title: Assessing cold chain status in a metro city of India: an intervention study.
abstract: BACKGROUND
  Cold chain maintenance is an essential activity to maintain the potency of vaccines and to prevent adverse events following immunization. One baseline study highlighted the unsatisfactory cold chain status in city of Kolkata in India.
  
  
  OBJECTIVE
  To assess the changes which occurred in the cold chain status after the intervention undertaken to improve the status and also to assess the awareness of the cold chain handlers regarding cold chain maintenance.
  
  
  METHODS
  Intervention consisted of reorganization of cold chain points and training of health manpower in Kolkata Municipal area regarding immunization and cold chain following the guidelines as laid by Govt of India. Reevaluation of cold chain status was done at 20 institutions selected by stratified systematic random sampling after the intervention. The results were compared with baseline survey.
  
  
  RESULTS
  Significant improvement had been observed in correct placing of cold chain equipment, maintenance of stock security, orderly placing of ice packs, diluents and vaccines inside the equipment, temperature recording and maintenance. But awareness and skill of cold chain handlers regarding basics of cold chain maintenance was not satisfactory.
  
  
  CONCLUSIONS
  The success of intervention included significant improvement of cold chain status including creation of a designated cold chain handler. The gaps lay in non-availability of non-electrical cold chain equipment and separate cold chain room, policy makers should stress. Cold chain handlers need reorientation training regarding heat & cold sensitive vaccines, preventive maintenance and correct contingency plan.
authors.affiliation: Dept of Community Medicine, Midnapur Medical College, West Midnapur, West Bengal, India. sarmila46@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Mallik
authors.forename: P K
authors.initials: PK
authors.lastname: Mandal
authors.forename: C
authors.initials: C
authors.lastname: Chatterjee
authors.forename: P
authors.initials: P
authors.lastname: Ghosh
authors.forename: N
authors.initials: N
authors.lastname: Manna
authors.forename: D
authors.initials: D
authors.lastname: Chakrabarty
authors.forename: S N
authors.initials: SN
authors.lastname: Bagchi
authors.forename: S
authors.initials: S
authors.lastname: Dasgupta
mesh_terms: D003080:Cold Temperature; D004356:Drug Storage / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007194:India; D011361:Professional Competence; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012034:Refrigeration / Q000379:methods / Q000592:standards*; D014505:Urban Population; D014612:Vaccines / Q000600:supply & distribution*
chemical_list: D014612:Vaccines