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

Cold Chain Assessment in Jharkhand! No training has been provided on the use of safety boxes and hub cutters.7.5. Record keeping! Temperature recording in inaccurate.! The vaccine stock registers do not reflect damaged and returned stocks and are not up-todateat all sites.! At quite a few sites, there was a mismatch between stocks available and stocks recorded.! Maintenance and repair activities (equipment and transport) are not recorded.! There is no record of training programmes attended.8. RECOMMENDATIONS8.1. Short-term! A plan as to what is to be done with ‘beyond repair’ and ‘non-working’ equipment needsto be drawn up. Special care needs to be taken when it comes to disposal of CFC machines.! The average working life for each piece of equipment needs to be defined and proceduresfor removing the equipment from the inventory described.! Units which are rusted externally and internally (CFC/non-CFC) and where the fault liesin the sealed system should not be repaired and should be removed from the inventory.! All CFC equipment which is not working and the body has rusted (indicating reducedlife-span) should not be repaired. All non-CFC units that have been repaired once andbecome non-functional again should not be repaired. Frequently, the unit has been damagedbeyond repair by the local mechanics if the sealed system has been touched.! Stabilizers need to be repaired centrally with clear instructions not to by-pass any safetycontrol measure.! Wiring and earthing need to be corrected on a priority basis.! Voltas now supplies a stabilizer that can deal with low voltage. It is recommended thatits performance be observed for some time and if found efficient, it be adopted for use atall PHCs.! Maintenance should preferably be preventive and not fire-fighting as is the present approach.Funds must be made available through UNICEF for better and more regularmaintenance coverage. Contract could be given to one sub-contractor with strict performance-boundcontract renewal clauses.! Some PHCs stock relatively large quantities of vaccine. This is inadvisable when there isinsufficient backup power. Although the catch-up programme could be one explanationfor the stocks, it is suggested that UNICEF immediately review quality and size of stockat each location.! An immediate review is required of the proposed solar systems. Although this is a hybridsystem, allowance should be made for low grid electricity inputs and frequent breakdowns.The load seems also relatively high: extractor fan, plugs and lights as well as oftena room fan. Systems should be sized according to demand, electricity availability and43