Evaluation of cold chain management system at district vaccine storage level in Thailand, 2015

Abstract

This study aims for evaluation of the cold chain management system at district level in all aspects including vaccine request and management of the stock, recording system, vaccine storage, cold chain main­tenance, human resource and emergency plan for cold chain breakdown. The study was carried out during February to July 2015 by a team composed of cold chain experts from national immunization program at central and regional levels. Multistage sampling was done. One province of each Regional Health area was randomly selected for 12 regions, and 3 district-level cold chain storages were randomly selected. Finally 36 district cold chain storages were recruited. The evaluation instrument was developed using checklist based on national standard guideline on cold chain management system. The monitoring and evaluation was performed through field visit and interview of the key responsible person at district-level cold chain storage. There are 26 district-level cold chain storages (72.2%) that achieved standard level of cold chain management. Most of them reached high score maintenance of the refrigerator’s temperature at 2 to 8 degree Celsius, having adequate number of standard cold chain equipments and appropriate arrangement of vaccines in the fridge and providing good maintenance of the cold chain storage. Key gaps included inconsistency between vaccine request and management of the stock, lack of regular monitoring and updating of the vaccine stock and recording system and inadequate planning in case of cold chain breakdown. Based on the findings, key recommendations include the following:- (1) Stock management system needs to be regularly monitored and adjusted to the current use rate to minimize wastage rate (2) Regular training for cold chain personnel and regular monitoring and evaluation at district-level cold chain storages are needed to improve cold chain sys­tem in the long run. (3) The Provincial Health Office should play key role as cold chain manager at provincial level while the Department of Disease Control provides technical support as well as external monitoring and evaluation.