title: Evaluation of the availability of cold chain tools and an assessment of health workers practice in dammam.
abstract: OBJECTIVE
  To evaluate the availability of cold chain tools and assess the practice of health workers in immunization rooms in health clinics in the Dammam area.
  
  
  METHODS
  A cross-sectional approach was used for the study. A stratified random sampling technique was used to obtain a sample of 10 governmental primary health care centers from the total of 20 centers that serve the Dammam area, and five out of 17 private health clinics. The Maternity and Child Health Hospital was included. A field survey was done at all sample sites. Data collection, analysis, and interpretation were done from July to September 2007, using a check list designed for this study according to cold chain criteria set by the Ministry of Health (MOH) and World Health Organization (WHO).
  
  
  RESULTS
  According to the MOH and WHO criteria, around 91% of governmental health facilities (GHF) and 80% of private health care (Private HC) rooms were suitable. Less than 20% of the private HC maintained proper vaccine temperatures during storage, compared with all (100%) of GHF clinics (p≤ 0.05). The difference in the appropriate handling and usage of vaccines during immunization sessions was also highly significant between GHF (90-100%) and private HC (20%) (p≤ 0.05). The knowledge of refrigeration maintenance by GHF and private HC health workers including keeping the refrigerator from dust, emergency retrieval and storage procedures in case of equipment failure or power outages, keeping the range of recommended temperature between 2°C- 8°C was 100% for GHF and for the Private HC's ranged from 20%-40% (p≤0.05). Vaccine vials on the refrigerator shelves was appropriate in all (100%) of the GHF and in only 40% for the Private HC (P≤0.05).
  
  
  CONCLUSIONS
  This study showed that private health clinics did not comply with standards defined by the MOH or WHO for cold chain tools and needed constant supervision and training as health care professionals. All personnel handling vaccines should understand the purpose and function of various cold chain tools in their setting for immunizations.
authors.affiliation: Primary Health Care and Preventive Health Administration in Eastern Province, Dammam, Saudi Arabia.
authors.forename: Kholood M
authors.initials: KM
authors.lastname: Mugharbel
authors.forename: Safa M
authors.initials: SM
authors.lastname: Al Wakeel