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Immunization Recorder document sample
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Strengthening Cold Chain &
Vaccine Logistics
Management (CC&VLM)
4/11/2011 Strengthening CC&VLM 1
Rationale of strengthening CC&VLM
1. Wide network of cold chain stores( GMSD,State,Regional, Divisional ,
District and PHC) that has been created since inception of
UIP (1985) needs renovation and up gradation.
2. Introduction of AD syringe in 2004-05 demands more
dry space and bundling of vaccine and logistics supply
3. Equipment or management failure at storage levels can
cause destruction or large quantities of vaccine in a
matter of a few hours.
4. Introduction of new vaccines like HepB, HIb, MR etc
5. Plans needs to be based on projected requirements for
next 15-20years
4/11/2011 Strengthening CC&VLM 2
Component of Cold chain &VLM
strengthening
1. Human Resource
2. Infrastructure
3. Planning , Monitoring and Supervision
4. Periodic Vaccine and Cold chain assessment
using VMAT/EVSM tools
5. Improved Documentation and reporting
and using standard practice for Vaccine
management
4/11/2011 Strengthening CC&VLM 3
Human Resource Strengthening
A. Adequate Human resource posted and
Available
State Level:
1. One cold chain and Vaccine manager and for large state ,additional
Asst Cold Chain officer and Vaccine logistics Manager
2. State vaccine store to be managed by trained personnel on cold
chain &vaccine logistics with computer skills. Contractual pharmacist
can be an option .
3. Semiskilled helpers available on 7/24duty in State store to handle
emergency, power failure and to coordinate implementation of
contingency plan.
4. State Cold chain repair team to resolve major failure in cold chain
system .
4/11/2011 Strengthening CC&VLM 4
Human Resource …
Regional/Divisional Level:
1. Regional Cold chain and Vaccine Logistics Manager for
coordination,Planning&supervision of CC&VLM.
2. Semiskilled helpers available on 7/24duty in Regional and Divisional
stores to handle emergency, power failure and to coordinate
implementation of contingency plan.
District Level:
1. Dedicated person to mange vaccine flow and storage .
2. Each district to have one Cold chain Technician who visit field for
preventive maintenance and not only for breakdown of equipment.
4/11/2011 Strengthening CC&VLM 5
Human resource…
B. Capacity Building on CC&VLM
1. Skill based training of cold chain technicians, store
mangers on cold chain and vaccine management .
2. Cold chain handlers training at district level by the
trained personnel with practical demonstration.
3. Regular reviews of district and block level cold chain
handlers at state and district level respectively.
4. Build capacity of programme managers to do self
assessment using tools like VMAT&EVSM
4/11/2011 Strengthening CC&VLM 6
Infrastructure strengthening
1. State/Divisional/Regional stores should have
a. adequate vaccine storage space
b. dry storage space for storage of AD syringes ,
Immunization cards and other immunization
supplies
c. Building to be leakage proof , well ventilated with
telephone, fax and internet connectivity.
d. power back up in the form of auto start generator
e. Temperature monitoring devices like Graphic chart
recorder, acoustic alarm should be fully functional.
f. Working Vaccine van (Refrigerated /Non
refrigerated) with driver at all level.
4/11/2011 Strengthening CC&VLM 7
Storage requirements and capacity
A state with 40 million population, Birth Rate 22/1000
Vaccine storage space required
WIC state level +1 Months)
Vaccine storage space required in in WIC atat state(2level (2 +1 Months)
80,000
70,000
60,000
Litres
50,000
Litres
40,000
30,000
20,000
10,000
0
Present Plan + MR Pentavalent Pneumococcal Pneumococcal
( without HeB)
(3M) (2 M)
Immunization Plans
Space Required Total Space Available Addl. Space Required
8
4/11/2011 Strengthening CC&VLM 8
Infrastructure streng…
2. Cold chain storage need to be extended beyond
block PHC to lower level PHCs where ever possible
3. Prepare site for installation of new WIC and WIF
4. Segregate all District Vaccine Stores attached to
Divisional /Regional Vaccine store physically along
with all documentation.
5. Ensuring timely supply of spare parts .
4/11/2011 Strengthening CC&VLM 9
Planning ,Monitoring & Supervision
• Each state to have CFC phase out plan, need
based cold chain facility expansion plan for
effective vaccine delivery to outreach session
and monitoring .
