PATNA: Most parents prefer private healthcare facilities for their infants' routine immunization (RI). But do a reality check before doing so next time. For, a recent Unicef survey reveals not even one of the 104-odd private facilities the Unicef experts visited in Patna has proper cold chain for storing those vaccines.
The survey was conducted from February to April this year and a copy of the survey report has also been submitted to State Health Society of Bihar. According to the survey report, not a single facility had ice-lined refrigerator (ILR) for storing vaccines. Instead, 97% of the healthcare facilities stored them in domestic refrigerators.
"This raises serious concern about the efficacy of vaccines as temperature regulator is not calibrated regularly," says the report and adds these vaccination points are never visited by government officials to monitor their quality.
ILRs are specially designed for storing vaccines and WHO does not recommend their storage in domestic refrigerators because they cannot maintain temperature for more than four hours, affecting potency of vaccines. Unicef's Dr Ghanashyam Sethy said domestic refrigerators were simultaneously used for drinking water too. The refrigerators were therefore opened many a time, which reduces the cooling effect of the refrigerator.
Adverse events following immunization (AEFI) are a major concern of any immunization programme.
AEFI include fever or swelling at the site of injection. At times, the reaction can be severe and, albeit in rare cases, may lead to death. Most of the surveyed immunization points had facilities to manage minor AEFI cases, but none of them had a proper AEFI kit (set of emergency medicines) to manage serious cases. Only 4.8% of these immunization points had some reporting mechanism of AEFI to a government institution. Its reportage is significant to study overall effect of the vaccine.
Maintenance of immunization record was poor with only 17% of the surveyed immunization points doing so. As many as 90% facilities are not reporting immunization record to the government. This creates a scenario of low immunization coverage of the state.
Dr Agrawal said there is no proper format for doctors to do the same. However Dr Sethy said, "Civil surgeons have issued letters many a time, but doctors do not heed to the instruction.'
It was also found only 60% facilities used hubcutter or needle syringe terminator which is mandatory in public health. The syringe of both these kinds is broken after one usage and can be easily disposed of compared to other syringes. About 5% doctors were found purchasing vaccines from nearby pharmacists who are not allowed to store RI vaccines.
Certain good practices are also highlighted in the report. At as many as 77% of the surveyed immunization points, doctors, not nurses or pharmacists, administered vaccines.
The survey was conducted from February to April this year and a copy of the survey report has also been submitted to State Health Society of Bihar. According to the survey report, not a single facility had ice-lined refrigerator (ILR) for storing vaccines. Instead, 97% of the healthcare facilities stored them in domestic refrigerators.
"This raises serious concern about the efficacy of vaccines as temperature regulator is not calibrated regularly," says the report and adds these vaccination points are never visited by government officials to monitor their quality.
ILRs are specially designed for storing vaccines and WHO does not recommend their storage in domestic refrigerators because they cannot maintain temperature for more than four hours, affecting potency of vaccines. Unicef's Dr Ghanashyam Sethy said domestic refrigerators were simultaneously used for drinking water too. The refrigerators were therefore opened many a time, which reduces the cooling effect of the refrigerator.
However, Dr Awadh Agarwal, a faculty member of State Institute of Health and Family Welfare who was also a part of this study, said, "Though WHO recommends usage of ILR, domestic refrigerators can also be used if certain guidelines are followed."
Adverse events following immunization (AEFI) are a major concern of any immunization programme.
Common
Maintenance of immunization record was poor with only 17% of the surveyed immunization points doing so. As many as 90% facilities are not reporting immunization record to the government. This creates a scenario of low immunization coverage of the state.
Dr Agrawal said there is no proper format for doctors to do the same. However Dr Sethy said, "Civil surgeons have issued letters many a time, but doctors do not heed to the instruction.'
It was also found only 60% facilities used hubcutter or needle syringe terminator which is mandatory in public health. The syringe of both these kinds is broken after one usage and can be easily disposed of compared to other syringes. About 5% doctors were found purchasing vaccines from nearby pharmacists who are not allowed to store RI vaccines.
Certain good practices are also highlighted in the report. At as many as 77% of the surveyed immunization points, doctors, not nurses or pharmacists, administered vaccines.
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