology is given below.4.1. Assessment of siteThe assessment team visited each site in the state to review quality of buildings, equipmentand transport. Sites were assessed to determine adequacy of space, ventilation, space forpacking and loading vaccine for onward despatch, location of burial pit or incineration siteused for the disposal of safety boxes, and availability of staff to monitor cold chain in theevent of power failure.4.2. Assessment of electrical cold chainAll the sites were assessed to evaluate vaccine storage capacity, stacking procedures, capacityto produce ice-packs for regular and campaign programmes and functional status of equipment.The power supply connections, stabilizer support, earthing of equipment, and temperaturelog books were also examined. The equipment was broadly classified into three categoriesnamely: Working (functional), Not Working (non-functional equipment, but could be repaired)and Condemned or Beyond Repair. 5 Maintenance and record keeping procedureswere evaluated.4.3. Assessment of non-electrical cold chain equipmentNon-electrical cold chain equipment includes cold boxes, vaccine carriers, ice-packs andthermometers. All sites were reviewed for their present stock and condition of the equipment.Cold boxes were physically checked for damage to hinges, locks, handles, lids, gaskets andchains and the body itself.4.4. Assessment of power situation and back-up power supply mechanismTo evaluate the power supply situation, the staff at the site were interviewed regarding hoursof assured supply, usage of the generator, fuel purchase, and funds for fuel. The temperaturerecord book was examined to corroborate information. Information garnered on power supplytended to be rather subjective and was frequently not substantiated by the temperature readingsand generator usage recorded.4.5. Assessment of vaccine storage and delivery mechanismStock books used for recording the entry and despatch of vaccines and diluents were checkedto evaluate stock management and record keeping. Vaccine consumption during routine im-5 Beyond repair: extensive damage to the body; rusted, damaged CFC-based compressors; the Voltas maintenancetechnicians have marked the equipment as ‘condemned’.10