Properly functioning cold Chain Equipment (CCE) is necessary to store vaccines at the desired temperature to protect their potency. Cold Chain Monitoring refers to the collection and analysis of CCE performance data to enable corrective and preventive action that leads to an overall improvement in the immunization system.
There is currently no systematic and central monitoring mechanism for CCE deployed in Pakistan and Bangladesh. This gap in equipment feedback from the country’s immunization systems causes poor design or performance to go unnoticed and unaddressed by the relevant stakeholders.
In February 2020, IRD’s Maternal & Child Health (MCH) program, in collaboration with the government of Sindh, EPI, and WHO, launched a comprehensive monitoring system to track the performance of cold chain equipment in Pakistan and Bangladesh. In Pakistan, the project was implemented at 45 immunization centers in Korangi (Karachi) and 48 centers in Tharparkar. The same monitoring system was implemented at 20 immunization centers in Bangladesh.
The monitoring system helps in prompt identification of any fault in the vaccine refrigerators that can alter the vaccine temperature from the optimum level. Any faults in the refrigerator are reported as heat or freeze alarms depending upon the deviation of temperature above or below the standard range.
Monitoring reports from the selected immunization centers are shared with the national and international stakeholders for preventive and corrective measures.
Between February 2020 and May 2021, IRD monitored the performance of 153 refrigerators in Pakistan and 52 refrigerators in Bangladesh on a monthly basis.
The most common issues identified during the monitoring period were due to equipment performance, human error, or external factors. Most of these issues are preventable in nature and can be avoided with prompt identification and action.
The monitoring system has proved to be successful and sustainable in improving the cold chain performance and thereby protecting the vaccine potency. The monitoring system has the potential to be implemented across all the immunization centers in Sindh as well as other provinces of Pakistan.