Evaluation Of Cold Chain Practices in Urban Health Centers of a Metro City in India
Keywords:
Cold chain, Ice lined refrigerator, Deep freezers, Urbanhealth centers, IndiaAbstract
Background: National Family Health Survey report (NFHS)-3 reports revealed that immunization coverage in India among children between 12-23 months was low at 43.5%. In lieu of strengthening Routine Immunization (RI), Government of Karnataka undertook state-wide training of Medical officers and Health workers on RI with concurrent efforts of strengthening cold chain system in health centers. With this background, this study was undertaken to assess the cold chain practices in urban health centers of Bangalore city.
Methodology: This Cross-sectional study was conducted during October-December 2008 in three-zones of Bruhat Bangalore Mahanagara Palike (BBMP) covering 35 units. Physical verification of the available cold chain equipments was done using predesigned pretested checklist and face to face interview of cold chain handlers was employed.
Results: Of 35 centers, 33(94%) and 32(91%) of them had atleast one functional Ice-lined refrigerator(ILR) and one deep freezer(DF) respectively. Good storage code practice was practiced in 12 out of 33 ILRs. Functional thermometer was available in 31(91%) ILRs of which 23(74%) had temperature in the recommend range. With respect to knowledge of cold chain handlers on RI, 86% were trained on RI and their overall knowledge regarding cold chain practices was satisfactory except for knowledge on temperature in DF and on conditioning of ice-packs.
Conclusion: Availability of cold chain equipments has improved and Cold storage practice was good/fair in most of the centers. Knowledge of cold chain handlers was low with respect to select cold chain practices.
References
Govt. of India. Handbook for vaccine and cold chain handlers. Ministry of Health & Family Welfare, New Delhi; 2010.Available from www.unicef.org/india/Cold_chain_book_Final_ (Correct-ed 19-04-10).pdf. Accessed on 2013 March 1st.
National Rural Health Mission & United Nations Children’s fund. National cold chain assessment India, July 2008. New Delhi, India: UNICEF & NRHM; 2008. Available from:http://www.unicef.org/india/National_Cold_Chain_Assessment_India_July_2008.pdf.Accessed on 2013 March 17th.
Guidelines on how to maintain vaccine cold chain. Available at:https://www.moh-ela.gov.sg/ela/content/Vaccine_Cold_ Chain.pdf2005. Accessed on April 10th 2013.
National Family Health Survey, Key indicators for Karnataka. Available at: http://www.rchiips.org/nfhs/pdf/Karnataka.pdf. Accessed on March 17th 2009.
Government of India. Immunization hand book for Medical Offic-ers. Ministry ofHealth & Family Welfare, New Delhi; 2008. [Available from http://nihfw.org/pdf/NCHRCPublications/ ImmuniHandbook.pdf] Accessed on 2013 March 1st.
Rao S, Naftar S and Baliga S and Unnikrishnana B. Evaluation, Awareness, Practice and Management of Cold Chain at the Prima-ry Health Care Centers in Coastal South India. Journal of Nepal Paediatr. Soc, 2012; 32 (2):19-22
Goel NK, Swami HM, Bhatia SP. Evaluation of cold chain system in Chandigarh during PPI campaign 2001–2002. Indian J Public Health. 2004;48:200–204
Deoki Nandan, Hamid Jafari, Utsuk Datta, Sunil Bahl, Renu paruthi, Bhattacharya M et al. Performance Assessment of Health Workers Training in Routine Immunization in India (WHO and NIHFW collaborative study).India: December 2009.
Yogindra Samant, Hemant Lanjewar, David Parker, Lester Block, Gajendra S. Tomar, Ben Stein. Public Health Rep. 2007 Jan-Feb; 122(1): 112–121.
Goel N K, Pathak R, Galhotra A, Dankal C, Swami H M. Status of cold-chain maintenance in Chandigarh.Indian J Public Health 2008;52:37-39
Mallik S, et al. Assessing cold chain status in a metro city of India: an intervention study. Afr Health Sci. 2011 March; 11(1): 128–133.
Sharma DK, Varun A, Patel R, Singh US. Process Evaluation of Immunization Component in Mamta Diwas and Support Services in Kheda District, Gujarat. Natl J Community Med 2013; 4(1): 81-5.
World Health Organization, Department of Immunization, Vac-cines and Biologicals, Geneva. Training for mid-level managers (MLM) - Module 1. Cold chain, vaccines and safe-injection equip-ment management. Geneva, Switzerland: WHO; 2008. p17. Avail-able from http://whqlibdoc.who.int/hq/2008/ WHO_IVB_08.01_eng.pdfAccessed on 2013 April 13th
Harsha Kumar HN, Aggarwal A. Cold Chain Maintenance and Vaccine Administration Practices in hospitals & clinics of Manga-lore City – A Health System’s Research. Natl J Community Med 2013; 4(2): 231-235.
Naik Ashish, Rupani Mihir, Bansal RK. Evaluation of vaccine cold chain in UrbanHealth Centres (UHCs) of Municipal Corpora-tion of Surat city, Western India.Int J Prev Med 2013; 4:1395-401.Available from: http://ijpm.mui.ac.ir/index.php/ijpm/ arti-cle/view/916. Accessed on 2013 July 1st
Tushar Patel, Devang Raval, Niraj Pandit. Processevaluation of routine immunization in rural areas of Anand District of Gujarat. Health line 2011; 2(1):17-20.
VVMhistory and milestones. Available at: http://www.who.int/immunization_standards/vaccine_quality/VVM_history_milestones.pdf. Accessed on 2013 July 5th.
Samant Y, Lanjewar H, Block L, Parker D, Stein B, Tomar G. Relationship between vaccine vial monitors and cold chain infra-structure in a rural district of India. Rural and Remote Health. 2007; 7:617. Available from: http://www.rrh.org.au. Accessed on 2013 April 8th.
UNICEF, Final report, Cold chain assessment Chhattisgarh, 2009. Pg 46. Available from: http://nccvmtc.org/PDF1/1_005.pdf. Ac-cessed on 2013 July 8th.
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