GUJARAT Fact Sheet Immunization Cold Chain and Vaccine Logistics Network 1 Gujarat Regional Vaccine 6 Stores District Vaccine 33 Stores The cold chain system in Gujarat consists of 4,083 working cold chain equipment. Corporation Vaccine 8 Stores 2 Walk-in Freezers Cold 9 Chain Walk-in 1,916 Points Coolers 2,142 Ice-Lined 51,602 Refrigerators Session Sites 1,930 Deep Freezers Sources of data: ॰ Live data from Electronic Vaccine Intelligence Network (eVIN), as accessed in July 2017. ॰ eVIN Preparatory Assessment Study, conducted by UNDP in year 2016, with updates provided by the state in 2017. 2 GUJARAT GujaratThe Universal Immunization Programme in Gujarat aims to immunize a target population of 13.2 lakh children and 14.5 lakh pregnant women, every year. The Electronic Vaccine Vaccine47 Cold1,916 Intelligence Network (eVIN) Store Chain Keepers Handlers has been implemented across all the vaccine stores The human resource network and cold chain points in to manage vaccine logistics in Gujarat. eVIN has facilitated Gujarat consists of 47 vaccine capacity-building of all store keepers and 1,916 cold vaccine store keepers and chain handlers, to manage the cold chain handlers in the vaccine logistics. They work state through 73 batches of under the guidance of the State training programmes on eVIN, Immunization Officer, District during the last two quarters of RCH Officers and Medical 2016. eVIN equipped them with Officers in-Charge. standardised stock registers and smartphones to digitise the vaccine stocks. The entire vaccine logistics data in Gujarat is now digitised and real-time data is available for informed decision-making. 3 A Vaccine Supply Network The six regional vaccine stores located at Gandhinagar, Ahmedabad, Vadodara, Rajkot, Surat and Bhavnagar cater to the entire vaccine supply in the state. Different vaccines follow different supply chains in Gujarat: ● Pentavalent Vaccine is directly supplied from the manufacturer to all RVSs. ● RVS Gandhinagar supplies: ○ All the vaccines (except Pentavalent) to two RVSs (Ahmedabad and Bhavnagar) ○ IPV, OPV and DPT to 3 RVSs (Surat, Rajkot and Vadodara) ● RVS Surat, RVS Rajkot and RVS Vadodara receive BCG, Measles and TT vaccines directly from the manufacturer. ● The buffer stock of all the vaccines is supplied from the Government Medical Stores Depot (GMSD) to RVS Gandhinagar. All RVSs supply vaccines to their respective district vaccine stores and corporation vaccine stores. The 33 DVSs and 8 CVSs supply vaccines to cold chain points located at community health centres, primary health centres, urban health centres, sub-district hospitals, district hospitals and medical college hospitals in their respective areas. These 1,916 CCPs cater to 51,602 session sites. Dry Stocks The supply of dry stock in Gujarat follows two levels of supply chain system: ● Auto-disabled syringes of 0.1ml, and 0.5ml and disposable reconstitution syringes of 5ml are supplied from manufacturers to the state dry stock store at Ahmedabad and then to all DVSs and CVSs. ● Syringes of 0.5 ml are supplied from manufacturers to all RVSs and then to DVSs and CVSs. Cold Chain Points ● Gujarat has an average number of 57 CCPs per district. ● Around 89 per cent CCPs cater to a population of less than a lakh. Session