MADHYA PRADESH Fact Sheet Immunization Cold Chain and Vaccine Logistics Network 1 Madhya Pradesh Divisional Vaccine 3 Stores The cold chain system in Madhya Pradesh consists of 3,250 Regional working cold chain Vaccine 4 Stores equipment. 4 Walk-in Freezers District Vaccine 10 51 Stores Walk-in Coolers 1,556 Ice-Lined Refrigerators Cold Chain 1,650 1,126 Points Deep Freezers 4 Sources of data: Solar ॰ Live data from Electronic Vaccine Intelligence Network (eVIN), as accessed in July Equipment 2017. ॰ eVIN Preparatory Assessment Study, conducted by UNDP in year 2016, with up- dates provided by the state in 2017. 2 MadhyaMADHYA Pradesh PRADESH The Universal Immunization Programme in Madhya Pradesh aims to immunize a target population of 18.45 lakh children and 21.65 lakh pregnant women, every year. The Electronic Vaccine Intelligence Network (eVIN) Vaccine58 Cold1,126 Store Chain has been implemented across Keepers Handlers all the vaccine stores and The human resource network cold chain points in Madhya to manage vaccines in Madhya Pradesh. eVIN has facilitated Pradesh consists of 58 vaccine store keepers and 1,126 cold capacity-building of all vaccine chain handlers. They work store keepers and cold chain under the guidance of the State handlers in the state through Immunization Officer, the State 81 batches of training and 30 Cold Chain Officer, Regional batches of refresher trainings Directors, District Immunization Officers and Medical Officers on eVIN.eVIN equipped them in-Charge. with standardised stock registers and smartphones to digitise the vaccine stocks. The entire vaccine logistics data in Madhya Pradesh is now digitised and real-time data is available for informed decision-making. 3 A Vaccine Supply Network The four regional vaccine stores located at Bhopal, Indore, Gwalior and Jabalpur, cater to the entire vaccine supply in the state. The supply chain is same for all the vaccines except for the Inactivated Polio Virus Vaccine. IPV is only supplied to RVS Bhopal, which further supplies it to other RVSs of the state. Moreover, the buffer stock of all the vaccines is supplied from the government medical stores depot to all regional vaccine stores directly, or at times only to RVS Bhopal. All RVSs supply vaccines to their respective divisional vaccine stores and to the district vaccine stores. The 51 district vaccines stores supply vaccines to the cold chain points located at the community health centres, primary health centres, urban health centres, civil hospitals, district hospitals and medical college hospitals in their respective areas. Dry Stocks The supply of dry stock in Madhya Pradesh follows a separate route. Auto-disabled syringes of 0.1ml, and 0.5ml and disposable reconstitution syringes of 5ml are supplied from manufacturers or GMSD Mumbai to regional dry stores at Indore, Bhopal, Jabalpur and Gwalior and then from there they are further supplied to the respective divisional dry store and to the district dry store. The district dry store then caters to all the cold chain points. Cold Chain Points ● Madhya Pradesh has an average number of 22 CCPs per district. However, there is a wide variation, ranging from 7 CCPs in Harda to 50 CCPs in Dhar. ● One-fourth of the total number of cold chain points in the state cater to a population of more than 1 lakh, including 74 such CCPs that cater to a population of over 2 