Best Practices For Managing Cold Chain Equipment

The increased availability and use of effective vaccines worldwide has significantly reduced the spread of debilitating and fatal diseases. As immunization programs expand to new vaccines and growing populations, there must be a concurrent increase of equipment needed to move and store vaccines at the ideal temperature range. For this, efficient cold chain equipment management is essential. By implementing the following best practices—planning with program needs in mind; committing to maintenance; and developing good recordkeeping, reporting, and data use practices—health care workers can maintain a strategic cold chain and lower risk to the vaccine. 

Before cold chain equipment is purchased, staff must determine which equipment is best suited to their facility by considering the types of vaccines they will administer, shipment volumes, cost, reliability of the equipment itself, and energy requirements.

After immunization program managers, logisticians, and cold chain technicians have ascertained their equipment requirements, but before purchasing it, they need to plan for its maintenance, including preventive measures such as regular cleaning, to ensure it is always operational. Cold chain equipment management will also require elements such as standard operating procedures, contingency plans, and effective reporting systems.

Initially, program and health facility managers must assign responsibilities for preventive maintenance to specific staff. This includes cleaning and defrosting the cold chain equipment regularly, ensuring air flow, and procedural tasks such as ensuring that staff have tools to monitor and record cold chain equipment temperatures; job aids to support routine reporting and visual inspection; and standard operating procedures to troubleshoot equipment malfunctions and breakdown (e.g., inventory of spare parts, identifying technicians available to repair the equipment). 

Assigning specific maintenance tasks to individual staff can reduce confusion. Clear expectations can minimize breaks in the cold chain. Once these procedures have been satisfied, contingency plans are required if the equipment’s normal functioning fails. This includes having an alternative short-term system to maintain vaccines at the proper temperatures while the cold chain equipment is being repaired. For example, if the equipment functions on electricity and there is a power outage, the facility will require a generator or alternative locations with reliable cold chain equipment to store its vaccines.

A recording and reporting system—including equipment inventories, spare part stock records, temperature monitoring, logistics reports, all focusing on performance indicators—can help to ensure that the equipment is functioning correctly. 

Once all of these elements are in place, staff can manage the inventory of cold chain equipment, which will in turn enable them to fulfill their vaccine delivery quantities. The overall objective is to ensure that vaccines do not get lost due to poorly or non-functioning cold chain equipment.

While all of these tools are beneficial, they can also be time-consuming and require manual upkeep. However, electronic tools can help to ensure that cold chain equipment maintenance data are accurately recorded and reported. One such tool is ODK-X, created by PATH, which enables health care workers to access real-time data analysis and maintenance logs. This software also can track repairs, spare parts, and log records from one source. However, it is ultimately up to program managers to ascertain if the costs and other resource requirements of electronic- or software-based solutions are within their budgets and are practicable for their health facilities.

The following webinars provide more information about managing cold chain equipment:
Managing the Inventory of Cold Chain Equipment
Cold Chain Equipment Management