Dear TechNet Colleagues,
I would like to share with you a report on our latest cold chain maintenance investigation in Mozambique: "Why Fridges Fail Part 2: RTM Data for Maintenance".
We are beginning to document how remote temperature monitoring data and dashboards can be used by maintenance technicians to significantly improve cold chain performance.
This assessment follows up on the randomized control trial conducted in 2014-2015 with Village Reach, PATH, and the Ministry of Health in Mozambique which aimed to evaluate the impact of remote temperature monitoring (RTM) on vaccine cold chain equipment performance at the health facility level. That study showed that RTM with SMS alerts increased fridge uptime and reduced freezing (See Appendix I of the report for more details.)
However, even some fridges in the RTM intervention group had chronic problems and failed to achieve 95% uptime.
We launched this follow-up investigation to answer the question: Can maintenance + RTM lead to 95% uptime?
We were very happy to work with Soren Spanner, a global cold chain expert with decades of experience. Soren traveled to Mozambique from September 24 until October 14, 2015. He used ColdTrace data to identify 27 fridges that were failing and worked with the Ministry of Health maintenance technician to visit or remotely diagnose and fix as many fridges as possible. Soren remained active in fridge fixes, phone calls and follow-ups through the end of November.
Perhaps the most interesting finding was that distinct patterns in the RTM data (which we call “temperature data signatures”) can be used to remotely diagnose problems and enable remote fixes via phone calls to nurses in clinics. For the improperly adjusted fridges in this investigation, thermostat adjustments increased uptime by 30%. Today, the MOH technician continues to use the dashboard data to diagnose problems, call clinics to address the issues, and verify fixes by monitoring subsequent temperature data. We also learned that, without access to key spare parts/tools, even an expert technician cannot get all fridges to 95%: flat batteries on solar fridges were one such problem that Soren did not have the resources to fix. With RTM data, however, those responsible for cold chain maintenance can identify which fridges need help and determine where to focus resources.
This report features all causes of fridge failure that the Technicians encountered, several key screenshots from the ColdTrace web dashboard, and critical recommendations for how to procure for and improve cold chain maintenance capacity at every level of the health system moving forward.
We hope you’ll find these results approachable and easy to understand. I would greatly appreciate your feedback on the report and I hope we can start a discussion here on how temperature monitoring data could improve maintenance.