Appendix 20. Cold chain evaluation/inventory

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    Country: ___________________________________ Province/region:  _____________________

    District: ____________________________________ Health care facility: ___________________

    Person in charge: ___________________________ Date: _______________________________

     

      Yes No

    1 - Is there a person in charge of the cold chain?
    If yes, person’s name and contact information:

     

    		    

    2 - Is the room well-ventilated?

    		    

    3 - Is the equipment protected from the sun?

    		    

    4 - If electricity is available, is it reliable?
    Specify the number of hours of electricity per day:

    		    

    5 - Is the distance between the wall and the refrigerator/freezer greater than or equal to 30 cm?

    		    


    6 - Refrigerators:

     


    Brand, model
    Number

    Energy
    source (a) Citation a. Specify the energy source, the electrical power and the availability (number of hours/day).

    Storage
    volume
    (in litres)

    Available
    volume
    (in litres)

    Monitoring equipment
    present
    Y/N (b) Citation b. One thermometer, one Stop!Watch® card with a Freeze-tag® and one temperature monitoring sheet per refrigerator.

               
               
               
               
               

    7 - Freezers:

     

    Brand, model

    Number

    Energy
    source (c) Citation c. Specify the energy source, the electrical power and the availability (number of hours/day).

    Storage
    volume

    Ice production
    per 24 hours

    Monitoring equipment
    present
    Y/N (d) Citation d. One thermometer and one temperature monitoring sheet per freezer.

    In litres

    In nb
    0.6-litre
    ice
    packs

    In
    kg/24h
    without
    vaccines

    In nb
    0.6-litre
    ice
    packs
                   
                   
                   
                   
                   
                   

    8 - Transport equipment:

     

    Vaccine carrier, brand and model Total number

    Number available

    Vaccine storage
    volume (in litres)
           
           
           
    Cold box, brand and model Total number

    Number available

    		  
           
           
           
    Ice packs Total number Number available  
    0.6 litre      
    0.4 litre      

    Other (specify volume)

     

    		      


    9 - Monitoring equipment:

     

    Equipement

    Total number
    available/functional
    Fridge-Tag® or Logtag® (with display) temperature logger  
    Moeller® alcohol thermometer  
    Thermometer with liquid-crystal display (LCD)  
    Other thermometer (specify):  
    Refrigerator monitoring card (Stop!Watch® with Freeze-tag®)  
    Freeze indicator (Freeze-tag®)  
    • (a)Specify the energy source, the electrical power and the availability (number of hours/day).
    • (b)One thermometer, one Stop!Watch® card with a Freeze-tag® and one temperature monitoring sheet per refrigerator.
    • (c)Specify the energy source, the electrical power and the availability (number of hours/day).
    • (d)One thermometer and one temperature monitoring sheet per freezer.
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