lakh. B Vaccine Delivery Mechanism Functional, insulated vaccine vans are available at 49 DVSs, 4 RVSs, and 3 DiVSs; and all of them have a full-time driver for the van. DVS Mandla and Ashoknagar do not have functional vaccine vans due to damaged tyres and mechanical work. All RVSs, DiVSs and DVSs have vaccine distribution plan along with route map for vaccine van. 4 C Cold Chain Equipment The immunization cold chain network of Madhya Pradesh runs on 3,224 working cold chain equipment installed across 1,184 vaccine stores and cold chain points. These include 4 walk-in freezers, 10 walk- in coolers, 1,556 ice-lined refrigerators and 1,650 deep freezers. There are four solar equipment in Madhya Pradesh. Table 1: Working Cold Chain Equipment in Madhya Pradesh Type of Equipment Type of Store WIF WIC ILR DF Solar 3,224 Total 4 10 1,556 1,650 4 RVS 4 7 3 20 - DiVS - 4 16 10 - DVS - 1 233 149 - CCP - - 1,302 1,501 4 Moreover, there are 600 cold chain equipment on stand-by and 183 cold chain equipment under repair. Additionally, around 500 ILRs and 330 DFs are under the process of procurement by the Government of India for strengthening the cold chain infrastructure in Madhya Pradesh. Non-electrical cold chain equipment The state has 2,023 functional large cold boxes, 11,637 functional small cold boxes and 86,191 vaccine carriers currently in use for the transportation of vaccines from stores to CCPs and from the CCPs to beneficiaries. D Human Resource ● Madhya Pradesh has 58 vaccine store keepers and 1,126 CCHs across all CCPs. None of the cold chain points have vacant position for cold chain handlers. ● There is no dedicated position of cold chain handler in the state and it is an assigned responsibility. In Madhya Pradesh, around 90 per cent CCHs are ANMs, pharmacists, MPHWs, LHVs, MPSs or Health Supervisors. ● Nearly one-fourth of the CCHs are qualified upto 10th standard and another one-fourth are qualified upto 12th standard. Nearly 30 per cent of them hold a diploma or are graduates; the remaining hold post graduate qualification. ● All the CCHs have received the training for cold chain handler within the last three years, while 100 per cent of them have received the eVIN training. ● Cold chain handlers are provided supportive supervision on a regular basis with emphasis on all significant aspects of the vaccine cold chain. 5 6 Figure 1:ImmunizationColdChainNetworkinMadhyaPradesh Figure Bhopal RVS Gwalior RVS Indore RVS Jabalpur RVS 1 DiVS 1 DiVS 1 DiVS Stores 8 DVSs 13 DVSs 15 DVSs 15 DVSs Regional Vaccine Vaccine Regional 155 CCPs 249 CCPs 389 CCPs 333 CCPs Sagar DiVS Ujjain DiVS Rewa DiVS 5 DVSs 7 DVSs 4 DVSs Divisional Vaccine Stores Vaccine 105 CCPs 153 CCPs 84 CCPs Bhopal DVS Gwalior DVS Sagar DVS Indore DVS Ujjain DVS Jabalpur DVS Anuppur DVS Rewa DiVS 29 CCPs 31 CCPs 31 CCPs 38 CCPs 33 CCPs 28 CCPs 17 CCPs 23 CCPs Sehore Bhind Dhar Balaghat Shahdol Satna Chhatarpur DVS Mandsaur DVS DVS DVS DVS DVS DVS DiVS 22 CCPs 19 CCPs 26 CCPs 50 CCPs 27 CCPs 30 CCPs 14 CCPs 29 CCPs Chhindwara Vidisha DVS Datia DVS Damoh DVS Jhabua DVS Dewas DVS Umariya DVS Sidhi DiVS DVS 19 CCPs 14 CCPs 14 CCPs 22 CCPs 28 CCPs 46 CCPs 16 CCPs 15 CCPs Betul DVS Ashok Nagar DVS Panna DVS Khargone DVS Neemuch DVS Dindori DVS Singrauli DiVS 20 CCPs 13 CCPs 18 CCPs 37 CCPs 15 CCPs 10 CCPs 17 CCPs Stores Raisen DVS Morena DVS Tikamgarh DVS Barwani DVS Ratlam DVS