Sites ● On an average, each CCP caters to 27 session sites in Gujarat. ● A few districts have higher than average number of session sites attached to their CCPs, namely Dang (38), Valsad (34), Banaskantha (27), Dahod (30) and Kutch (28). ● A few CCPs cater to a very high number of session sites, namely UHC Gandhidham, Kutch (150 session sites) and UHC Vatva and UHC Nikol, Ahmedabad (75 session sites). ● Majority of the session sites in Gujarat are within the range of 30 km from respective CCPs. Only a handful of session sites are located at the distance of more than 30 km. B Vaccine Delivery Mechanism ● 17 per cent of the vaccine delivery from the CCPs to session sites is done by the ANM and 83 per cent of vaccine delivery is carried out by the AVD. ● Vaccine vans are available at all DVSs, except DVS Botad. The state has 41 vaccine vans, of which 38 vans are functional. These vans comprise of both full-time (24) and part-time (14) drivers associated with them. ● 9 DVSs have two vaccine vans each. ● 73 per cent DVSs follow pull mechanism of vaccine distribution, based on requisition raised by CCPs. Although vaccines are distributed by DVS up to the last cold chain point through vaccine vans. 4 C Cold Chain Equipment The immunization cold chain network of Gujarat runs on 4,083 working cold chain equipment installed across 1,963 vaccine stores and cold chain points. These include 2 walk-in freezer, 9 walk-in coolers, 2,142 ice-lined refrigerators and 1,930 deep freezers. There are no solar equipment in Gujarat. Table 1: Working Cold Chain Equipment in Gujarat Type of Equipment Type of Store WIF WIC ILR DF 4,083 Total 2 9 2,142 1,930 RVS 2 9 33 32 DVS/CVS - - 198 80 CCP - - 1,911 1,818 There are 136 cold chain equipment on stand-by and 37 cold chain equipment under repair. Additionally, around 870 ILRs and 570 DFs are under the process of procurement by the Government of India for strengthening the cold chain infrastructure in Gujarat. Non-electrical cold chain equipment The state has 2,461 functional large cold boxes and 15,083 functional small cold boxes which are currently in use for the transportation of vaccines from stores to CCPs and from CCPs to beneficiaries. Stabiliser Majority of ILRs and DFs (93 per cent) are attached with a dedicated and functional stabiliser. Thermometer Majority of ILRs and DFs (97 per cent) have a functional thermometer kept inside them. D Human Resource ● The state has 47 vaccine store keepers and 1,916 cold chain handlers. The position of cold chain handlers is vacant at 10 cold chain points. ● 89 per cent of vaccine store keepers and CCHs are designated as pharmacist. ● Nearly all (97 per cent) of the CCHs hold diploma, graduate or post graduate qualification. ● 87 per cent of the CCHs have received the training for cold chain handler within the last three years. ● All the CCHs have received the eVIN training. ● CCHs are provided supportive supervision on a regular basis. 