Post 00980e : Cold Chain Capacity Assessment

POST 00980E : COLD CHAIN CAPACITY ASSESSMENT Follow-up on Posts 00965E, 00971E and 00974E 27 September 2006 _____________________________________ This posting contains four contributions. 1. from Anil Varshney ([log in to unmask]" eudora="autourl">mailto:anil[log in to unmask]) from India. 2. from Andrew Garnett ([log in to unmask]" eudora="autourl">mailto:[log in to unmask]) from the United Kingdom. 3. from Alasdair Wylie ([log in to unmask]" eudora="autourl">mailto:[log in to unmask]) also from the UK. Alasdair sends an example of a spreadsheet introduced by WHO/EURO in Uzbekistan. His message also contributes to the discussion of the meeting agenda topic "Vaccine Management". 4. from Dereje Ayalew ([log in to unmask]" eudora="autourl">mailto:[log in to unmask]" eudora="autourl">[email protected]) from Ethiopia. _____________________________________ Dear ALL It’s interesting calculating cold chain capacity. I had used an Excel sheet in 2001 while working with PATH as project manager, when we were introducing the Hepatitis B vaccine in the state of Andhra Pradesh as well as JE vaccine in the state’s 23 districts in a camp mode. The basis were 1. the universe - i.e number of chidren targeted at point A (the present) and the children a decade later 2. Detailed population analysis was done to calculate the infants in each sub-centre 3. All vaccines with their volumes in multidose vial were actually measured in their single bottle packings and cartons 4. The dosages required at each store from PHC to state was calculated with buffer, 25 % space for air circulation, plus other variables 5. Thus volume of cold chain required now at each point of store was calculated 6. Existing cold chain store capacities at each location was compiled and compared with the calculated voulmes required for all vaccines. 7. Projection was then based for next decade and then compared the volumes at each location as we did for stage A 8. Excess requirements were calculated thus for future including volumes for Hepatitis B and JE vaccines, Polio NIDs, measles campaign if any, 9. A volume requirement comparison was made with single dose vaccine and multi dose vaccine vials 10. It was discovered that most PHCs had adequate stores for next decade infant need, except change for old ILRs 11. Need was only for state and few district level stores and regional stores, which were ordered in a phased manner over a 5-year period, first for state and later lower level regions 12. The same was proved right when first the JE vaccine campaign was carried out and later HBV introduced Similar cold chain for the country for the WB supported project and in other SE countries, I will search my old records and share the same with all With kind regards DR ANIL VARSHNEY Independant healthcare management consultant -------------------------------------- Dear Claude, For day to day vaccine management, Dr Biellick might like to look at the Andhra Pradesh Management Information System developed recently by IT Power, India. This is a rather sophisticated network-based MIS that performs the following tasks: Transactions: * Shipment activity: Records arrival and dispatch of vaccines, consumables, spares and equipment. * Damaged vaccines: Maintains record of damaged vaccine. * VVM changes: Records changes in VVM stage. Stage 2 vaccines are automatically issued in preference to VVM stage 1 vaccines when a shipment order is prepared. * Multilog data transmission: Temperature monitoring records. * Expired vaccine: Overview and detailed views of expired vaccines. Ledgers: * Vaccine in stock: Overview and detailed view of vaccines in stock. * Consumables in stock: Overview and detailed view of consumables in stock. * MIS reports: Multiple report generation with sophisticated filtering options. Reports include vaccine and consumables stock, storage capacity utilization, vaccine/consumables ratios, expired vaccine and several others. * Equipment information: Records of equipment at each facility. * Spares in stock: Record of spare parts Messaging: Internal messaging system. Contact Ranjit Dhiman [log in to unmask]" eudora="autourl">mailto:[log in to unmask] For forward planning purposes Umit Kartoglu and I have developed an upgraded version of the WHO Vaccine Volume Calculator. This is designed to be used for forward planning purposes (over a 5 year period). It models the flow of vaccine through a single store and is specifically designed to deal with new vaccine introduction and multivalent vaccine substitutions. Contact me for details. Regards, Andrew Garnett ---------------------------------- A further tool which I do not think has yet been mentioned , and which I have referred to Robin Biellik, is a spreadsheet introduced in Uzbekistan by WHO/EURO for use initially at national level, when EVSM assessment was done there early 2005. An example of the national level one is attached. There are discrepancies in the figures for available cold chain capacity (so this may not have been the final version) but you will get the idea. Suggest contact Eric Laurent at EURO for further info. Mailto:[log in to unmask] This tool was adapted and introduced at oblast (regional store) level in Uzbekistan by UNICEF/MOH in Aug 2005 when I was working with them on a Vaccine Management Assessment. I have copies of the speadsheets for four regional stores, in russian, if anyone wants. I am concerned by the suggestion in Robin's message (post 965E), that cold chain capacity assessment may not have been done (well enough) prior to the introduction of rotavirus vaccine in various Latin America countries. There are very likely country examples from the HepB/Hib vaccine introduction experience since 2000 which illustrate the risks of not doing good capacity assessment at the right time in the planning process. What are we learning (or not) from experience? In light of this I think it is important that the Technet meeting should give adequate time to discussing the role and experience of cold chain capacity assessment (availability, as opposed to just needs) in planning for new vaccine introduction. Such assessment should be mandatory, not optional, as part of good planning process, and should be conducted by experienced logisticians - who should of course be included in any vaccine introduction assessment exercise. Have they always been? Best regards Alasdair Wylie Consultant, Immunization Management & Logistics ------------------------------------------- Dear all. I would like to contribute towards the development of this tool, which I am very much interested. This is an assessment tool, and at the end of the assessment, this tool should give us the gap at various levels (Regional, Zonal, District ...) just like the Vaccine Management Assessment tool. In this case the questionnaires that we should ask at all levels should be different. To mention few At National level Apart from cold chain inventory, we should know the country plan in terms of coverage improvement, population growth in the next few years, new strategies to enhance coverage, frequency of supply (6 month or 3 month) etc... At sub national levels Type of equipment (PIS approved or not), Age of equipment, temperature monitoring, spare part availability, maintenance, etc At service delivery level Type of equipment (PIS approved or not), Age of equipment, Availability of emergency plan, etc. Regards Dereje Ayalew WHO Ethiopia ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. 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