Evaluation, Awareness, Practice and Management of Cold Chain at the Primary Health Care Centers in Coastal South India

Abstract

Introduction: Vaccination is one of the most effective disease prevention strategies and potency of vaccines is dependent on effective management of cold chain at all levels of vaccine handling. The objective was to assess the status of cold chain at the primary health centers and to assess the knowledge and practices of medical officers at these centers regarding cold chain management. Materials and Methods: This cross sectional study was conducted at 70 primary health centers of Dakshina Kannada District of Coastal South India. Cold chain equipment and maintenance process was noted following direct observation on uninformed visits. Data regarding the knowledge and practices of cold chain management was obtained by interviewing the medical officers using structured pretested questionnaire. Results: Ice lined refrigerators and deep freezers were available in 69 (98.6%) and 67(95.8%) of centers. Dial thermometer was present in all the centers. Cold boxes, frozen packs and automated voltage stabilizers were available in 68(97.2%) centers. Improper vaccine storage was observed in 7 (10%) centers. Majority of medical officers had knowledge and correct practices in fields like ideal equipment, OPV administration, vaccine requiring diluents but only 47 (61.8%) medical officers had correct practice of defrosting the deep freezers. Conclusions: The availability of equipment is near universal. Improper vaccine storage practices and poor knowledge in some fields of cold chain management may adversely affect the quality of administered vaccine. Relevant training for those handling the cold chain is recommended.

Evaluation of cold chain and logistics management practice in Durg district of Chhattisgarh: pointer from Central India

“…12 The findings in our study was more than that what Mallik S et al (60%), Samath et al (65%) and Sachdeva et al (71.87%) found in their studies. [13][14][15] The present study revealed that there was poor documentation of records of power failure only in 30% CCPs.…”

“…Other researcher Naik AK et al, Gupta A et al and Roa S et al reported the same observation among two third, 66.66% and 22.4% of CCHs respectively. 11,12,16 In 1966, VVMs were introduced on oral polio vaccine. Their use was the extended to all expanded program on immunization (EPI) vaccines.…”

Assessment of cold chain maintenance for routine immunization in Jamnagar district, Gujarat

“…[13] Similarly, Rao et al in their study done at Primary Health Care Centres in South India found improper storage of vaccine in 10% of study centers. [14] In other studies done in various areas of Gujarat state, similar findings were reported by Sharma et al (90%) and Tushar et al (93.2%) that vaccines were properly arranged in the ILR. [15,16] Vaccines lose their potency due to exposure to excessive heat or excessive cold.…”

Factors affecting vaccine handling and storage practices among immunization service providers in Ibadan, Oyo State, Nigeria

“…This calls for utmost attention to vaccine handling and storage as it is essential in ensuring vaccine potency and maximizing immunisation efficacy. Several studies have made this suggestion 1,6,8,9,10 . Though a large proportion of respondents had received formal training on vaccine handling and storage, there still existed knowledge and practice gaps.…”

“…With results from this study showing a strong association between level of knowledge of vaccine management and vaccine management practices, the need arises to constantly, update knowledge of vaccine handlers about vaccine management through trainings and frequent monitoring and supervision. This has been suggested by numerous studies on vaccine and cold chain management 1,3,5,6,10 . The National Primary Health Care Development Agency (NPHCDA) should ensure the National Immunisation Policy document is available and utilized in all cold stores and health facilities conducting RI.…”