Immunization Recorder by kbi18197


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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

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            Component of Cold chain &VLM
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
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Human Resource Strengthening
A. Adequate Human resource posted and
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 .

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             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.

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             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

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            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
   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)


                        Present Plan      + MR        Pentavalent   Pneumococcal Pneumococcal
                         ( without HeB)
                                                                        (3M)        (2 M)
                                            Immunization Plans
                     Space Required       Total Space Available        Addl. Space Required
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            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 .

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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)
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   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
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
                             70% 66%                                                     re
       21%        100%
                                                                                  100%        83%   67%
      Wastage                      Capacity
                  80%                                                  Wastage                      Capacity
                  40%                    76%                                                              67%
  MDVP                                   Equipment                                40%
                  20%                                           MDVP                                      Equipment
  97%                                    85%                                       0%
                                         Maintenanc              97%                                      Maintenan
                                              e                  VVMs
       93%                           70%
       Diluents                    Stock mgt                           80%                           61%
                                                                       Diluents                     Stock mgt
                                      Performance at BVS level
                                    2009 - 38 BVS; 2007 - 28 BVS
                                               ure 74%
                                    22% 100%          100%
                                   Wastage      80%         Capacity
                                                60%              88%
                                                40%             Equipme
                                                20%                nt
                                                 0%               82%
                                   90%                          Maintena

                                    73%                          59%
4/11/2011                                                      mgt
                                               Strengthening CC&VLM                                             12
 EVSM Assessment Results - September 2009
                            C1: Pre-shipment
                               and arrival
                46%           100%         11%
        C7 + C8: Vaccine           80%                           54%
                                                             C2: Temperature
           deliveries              60%                         monitoring
          and damage


                                     0%                            33%
                                                                  C3: Available
  C6: Stock control
                                                                 storage capacity

                      68%                              C4: Buildings,
              C5: Maintenance                           equipment,
                                                         transport             13
4/11/2011                       Strengthening CC&VLM                                13
            Improved Documentation and
• 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.
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            Vaccine store register

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            Solar Freezers

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              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
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                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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