Katni DVS District Vaccine Vaccine District 22 CCPs 17 CCPs 16 CCPs 35 CCPs 27 CCPs 14 CCPs Rajgarh DVS Guna DVS Khandwa DVS Shajapur DVS Mandla DVS 20 CCPs 18 CCPs 20 CCPs 16 CCPs 26 CCPs Narsinghpur Harda DVS Shivpuri DVS Burhanpur DVS Agar DVS DVS 7 CCPs 22 CCPs 14 CCPs 7 CCPs 19 CCPs Hoshangabad Sheopur DVS Alirajpur DVS Seoni DVS 16 CCPs 10 CCPs 20 CCPs 29 CCPs Figure 2:MapofImmunizationColdChainNetworkinMadhyaPradesh Figure Code District 0 65 130 260 Kilometers 33 Raisen Code District 34 Rajgarh 1 Agar Malwa 35 Ratlam 2 Alirajpur 36 Rewa 3 Anuppur 37 Sagar 0# 8 38 Satna 4 Ashoknagar 29 0# 5 Balaghat Gwalior 39 Sehore 6 Barwani E0# 40 Seoni 7 Betul 41 Shahdol 8 Bhind 20 42 Shajapur 9 Bhopal 43 Sheopur 14 44 Shivpuri 10 Burhanpur 0# 43 0# 11 Chhatarpur 45 Sidhi 12 Chhindwara 46 Singrauli 0# 47 Tikamgarh 13 Damoh 44 14 Datia 48 Ujjain 15 Dewas 49 Umaria 16 Dhar 50 Vidisha 0# 51 Khargone 17 Dindori 47 18 36 Khandwa 0# 11 0# 19 Guna 0# 0# Rewa 20 Gwalior 31 19 0# 4 0#)" 0# 38 21 Harda 32 0# 22 Hoshangabad 23 Indore 28 45 46 24 Jabalpur 0# 0# 25 Jhabua Sagar 26 Katni 50 0# 0# 1 34 37 )" 0#13 0# 27 Mandla 0# 26 28 Mandsaur 9 0# 0# 49 29 Morena 35 0# 41 30 Narsinghpur Bhopal 0# 42 0# 31 Neemuch 48 Ujjain 0# Jabalpur 0# )" 0# E 0# 32 Panna 0# 33 2E4 0# 39 3 0# 30# 0# 0#25 Indore E0# 0# 17 0# 23 15 0# 27 22 16 0#2 0# 40 21 0# 120# 0# 18 0# 5 Legend 6 0#51 0# 7 0# E Regional Vaccine Store )" Divisional Vaccine Store 0# 10 0# District Vaccine Store Cold Chain Points 7 8 Table 2: District-Wise Availability ofColdChainEquipmentinMadhyaPradesh 2:District-WiseAvailability Table Working Cold Chain Equipment CCE on Stand- CCE Under District RVS DiVS DVS CCP Total By Repair WIF WIC ILR DF WIC ILR DF WIC ILR DF ILR DF Solar 34 29 378 2,768 Total 3,224 600 183 4 7 3 20 2 16 11 1 232 151 1,305 1,468 4 Agar 3 3 10 14 30 2 6 Alirajpur 5 4 21 23 53 3 0 Anuppur 4 2 21 24 51 0 1 Ashok Nagar 3 3 17 31 54 3 2 Barwani 4 2 36 35 77 41 8 Balaghat 3 4 30 41 78 11 0 Betul 3 3 27 42 75 10 2 Bhind 1 1 19 23 44 37 1 Bhopal 1 3 8 7 2 37 34 92 14 14 Burhanpur 4 1 14 18 37 4 7 Chhatarpur 7 5 29 29 1 71 7 4 Chhindwara 6 2 53 50 1 112 10 0 Damoh 4 2 14 50 44 4 8 Datia 8 1 14 23 46 16 6 Dewas 5 4 26 34 69 0 3 Dhar 6 4 52 53 115 10 1 Dindori 6 2 10 19 37 5 9 Guna 2 7 23 21 53 3 5 Gwalior 1 1 2 2 36 25 67 13 1 Harda 4 2 7 9 22 32 5 Hoshangabad 6 2 24 24 56 18 1 Indore 1 2 7 3 40 38 91 12 0 Jabalpur 1 1 3 12 8 1 31 31 88 15 0 Jhabua 4 3 24 27 58 5 0 Katni 5 2 19 24 50 15 0 Khandwa 4 2 20 28 54 19 1 Khargone 4 2 39 46 91 10 5 Mandla 4 2 26 30 62 11 4 Mandsaur 4 3 34 32 73 22 1 Working Cold Chain Equipment CCE on Stand- CCE Under District RVS DiVS DVS CCP Total By Repair WIF WIC ILR DF WIC ILR DF WIC ILR DF ILR DF Solar Morena 4 2 21 25 52 13 3 Narsinghpur 6 2 20 26 54 2 5 Neemuch 4 4 15 16 39 10 0 Panna 3 4 18 24 49 6 1 Raisen 2 2 28 29 61 45 1 Rajgarh 5 1 20 27 53 33 12 Ratlam 1 1 4 29 30 65 10 0 Rewa 1 3 4 3 19 22 52 7 1 Sagar 8 3 3 3 37 34 88 15 20 Satna 4 2 17 22 45 3 7 Sehore 3 3 24 34 64 29 6 Seoni 7 2 34 37 80 26 0 Shahdol 3 3 27 30 63 4 1 Shajapur 5 3 19 24 51 2 5 Sheopur 4 5 12 44 2 67 3 10 Shivpuri 9 2 46 15 72 2 7 Sidhi 5 4 20 24 53 2 0 Singrauli 4 3 17 20 44 2 2 Tikamgarh 4 4 24 31 63 6 4 Ujjain 1 8 5 9 7 42 46 118 1 0 Umariya 5 3 31 35 74 2 5 Vidisha 5 3 27 21 56 55 1 9 Table 3: List of Vaccine Storage Points in Madhya Pradesh Name of Vaccine Name of Vaccine Sr.