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Dear viewers - sharing the following for needful
Universally it is very well known that vaccination is one of the most cost effective public health programme from control to eradication of Vaccine Preventable diseases.
Public sector is provided with proper cold chain equipments, periodic training blended with monitoring & supportive supervision. National Immunization Schedule (NIS) is expanding; included IPV, Rota, MR, JE and Pneumococcal is the next candidate vaccine. Vaccines of NIS have Vaccine Vial Monitor (VVM).
Optional vaccines applicable to our country [Meningococcal, Seasonal Influenza, Hepatitis A, Varicella, Typhoid, HPV for females] without VVM are easily available and accessible to the affordable. Availability of vaccines in various combinations: [Triple / Quadri / Penta….]; no uniform Immunization schedule created confusion among parents. Service providers in the tertiary care centers also have confusion / difference of opinion. Pilot study conducted among Medicos [undergraduate students / post graduates / faculties] revealed dangerously low operational knowledge about routine immunization. Absence of regular monitoring / supportive supervision; periodic training of private service providers have further accentuated the quality of vaccination service; e.g. Hepatitis B birth dose vaccine is yet to be started in some of the reputed pioneer Medical Colleges and in private clinics / hospitals. To address some of these issues, COMBOCARD was developed and shared, communicated with Govt, IAP and other stakeholders. Withdrawal of current IAP schedule by the IAP President [Ref:TOI] and assurance of issuing revised schedule is a welcome step provided the entire country will follow uniform schedule compatible with NIS. Sustaining >85% coverage of optional vaccines solely by the private sector is impossible without which community may not benefit “herd immunity”. The study also revealed that administering vaccine with known potency is not the task responsibility of private service provider. To create more awareness, simplified PPT on 8 rights before vaccine administration based on CDC guidelines and GoI guidelines was shared with the stakeholders.
Proper cold chain equipment has an extremely important role in administering vaccines in potent condition which is seriously lacking in the private sector in India including private Medical Colleges. For solving this issue, “VaccineSafe” is designed and developed for the private service providers. Very few units are in use in Karnataka since 2005 due to lack of bulk manufacturer. Manufacturing locally in sufficient number incurs low cost and can solve the problem of private practitioners. With this in view, “VaccineSafe” Vs Conventional ILR with illustrations in 2 pages is attached for needful by the policymakers / global RI players / manufacturers of ILR / Pharmaceutical fridge.
Dear Narayana
With the private sector the Goverment must fix targets like improvements planns, this is because to implement equipments whitout PQS, is a risk to the vaccines. I mean, a PQS refrigerator no needs icepacks in the bottom and any part of it. The icepacks are inside between both sheets. In the pictures of the document there is evidence of corrosion in the bottom sheet. The insulation thickness in PQS is higger than commercial refrigerators, the thermostat is electronic vs mechanics, in consequence the temperature is more reliable. The laboratory which is the responsable to certify them do it 8 tests at least to guarantee the performance, quality and safety.
If the private sector. looks the cost of the vaccines inside the equipment, a PQS equipment with 15 years of useful life is not expensive.
Best regards
Dear sir
I fully agrre with you and looking for a long term solution.
With regards
Holla
Dear RAFAEL HERNAN RIVERA
I missed responding to the following observations
"In the pictures of the document there is evidence of corrosion in the bottom sheet; no needs icepacks in the bottom and any part of it"...
Above observations in one of the photos is true. In the write-up posted only theme points are discussed. During the monitoring several astonishing lapses were found but not shared as it becomes altogether a different topic by itself.
At many places, ILR were denuded of Ice-Lining itself, unable to place the baskets for making bottom and upper zones. All vaccines were (are - even now holds good) kept in the bottom. Author had dressed the ILR with icelining recovered from the condemned ILR / store at several planning units throughout the country from Karnataka to Nepal border - some of them are shared with the viewers of tehcNet in the past. A few CCH/Pharmacists in charge of the equipment argued that the equipment was supplied to them like that from the "begining" - got convineced only after demonstrating / comparing with newly supplied ILR. They do not have the cocept of maintaing the cleanliness as their task responsibility - attributable to gap in demonstrative teaching though they know partially about "defrosting" - not done on a regular basis.
In the above example, ILR had no baskets - an evergreen comon lapse all over the country. The state took the initiative and supplied the baskets but a little oversize - fitted snugly. The bottom one was not sitting on the ridge ment for suspension and hence it was placed on empty ice packs without watre in it to prevent siiting directly on the bottom.
If any body wishes to have more observations on lapses of maintenance, corrective measures under taken may contact on my personal i.d.
best regards
Holla
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