Sumatera Utara (1SN01) (Version 1)

Effective Vaccine Management Initiative
EVM Assessment Tool
Country: Indonesia
Facility Name: Sumatera Utara (1SN01)
Release notes
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Sumatera Utara
Note to assessors: Obtain as much of this information as possible before the on-site inspection begins.
L1
Assessment scope:
L2
Facility details
L2.01
Supply chain level:
Sub-national store (1)
L2.02
Administrative area:
L2.03
Facility name:
Sumatera Utara
L2.04
Unique code for this facility:
L2.05
Facility address:
L2.06
Telephone:
L2.07
Fax number:
L2.08
Email:
L2.09
Primary contact:
L2.10
Maximum temperature at site C:
L2.11
Minimum temperature at site C:
L2.12
Facility assessment start date:
L2.13
Facility assessment finish date:
L2.14
Assessed records start date:
L2.15
Assessed records finish date:
L2.16
Assessment team members:
L2.17
Target eligibles:
L2.18
Target population:
L3
Permanently employed staff in the facility

List permanently employed members of staff, including managers, storekeepers, administrators, drivers, cleaners, etc.
Name
Full
1SN
Job title
Qualifications (see note 1)
L3.01
L3.02
L3.03
L3.04
L3.05
1) Qualifications: Specify level of education: e.g.
technical college vocational qualification,
university first degree etc.
2) Experience: In particular record previous
experience in the field of vaccine management.
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Location Data
Sumatera Utara
1SN01
On-line climate database

http://www.wolframalpha.com
http://www.weatherbase.com
Experience (see note 2)
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Years in post
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EVM #
EVM REQUIREMENTS
Q no.
EVM QUESTION
E0
Complete these facility-specific questions before continuing
0.1
Answers to these questions switch indicators below on

and off.
E0:01a
Result
Score
Max
What type of cold chain equipment is used in the store?

[Select one or more options]:
A Freezer room(s) and/or cold room(s) are used for storing vaccine [Y, N]
B Freezers and/or refrigerators are used for storing vaccine [Y, N]
C Freezer room(s), cold room(s), freezers or refrigerators are used for
freezing icepacks or cooling cool water packs [Y,N]
Notes:
Where are vaccines and diluents, syringes and safety boxes stored?
E0:02a
[Select one option only]:
A Only vaccines are stored. The facility is not responsible for syringes and
safety boxes [Y, N]
B Vaccine storage and dry storage in the same building? [Y, N]

C Vaccine storage and dry storage in separate buildings on the same site?
[Y, N]
D Vaccine storage and dry storage on separate sites? [Y, N]
Notes:
E0:03a
What type of equipment is used to deliver and/or collect vaccine at this
store?
[Select one or both options]:
A Cold boxes, vaccine carriers and/or other passive containers [Y,N]
B Refrigerated vehicles [Y,N]
Notes:
E0:04a
What organization is responsible for vehicle operations at this store?
[Select either A, A+B or C only and explain in notes box]:
A Government agency [Y, N]

B Parastatal, PPP or 3PL contractor. [Y, N]
C There is no official transport at this store [Y, N]
Notes:
E0:05a
Specify all transport types used for vaccine delivery or collection at this
level. [Select at least one option]:
0.00
A Motorcycles [Y, N]
B Cars, vans, trucks, refrigerated trucks and other road vehicles [Y, N]
C
D
E
F
Notes:
Aircraft [Y, N]
Railway [Y, N]
Boat [Y, N]
Other [Y, N. Enter description in notes box]
E2
All vaccines and diluents are stored within WHO-recommended temperature ranges.
2.1
The quality of the cold chain must be systematically and

routinely monitored
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EVM REQUIREMENTS
Q no.
2.1.2
Temperature map all freezer rooms and cold rooms used for E2:02a
storing vaccine
EVM QUESTION
Result
Score
Max
CONDITION: If there are freezer rooms and/or cold rooms.