5 6 Figure 1:ImmunizationColdChainNetworkinGujarat Figure Gandhinagar RVS Ahmedabad RVS Vadodara RVS Surat RVS Rajkot RVS Bhavnagar RVS 6 DVSs 4 DVSs 7 DVSs 5 DVSs 6 DVSs 5 DVSs 1 CVS 1 CVS 1 CVS 1 CVS 2 CVSs 2 CVSs Stores 380 CCPs 328 CCPs 403 CCPs 268 CCPs 276 CCPs 261 CCPs Regional Vaccine Vaccine Regional 9,959 SSs 8,761 SSs 9,952 SSs 8,965 SSs 7,593 SSs 6,372 SSs Gandhinagar DVS Ahmedabad DVS Vadodara DVS Surat DVS Rajkot DVS Junagadh DVS 34 CCPs 52 CCPs 56 CCPs 62 CCPs 60 CCPs 50 CCPs 1,157 SSs 1,444 SSs 1,182 SSs 1,443 SSs 1,475 SSs 1,137 SSs Gandhinagar CVS Ahmedabad CVS Vadodara CVS Surat CVS Rajkot CVS Junagadh CVS 5 CCPs 70 CCPs 35 CCPs 45 CCPs 23 CCPs 7 CCPs 120 SSs 2,490 SSs 841 SSs 2,920 SSs 1,081 SSs 238 SSs Patan DVS Kheda DVS Chhotaudepur DVS Navsari DVS Jamnagar DVS Bhavnagar DVS 58 CCPs 67 CCPs 47 CCPs 52 CCPs 37 CCPs 65 CCPs 1,109 SSs 1,835 SSs 1,076 SSs 1,307 SSs 1,018 SSs 1,786 SSs Banaskantha DVS Anand DVS Bharuch DVS Valsad DVS Jamnagar CVS Bhavnagar CVS 118 CCPs 74 CCPs 53 CCPs 60 CCPs 8 CCPs 15 CCPs Stores 3,195 SSs 1,629 SSs 1,408 SSs 2,081 SSs 210 SSs 403 SSs District Vaccine Vaccine District Sabarkantha DVS Surendranagar DVS Narmada DVS Tapi DVS Devbhumi Dwarka DVS Amreli DVS 55 CCPs 65 CCPs 28 CCPs 38 CCPs 27 CCPs 64 CCPs 1,496 SSs 1,363 SSs 630 SSs 793 SSs 688 SSs 1,196 SSs Aravalli DVS Panchmahal DVS Dang DVS Morbi DVS Gir Somnath DVS 41 CCPs 64 CCPs 11 CCPs 28 CCPs 31 CCPs 1,078 SSs 1,550 SSs 421 SSs 752 SSs 1,060 SSs Mehsana DVS Mahisagar DVS Kutch DVS Botad DVS 68 CCPs 40 CCPs 67 CCPs 24 CCPs 1,804 SSs 904 SSs 1,908 SSs 552 SSs Dahod DVS Porbandar DVS 80 CCPs 20 CCPs 2,361 SSs 461 SSs Figure 2:MapofImmunizationColdChainNetworkinGujarat Figure Code District 1 Ahmadabad 2 Amreli 3 Anand 4 Aravalli 5 Banaskantha 6 Bharuch 7 Bhavnagar 8 Botad 9 Chhotaudepur 10 Dahod 11 Devbhumi Dwarka 12 Gandhinagar 13 Gir Somnath 14 Jamnagar 15 Junagadh 16 Kachchh 17 Kheda 18 Mahesana 19 Mahisagar 20 Morbi 21 Narmada 22 Navsari 23 Panchmahal 24 Patan 25 Porbandar 26 Rajkot 27 Sabarkantha 28 Surat Corporation Vaccine Store 29 Surendranagar 30 Tapi 31 The Dangs 32 Vadodara 33 Valsad 7 8 Table 2: District-Wise Availability ofColdChainEquipmentinGujarat 2:District-WiseAvailability Table Working Cold Chain Equipment District RVS DVS CCP Total CCE on Stand-By CCE Under Repair WIF WIC ILR DF ILR DF ILR DF 76 278 3,729 Total 4,083 136 37 2 9 33 32 198 80 1,911 1,818 Ahmedabad 1 7 7 6 2 53 47 123 Ahmedabad Corporation 6 2 70 69 147 Amreli 7 2 63 65 137 4 Anand 8 2 74 72 156 Aravalli 4 1 41 34 80 3 Banaskantha 8 2 120 98 228 2 Bhavnagar 1 8 4 8 2 65 65 153 13 21 Bhavnagar Corporation 3 2 14 14 33 7 Bhrauch 5 3 53 61 122 Botad 4 1 23 23 51 4 Chhotaudepur 3 5 46 46 100 Dahod 7 4 80 78 169 Dangs 2 2 11 11 26 10 Devbhumi Dwarka 4 1 27 23 55 2 Gandhinagar 1 3 6 7 2 1 34 37 91 6 3 Gandhinagar Corporation 1 1 5 5 12 2 Gir Somnath 4 2 33 32 71 4 2 Jamnagar 4 2 37 35 78 2 1 Jamnagar Corporation 2 1 11 8 22 12 Junagarh 4 2 50 51 107 2 2 Junagarh Corporation 3 2 6 8 19 Kheda 10 2 67 64 143 Kutch 5 1 67 67 140 4 Mahisagar 5 2 40 38 85 Mehsana 5 2 70 69 146 3 Morbi 3 1 28 28 60 2 1 Narmada 4 1 28 32 65 Navsari 4 2 52 49 107 1 Panchmahal 5 3 64 56 128 Patan 5 2 60 57 124 Porbander 3 1 20 20 44 11 Rajkot 1 3 3 3 1 60 60 131 22 Rajkot Corporation 2 1 23 23 49 20 Sabarkantha 8 2 55 51 116 1 Surat 2 5 6 2 62 54 131 2 2 Surat Corporation 7 2 45 46 100 1 Surendranagar 6 2 64 55 127 Tapi 4 3 38 34 79 Vadodara 1 1 9 6 8 3 56 52 136 Vadodara Corporation 5 2 36 31 74 Valsad 5 3 60 50 118 1 Table 3: List of Vaccine Storage Points in Gujarat Name of Vaccine Name of Vaccine Sr.