Isparta il ve ilçe merkezlerindeki aile sağlığı merkezlerinde soğuk zincir, mevcut durum ve uygulamalar

Abstract

One of the main essentials in supplying the supposed immune response isthe storage and transport of the vaccines regarding to the cold chain rules. Coldchain is the system that protects the efficiency of a vaccine beginning fromproduction until application, and includes staff and vehicles that secures thevaccine which is effective enough reach the humans in need.Family doctors (FD) and health staff in in 33 family health centers (FHC)centers Isparta City and its 12 districts participated in the study. 95 FDs and 95health staff adding up to 190 was questionnaired under supervision. Observationforms were filled out for 32 fridges in FHCs.The ratios of participants were 50.0% for doctors, 31.6% for midwifes16.3%for nurses and 2.1% for health officials, and mean age was 34.5± 5.5, and meanworking period was 11.7±5.5.96.3% knew that there was staff responsible for the cold chain, and 68.9%attended a course concerning the cold chain.None could replied all the seven querries concerning the cold chain. Threeof the querries were truly replied in higher frequency by midwifes, also anotherthree by nurses, and one by the doctors. Two querries were truly replied by 75%,one by 11%, and three by less than 5%.43.7% of the staff in FHCs did not know for how many years the fridge hadbeen working, and 55.3% said it had been used regardless of staff, or co-staff,responsible for the cold chain. 60.0% said the temperature was not controlled atweekends, 66.3% knew that there was an application plan ready for use for thesituations in which the temperature is out of normal range, and 15.3% could trulydefine the cold chain.Staff other than doctors knew better than doctors where to place theMeasles, OP, BCG, MMR, Hib, Rabies, DBT and Hepatitis B vaccines and theirdiluents in the freidge.75.2% of the participants said that the cold chain only worked or workedperfect.12 of the 32 fridges in FHCs was found door closed, and only one had alock. 17 were snow-clad more than 5 mm. All had ice-containers but nothermometers in ice-boxes.arrangement is explained, and 18.8% had temperature follow-up chart hung on thedoor, whereas none had any sheets showing the input dates of the vaccines. Onlyone had all the vaccines and diluents placed correct, and OPV was the first incorrectness by 84.4%.31.3% of the fridges had ordinarily placed water bottles in greens division.12.6% had the vaccines packed by producer, and 25.0% had them placed so as theair to circulate amongst. The vaccines had boxes for first use in shelves of 53.3%.59.4% of the fridges contained some stuff other than vaccines, but all had workingthermometers and the temperatures were all in normal range. Used vaccines hadno date inscriptions on the vials in 40.6% but none had any expired date vaccines.All the FHCs had vaccine port cases with hangings, and 18.8% of thesewere old. None of the FHCs had long-life vaccine port case.According to the cold chain control list including 10 articles for fridges orother cold chain applications, 3 of the articles were thoroughly, and 4 wasincompletely carried out in all the FHCs, 3 was applied in nowhere.In conclusion, recent situation and the aplications in cold chain is generallyat a good level with the fact that it has some defects. For the improvement, coursesconcerning the cold chain should be provided for all the staff in FHCs, and thesecourses should be re-held perodically. Secondly, the doctors in the FHCs should beinvolved in active management in providing the continuity and controlling the coldchain. The health administrations should periodically control the equipment andapplications.Key words:The Family Health Centers, cold chain, recent status, applications