Strengthening Cold Chain & Vaccine Logistics Management (CC&VLM) 11/28/2018 Strengthening CC&VLM

Rationale of strengthening CC&VLM 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. Introduction of AD syringe in 2004-05 demands more dry space and bundling of vaccine and logistics supply Equipment or management failure at storage levels can cause destruction or large quantities of vaccine in a matter of a few hours. Introduction of new vaccines like HepB, HIb, MR etc Plans needs to be based on projected requirements for next 15-20years 11/28/2018 Strengthening CC&VLM

Component of Cold chain &VLM strengthening Human Resource Infrastructure Planning , Monitoring and Supervision Periodic Vaccine and Cold chain assessment using VMAT/EVSM tools Improved Documentation and reporting and using standard practice for Vaccine management 11/28/2018 Strengthening CC&VLM

Human Resource Strengthening Adequate Human resource posted and Available State Level: One cold chain and Vaccine manager and for large state ,additional Asst Cold Chain officer and Vaccine logistics Manager State vaccine store to be managed by trained personnel on cold chain &vaccine logistics with computer skills. Contractual pharmacist can be an option . Semiskilled helpers available on 7/24duty in State store to handle emergency, power failure and to coordinate implementation of contingency plan. State Cold chain repair team to resolve major failure in cold chain system . 11/28/2018 Strengthening CC&VLM

Human Resource … Regional/Divisional Level: Regional Cold chain and Vaccine Logistics Manager for coordination,Planning&supervision of CC&VLM. 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: Dedicated person to mange vaccine flow and storage . Each district to have one Cold chain Technician who visit field for preventive maintenance and not only for breakdown of equipment. 11/28/2018 Strengthening CC&VLM

Human resource… B. Capacity Building on CC&VLM Skill based training of cold chain technicians, store mangers on cold chain and vaccine management . Cold chain handlers training at district level by the trained personnel with practical demonstration. Regular reviews of district and block level cold chain handlers at state and district level respectively. Build capacity of programme managers to do self assessment using tools like VMAT&EVSM 11/28/2018 Strengthening CC&VLM

Infrastructure strengthening State/Divisional/Regional stores should have adequate vaccine storage space dry storage space for storage of AD syringes , Immunization cards and other immunization supplies Building to be leakage proof , well ventilated with telephone, fax and internet connectivity. power back up in the form of auto start generator Temperature monitoring devices like Graphic chart recorder, acoustic alarm should be fully functional. Working Vaccine van (Refrigerated /Non refrigerated) with driver at all level. 11/28/2018 Strengthening CC&VLM

Storage requirements and capacity A state with 40 million population, Birth Rate 22/1000 ( without HeB) 8 11/28/2018 Strengthening CC&VLM 8

Infrastructure streng… Cold chain storage need to be extended beyond block PHC to lower level PHCs where ever possible Prepare site for installation of new WIC and WIF Segregate all District Vaccine Stores attached to Divisional /Regional Vaccine store physically along with all documentation. Ensuring timely supply of spare parts . 11/28/2018 Strengthening CC&VLM

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) 11/28/2018 Strengthening CC&VLM

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 after 1-2 year to monitor progress. 11/28/2018 Strengthening CC&VLM

VMAT-Assessment graphs 11/28/2018 Strengthening CC&VLM

EVSM Assessment Results - September 2009 13 11/28/2018 Strengthening CC&VLM

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. 11/28/2018 Strengthening CC&VLM

Vaccine store register 11/28/2018 Strengthening CC&VLM

Solar Freezers 11/28/2018 Strengthening CC&VLM

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 11/28/2018 Strengthening CC&VLM

Solar Freezers Site selection Criteria Installation Procedures 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) 11/28/2018 Strengthening CC&VLM

Let us care for the vaccines for the sake of our children Thank You Let us care for the vaccines for the sake of our children 11/28/2018 Strengthening CC&VLM