• Installation of Solar refrigerators for difficult to
reach areas with out electricity or poor supply
• Increased field visit of state programme officers
for immunization and cold chain monitoring at
District, Block and cold chain facilities .
• District wise review of cold chain performance
indicators like
• Sickness Rate( SR)
• Down Time (DT)
• Response Time (RT)
4/11/2011 Strengthening CC&VLM 10
Periodic Vaccine and Cold Chain
Assessment –VMAT/EVSM
• Build the capacity of departmental staffs on
Vaccine management assessment.
• Capacity to do self assessment and improve
the existing gaps.
• Identify the gaps and do all possible on site
correction and provide input for long term
planning
Standard tools available like : VMAT and EVSM
Orissa ,Bihar &Jharkhand have conducted
assessment in 2007-09 , initiated steps to improve,
self follow up assessment should be done
4/11/2011 Strengthening CC&VLM 11
after 1-2 year to monitor progress.
VMAT-Assessment graphs
Performance at RVS level Pperformance at DVS level
2009 - 7 RVS; 2007 - 6 RVS
Temperatur 2009 - 10 DVS; 2007 - 18 DVS
Temperatu
e
70% 66% re
21% 100%
100% 83% 67%
Wastage Capacity
26%
80% Wastage Capacity
80%
60%
60%
40% 76% 67%
MDVP Equipment 40%
20% MDVP Equipment
20%
0%
97% 85% 0%
88%
VVMs
Maintenanc 97% Maintenan
e VVMs
ce
93% 70%
Diluents Stock mgt 80% 61%
Diluents Stock mgt
41%
Delivery
Delivery
38%
Performance at BVS level
Temperat
2009 - 38 BVS; 2007 - 28 BVS
ure 74%
22% 100% 100%
Wastage 80% Capacity
60% 88%
40% Equipme
MDVP
20% nt
0% 82%
90% Maintena
VVMs
nce
73% 59%
Stock
Diluents
4/11/2011 mgt
Strengthening CC&VLM 12
Delivery
53%
EVSM Assessment Results - September 2009
C1: Pre-shipment
and arrival
1
procedures
46% 100% 11%
C7 + C8: Vaccine 80% 54%
C2: Temperature
deliveries 60% monitoring
and damage
40%
20%
0% 33%
53%
C3: Available
C6: Stock control
storage capacity
52%
68% C4: Buildings,
C5: Maintenance equipment,
transport 13
4/11/2011 Strengthening CC&VLM 13
Improved Documentation and
Reporting
• Standardized vaccine management registers
from State to SC for indenting ,reporting
,vaccine utilization and monitoring wastage.
• Establish system of regular, planned vaccine
flow from and to the next cold chain point.
• Use MIS like ProMIS/HMIS/RIMS and to link
state, Divisional and District Vaccine stores to
monitor real-time vaccine stock situation and
online transactions.
4/11/2011 Strengthening CC&VLM 14
Vaccine store register
4/11/2011 Strengthening CC&VLM 15
Solar Freezers
4/11/2011 Strengthening CC&VLM 16
States with Solar Freezers
• States presently using Solar Freezers:
– Assam ,
– NE States,
– Jharkhand,
– Orissa
• States to be supplied with Solar Freezers in 2010:
– HP-10, J&K-20, UP-20,Arunachal Pradesh-30,
– Assam-20,Manipur-20,Meghalaya-20,Mizoram-10,
– Nagaland-20,Orissa-30,Skkim-10,Tripura-10
– Chattisgarh-20,Rajasthan-20,maharastra-20,MP-20
4/11/2011 Strengthening CC&VLM 17
Solar Freezers
Site selection Criteria
• Functional PHC
• Inaccessible areas with poor supply of electricity
• Some body available to take care of batteries ,
panels and regular preventive maintenance and
security issues.
Installation Procedures
•Offshore items comes to GMSD( Kolkata and Mumbai)
•Comes with Toolkits, Spare parts and installation procedure
•Cold chain Technicians of these states to be trained centrally( SHTO,Pune)
4/11/2011 Strengthening CC&VLM 18
Thank You
Let us care for the
vaccines for the sake of
our children
4/11/2011 Strengthening CC&VLM 19
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