Friday, 15 February 2008
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POST 01227E: COLD CHAIN MANAGEMENT : SUB-NATIONAL CAPACITY 16 FEBRUARY 2008 Follow-up on posts: 01226E, 01225E , 01221E, 01218, 01216, 01214E *************************************************************** BUILDING AND MAINTAINING SUB-NATIONAL CAPACITY As a part of the Reaching Every District (RED) Evaluation team led by AFRO, in which IMMUNIZATION basics participated, we anecdotally saw a number of cold chain capacity/maintenance issues that relate to this very pertinent TechNet discussion. It should be noted that the evaluation itself did not focus on the cold chain, but issues surrounding it came up while reviewing the RED component of planning and management of resources. In countries such as DRC, Ghana, Madagascar and Uganda, districts (or their equivalent) have undergone a dividing process in the recent past, with new districts created out of "mother" districts. Managerial and maintenance capacity at the district level and below becomes an even more critical issue in relation to these new districts, where the "mother" district may retain the most experienced personnel (in settings with already-limited health personnel) and a majority of the cold chain and logistics equipment (including transportation). If there is basic or limited maintenance capacity at the district level, what happens when that district divides? How are functional equipment such as refrigerators or freezers split when one district divides into two...how does one divide a vehicle? Division of districts was occurring in at least four of the nine countries reviewed in the RED evaluation, and seems a widespread enough issue across the African region to bring this up. Division of districts may not always be predictable, making it difficult for health teams to make and implement well-thought through transition plans. As Lora Shimp pointed out, staff usually find some sort of temporary solution. But it would be interesting to hear how countries that have undergone district divisions are finding longer term solutions to address capacity issues. Thanks for this very interesting discussion, [log in to unmask]">Jenny Sequeira Technical Officer JSI / IMMUNIZATIONbasics project ------------------------------------------------------------------------------------ [log in to unmask]">Lora Shimp writes in response to post 01225E: I just wanted to acknowledge this very useful, concise, and descriptive contribution. It's wonderful and necessary to have these field insights! I hope this feedback also goes to the MOHFW/UIP for nationwide and state guidance. All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. To UNSUBSCRIBE, send a message to : [log in to unmask]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Padmini Menon and is hosted in cooperation with IT Power India (www.itpi.co.in)
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