Monday, 05 September 2011
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At request of Government of India, MCHIP immunization team has prepared a ready reckoner for health workers, which captures key aspects of immunization that a peripheral health worker (ANM, LHV others) should know. Comments welcome from Technet colleagues Immunization-ready-reckoner-for-health-workers.pdf
12 years ago
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#2247
Sir The hand book is really handy and so attractive that every HCW will love to have a copy (including me). As of today I suggest the POLIO drops may please be shaded with its usual light pink color instead of blue and if possible the picture of keeping Vaccines in the ILR may please be replaced by the natural photo of the ILR. I wish to translate this to Kannada if I can get the copy in the word format and will be submitted to MCHIP. Regards
12 years ago
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#2249
This is really good. Congratulations GoI, NRHM and MCHIP! Are there other examples of similar guidance for health workers? For example, how to manage vaccine stocks, how to estimate local immunization coverage, how to be an effective supervisor Can we hear from other countries and regions, please, that have other attractive materials like these to help health workers do their jobs?
12 years ago
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#2251
Thanks for this wonderful manual, which I may label it (as) "an Immunization cookbook for health workers" because it is well presented and is (a) quick reference book which any health worker can quickly refer to in case of any doubt in immunization practice. However, I have few comments if you allow me. We need to put a page on abbreviations. There has been a talk on TechNet21 on definition of Adverse Events and Effects and I feel the two definitions would be very helpful to the health workers knowing the confusions most health workers have been having regarding the two words. Concerning the 4 and 2 hours of discarding after reconstitution of BCG and Measles respectively, this may confuse the health workers. Why can't we take a safe average duration for the two vaccines and talk of either 2 or 3 hours after reconstituting the two to avoid confusion of 4 and 2 hours? Also emphasize the importance of having a stop watch or any other means to monitor the 4 and 2 hours. It is easier to remember the condition of usable and unusable VVM stages by giving them stages: stage 1, stage 2 stage 3 and stage 4. Usable stages are stage 1 and stage 2 and unusable stages are stage 3 and stage 4. When vaccines are in stages 1 and 2, use those in stage 2 first. I feel this easier to remember. You may wish to include this in the manual. I feel we should include just few points to remember when receiving vaccines such as: what type of vaccine am I receiving? is this what I had ordered? are they physically in order are all label intact? is the expiry date okay? what is their VVM status? etc. On the cold chain, some mandatory daily activities should be emphasized knowing the sensitivity of the cold chain in the delivery of immunization services such as checking temperature twice in a day is must; the concern of frosting of the equipment, storage of other things apart from vaccines should be totally be discouraged. Include a short section on how to estimate the logistics and vaccines to avoid wastage, and (ensure) the ownership of the activities by (stakeholders) feeling they are party to the activities by participating in determining their needs. Please take these as my personal views about this good manual. You are free to ignore or take any. Thank you for the good work. Samuel M Kamau Former National EPI cold chain and Logistician, Kenya. Currently working with Micro-nutrient Initiative as EPI/ Micro-nutrient Logistics management Consultant
12 years ago
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#2252
Thank you for your comments, we are in the process of revising the ready reckoner and will address issues raised by the members. I agree that there is confusion surrounding AEFI and to keep the message simple for peripheral health worker we will stick to AEFI being defined as adverse event following immunization. You mentioned about time of use of reconstituted vaccine, in India we use BCG and Measles up to 4 hours after reconstitution and JE vaccine up to 2 hours and hence the message, and of course the health worker has to note the time of reconstitution and use the vaccine during the given time provided cold chain and other aseptic precautions are maintained. We are now promoting use of VVM in just 2 stages viz. useable and nonuseable because of our experience that workers, at times get confused in stages (e.g. stage 1, late stage 1, early stage 2 etc). This creates unnecessary issues at field level. Thanks for your suggestion on points to remember while receiving vaccines (by workers), we will include these. We have not touched on certain aspects of cold chain, which need to be managed by another cadre of workers (in India) and they are being trained separately on those issues. We have prepared some other job-aids on various topics, which are available in print ready format on request.
12 years ago
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#2253
This is an Excellent Handbook which I quite remember, PPRRIN in Northern Nigeria was also trying to develop. Well done! However, I would like to ask a question/comment which may/may not affect the handbook. The issue is about the content on page 9 of the book. The picture depicts the use of the insert/holes in the ice pack during immunization. Is it still being encouraged in the event of penta-valent and other freeze-sensitive vaccines? Please clear the issue. Thanks Paapa Turkson +233-27-7427657
12 years ago
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#2254
We are only asking the health workers to keep BCG, Measles and polio vaccine in the holes of the icepack (which is conditioned) or on the icepack. No other vaccine is to be kept in direct contact with the ice pack. This of course is to be supervised closely and workers need to be constantly reminded to follow the guidlines.
12 years ago
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#2255
Based on suggestions and comments received, we have revised the handbook. I am sharing the final version. Thanks to all for the comments and MCHIP team (Dr Manish Jain, Sachin and Vijay Kiran).Immunization-Ready-Reckoner-for-Health-Workers-India.pdf
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