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

Cold Chain Assessment in JharkhandAppendix O provides the complete list of the staff placed at the various sites visited. It alsocovers the details of the training received.)6.9.1. Training in cold chainOnly 88 cold chain operators have received any training in cold chain. The records were betterfor some districts than others. For instance, East Singhbhum had held a training programmeat Jamshedpur in May-June 2005. But in most instances where training has been imparted,it has been a one-time programme with no follow-up.All the staff involved in the cold chain has received training in handling OPV. No specializedtraining has been provided on equipment maintenance and vaccine storage. The Early ExpiryFirst Out (EEFO) stacking practice is not followed at any site visited. There was noknowledge of bin cards at the staff level. There is considerable ignorance when it comes tohandling the T series vaccines.6.9.2. Training in maintenance of solar equipmentSince solar refrigerators are being introduced in the Jharkhand cold chain for the first time, itis extremely important that staff be trained to operate and maintain the system. A comprehensiveinitial training programme should be followed by shorter sessions at regular intervals.6.10. Monitoring and reporting systemsRecording keeping is a very important component of the cold chain. It is important in vaccineforecasting, requisitioning and stock management, assuring the quality of the cold chainthrough temperature monitoring, tracking wastage, implementing maintenance and repair,drawing up replacement and contingency plans and identifying training needs. It becomes thebasis for evaluating the performance of the cold chain.6.10.1. Temperature monitoring systemsTemperature monitoring seems to lack the kind of accuracy and consistency that is required,although the staff appear to be aware of the purpose of the entire exercise. Temperature readingsare manually recorded at 74 sites. Temperature records were not maintained at rest of thesites. Often, the temperature recording in the WHO-recommended temperature booklet(sheets of paper are also used) is done mechanically and do not reflect actual readings. Atmost sites where temperature recording is done, the twice-a-day routine seems to be followed.6.10.2. Vaccine stock registersVaccine stock registers are fairly well-maintained at 140 sites with clear entries of stock receivedand dispatched. Stock mismatch in terms of physical vs. book stock was found atsome sites. Vaccine wastage is not recorded.6.10.3. ComputerizationAt all sites, the cold chain data is manually recorded in registers. In Ranchi district, all PHCshave been computerized as part of the government’s computerization programme. The hardwarecomprises a monitor, a central processing unit, a UPS, a printer, a genset and a speciallydesigned software to collect information related to the cold chain. The hardware has beensupplied by Mumbai-based 3DI Systems (India) Pvt. Ltd.40