Comparison of Ice Lined Refrigerators of the different types used in Western part of India under the Universal Immunization Program
DOI:
https://doi.org/10.47203/IJCH.2025.v37i04.014Keywords:
Cold Chain, Immunization, Program EfficiencyAbstract
Background & Objective: The effectiveness of Ice-Lined Refrigerators (ILRs) is crucial in maintaining the cold chain for vaccines, particularly in India's Universal Immunization Program (UIP). This cross-sectional study aimed to compare the performance of top-and front-opening ILRs in Gujarat, focusing on temperature stability, holdover time, and functionality. Methods: A total of 123 ILRs from various manufacturers were assessed across urban and rural health facilities. Key parameters such as ambient temperature, breakdown frequency, ease of use, and temperature fluctuations during door openings were recorded. Mann-whitney U test/ t-test and Binary logistic regression model were used as statistical methods. Results: Analysis indicated that top-opening ILRs, which made up 72.4% of the sample, performed significantly better in maintaining temperature stability and had a longer holdover time (mean: 5.4hours) compared to front-opening ILRs (mean: 4.3hours). Temperature breaches were more frequent in top-opening models (34.8%) compared to front-opening ones (5.9%), but the front-opening ILRs exhibited a greater temperature rise during door openings. Logistic regression analysis revealed a strong association between longer holdover time and top-opening ILRs. The study also found infrastructure and training gaps at some facilities, with only 57.7% of ILRs equipped with functional temperature monitoring systems, and many health workers lacking updated training. The findings suggest that top-opening ILRs are more reliable for cold chain management, though further investigation into front-opening models is warranted. Conclusion: For future cold chain management, prioritize top-opening ILRs for their reliability, increase AMC coverage for consistent maintenance, and enhance training for personnel on ILR handling, especially with newer models. Additionally, invest in backup-power and temperature monitoring equipment to prevent temperature breaches, particularly in remote areas.
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References
Immunization. National Health Mission, Ministry of health and family Welfare India. Available from: https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=824&lid=220 Accessed on 25/08/2025
Sample registration system (SRS)-bulletin 2020 volume 55-i, Office of the Registrar General & Census Commissioner, India (ORGI). Available at: https://censusindia.gov.in/nada/index.php/catalog/42687 Accessed on 25/08/25
Immunization. https://www.who.int/news-room/facts-in-pictures/detail/immunization Accessed on 25/08/25
Yakum, M.N., Ateudjieu, J., Pélagie, F.R. et al. Factors associated with the exposure of vaccines to adverse temperature conditions: the case of North West region, Cameroon. BMC Res Notes 2015; 8:277. https://doi.org/10.1186/s13104-015-1257-y
Isaacs A. Immunization in practice, a practical guide for health staff. Arch Dis Child. 2005 Sep;90(9):988.
Universal Immunization Program. Available at: https://main.mohfw.gov.in/sites/default/files/Universal.pdf accessed on 25/08/2025
Krishnappa L, Anniappan AB, Voderhobli NH, Krishna SK, Yathiraj S, Sreekantaiah P. Evaluation of Cold Chain Practices in Urban Health Centers of a Metro City in India. Natl J Community Med 2014;5(03):288-92. https://njcmindia.com/index.php/file/article/view/1396
Goel NK, Pathak R, Galhotra A, Dankal C, Swami HM. Status of cold-chain maintenance in Chandigarh. Indian J Public Health. 2008;52(1):37-9.
Naik AK, Rupani MP, Bansal RK. Evaluation of vaccine cold chain in urban health centers of municipal corporation of Surat city, Western India. Int J Prev Med. 2013;4(12):1395-401..
Sachdeva S, Datta U. Status of vaccine cold chain maintenance in Delhi, India. Indian J Med Microbiol. 2010 Apr-Jun;28(2):184-5.
Patel N, Unadkat S, Parmar D, Rathod M. Evaluation of vaccine cold chain in Urban Health centers (UHCs) of Jamnagar Municipal Corporation (JMC), Gujarat. Healthline J 2017;8:67-70.
Biradar SM, Biradar MK. Evaluation of Vaccine Storage Practices in Primary Health Centres of Bijapur District of Karnataka. Int J Pharma Bio Sci. 2013;4(4):1290-3.
Sinha AK, Verma AR, Chandraker A, Shanta PK, Dixit S. Evaluation of cold chain and logistics management practice in Durg district of Chhattisgarh: pointer from Central India Int J Community Med Public Health. 2017;4(2):390-5.
Rao S, Naftar S, Unnikrishnana B. Evaluation, awareness, practice and management of cold chain at the primary health care centers in coastal South India. J Nepal Paediatric Society. 2012;32(1):19-22.
Mallik S, Mandal PK, Chatterjee C, Ghosh P, Manna N, Chakrabarty D, et al. Assessing cold chain status in a metro city of India: an intervention study. Afr Health Sci. 2011;11(1):128-33.
Chourasiya SK, Baghel AS, Verma A, Kale S. A cross sectional study to assess the functioning of cold chain in a tribal district of central India. Int J Community Med Public Health [Internet]. 2018;5(11):4826-30.
Sharma DK, Varun A, Patel R, Singh US. Process Evaluation of Immunization Component in Mamta Diwas and Support Services in Kheda District, Gujarat. Natl J Community Med 2013; 4(1): 81-5.
Patel T, Raval D, Pandit N. Process evaluation of routine immunization in rural areas of Anand District of Gujarat. Health Line 2011;2(1):17-20.
Kumar S, Mvundura M, Ray A, et al. Using new cold chain technologies to extend the vaccine cold chain in India: Equipment performance, acceptability, systems fit, and costs. Vaccine X 2023;15:100385.
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Copyright (c) 2025 Bhautik Modi, Krupal J Joshi, Vikas Kokare, Sanjay Singhal, Krishna Jasani, Kamlesh Parmar
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