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

Abstract

Background: Immunization is one of the main components of primary healthcare. At the peripheral level, primary health center (PHC) is the key holder of cold chain system. One of the important elements for improving the immunization is cold chain and vaccine logistics management which is the backbone of immunization program. Objectives: The objectives of this study were to assess cold chain and logistics management for routine immunization at PHCs and community health centers (CHCs). Materials and Methods: It was a cross-sectional study conducted during November 2013–November 2014 at 20 PHCs and 10 CHCs of Jamnagar district using prestructured and pretested questionnaire. Result: A single person was assigned for cold chain handling at 15 out of 20 PHCs, all were trained and 9 out of 10 CHCs of whom only four were trained. At the time of visit, 56.7% cold chain equipments were locked. Only 36.7% cold chain equipments were having digital thermometers. Two PHCs and one CHC had stored other sera or vaccines in ice-lined refrigerators (ILRs). Proper placement of vaccine in ILR was seen at majority of PHCs and CHCs. Temperature records were proper, but alternate power source was available at 70% PHCs only. In only 20% PHCs, Medical Officers cross-checked temperature book at least 4 times in a month. Conclusion: Overall, cold chain management for routine immunization was good at all visited PHCs of Jamnagar, but some aspects need improvement such as internal monitoring, training for all cold chain handlers, and alternate source of energy in case of power failure.