POST 00688E : PIS EQUIPMENT PERFORMANCE FEEDBACK
Follow-up on Posts 00670E and 00676E
21 June 2004
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Three further contributions were received on this topic. The first is by
Adelaide Shearley (mailto:
[email protected]) from WHO Namibia and the
second translated from French is by Ndiouga Diallo
(mailto:
[email protected]) . Finally, Alejo Bejemino
(mailto:
[email protected]) from UNICEF/Afghanistan shares a table
listing feedback from the field.
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1. How very true about the need for a systematic collection of performance
data of these different types of equipment used for EPI. Can the
logisticians develop a tool for appraising these units, under different
conditions i.e climatic conditions. For instance, the RCW42 is an excellent
piece of equipment for small rural clinics, but does not freeze the icepack
compartment nor maintains the +2 DEGREE to +8 DEGREE Centrigrade in very hot climates.
I have had this experience in Zimbabwe and Namibia where I have worked. The
appropriateness of the equipment should not only consider the capacity but
also the environmental conditions where the equipment is installed.
We have tried to use the temperature monitoring charts over a period of
time to assess the performance of the refrigerators, but health workers are
not always honest in the recordings of these temperatures; they record what
is expected but not what the thermometer indicates. Our other problem is
the quality of the thermometers, you find two thermometers placed at the
same place but registering different temperatures in the same fridge.The
other problem is that we do not have trained cold chain officers,
Ministries of Health do not have posts for such cadres.
If we train senior staff, we always lose them to private sector. Proper
maintenance of EPI equipment becomes even more crucial, given the
integration of more expensive new vaccines into the routine EPI.
Adelaide Shearley
EPI Focal Point
WHO Namibia
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2. It is true that problems of appropriate temperatures with RCW 50 EG
have been often reported (and observed). The fact is that, beside adjusting
the thermostat, no other actions can be taken on this type of equipment at
field level. To know the cause of the dysfunction (manufacturing defects,
incorrect use) it will be necessary to carry out investigations. However,
I find it is fundamental that each time new equipment is installed, its
users should be trained in handling it. On the other hand, any first time
certification of equipment should be followed by an active monitoring of 2
to 3 years (at the costs of the manufacturer of the equipment??) before the
final certification.
Dr Ndiouga Diallo
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3. Attached please find a table listing the various cold chain equipment
we are using in Afghanistan EPI programme and the feedback gathered from
the field. Hope these feedback will help in the improvement of the weak
cold chain units and to strengthen equipment that were performing well.
Regards.
Alejo
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