Freezer room and cold room temperature mapping checklist:
A How many vaccine freezer rooms and cold rooms are there?
B How many of these rooms have a fully documented temperature
mapping study?
0.00
0.00
0.00
5.00
Notes:
E2:04a
Do the storekeeper(s) or health worker(s) know which vaccines on the
schedule can be damaged by temperatures below 0C? [Y, N]
0.00
5.00
Notes:
E2:05a
Has the storekeeper received classroom, or on-the-job, training in how
to look after vaccines? [Y, N]
0.00
1.00
0.00
1.00
0.00
0.00
0.00
0.00
Notes:
2.2
Continuous temperature records must be kept, and

these records must demonstrate that vaccine has been
stored correctly in both permanent and temporary cold
stores.
2.2.1
Store all vaccines and diluents at the correct temperature
2.2.3
Maintain complete temperature records for every freezer

room, cold room, vaccine freezer, vaccine refrigerator and
refrigerated vehicle.
E2:03a
Can the storekeeper(s) or health worker(s) give the correct storage

temperature range for each of the vaccines on the schedule? [Y, N].
Notes:
E2:07a
CONDITION: If there is refrigeration equipment
Is there a complete set of manual temperature records for each and
every cold room, freezer room, vaccine refrigerator and vaccine freezer
throughout the review period? [Y, N]
Notes:
CONDITION: If there are freezer rooms and/or cold rooms
E2:08a
Is there a complete set of temperature recorder discs and/or
temperature logger printouts for each and every cold room and freezer
room throughout the review period?
[Y, N]
Notes:
CONDITION: If refrigerated vehicles are used
E2:09a
Is there a complete set of temperature recorder traces and/or
temperature logger printouts for each and every refrigerated vehicle
throughout the review period? [Y, N]
Notes:
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2.2.4
2.2.5
EVM REQUIREMENTS
Keep temperature records in a safe place for a minimum of

three years.
Q no.
EVM QUESTION
Result
E2:10a
CONDITION: If there are freezer rooms or cold rooms

Does a random 7 day sample of temperature recorder traces/logger
printouts for each cold room and freezer room agree with the matching
manual temperature records? [Y, N].
Notes:
E2:11a
Have temperature records been kept in a safe place for at least three
years? [Y, N]
Score
Max
0.00
1.00
0.00
1.00
0.00
5.00
0.00
0.00
Notes:
Carry out an internal review of the temperature records every E2:12a
month.
Temperature review checklist.
A Are temperature records formally reviewed at least once a month in
order to identify temperature excursions and their causes? [Y, N]
B Have correct remedial actions been taken? [Y, N, n/a if there are no
excursions or breakdowns]
Notes:
2.3
Temperature recording devices must be accurate to +/0.5 deg C.
2.3.1
Provide evidence that temperature recording devices comply E2:13a

with the specified level of accuracy. Carry out this test at
least once every 12 months.
CONDITION: If there are freezer rooms or cold rooms or refrigerated

vehicle(s)
Is there a test calibration record to show that the cold rooms , freezer
rooms and refrigerated vehicle (if used) are calibrated every 12 months?
[Y,N]
Notes:
Criteria score E2:

Maximum score:
Percentage:
E3
Cold storage, dry storage and transport capacity is sufficient to accommodate all vaccines and supplies needed for the programme.
3.1
Storage capacity must be sufficient for maximum stock

levels of routine vaccines and related consumables.
Where supplementary vaccines and/or other products
are also held in the store it must be able to accomodate
these.
3.1.1
Carry out volume calculations for all vaccines, diluents and

droppers that are kept in the vaccine store.
0.00
19.00
0%

Using data from the annual vaccine arrival schedule (primary level) or
the annual vaccine delivery schedule (lower levels), establish whether
the capacity of the +2C to + 8C vaccine store is sufficient over a one
year cycle. Where relevant, include other products and supplementary
vaccines.
E3:01a
A Measure the net storage capacity of the +2C to + 8C store(s) in litres

or m.
B Enter maximum estimated vaccine volume in litres or m, plus 10%.
0.00
5.00
Notes:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
E3:02a

Using data from the annual vaccine arrival schedule (primary store) and
the annual vaccine delivery schedule (lower levels), establish whether
the capacity of the -20C vaccine store is sufficient over a one year
cycle. Where relevant, include other products and supplementary
vaccines.
Score
Max
A Is any vaccine stored at -20C in this store? [Y, N]

B Measure the net storage capacity of the -20C store(s) in litres or m.
C Enter maximum estimated vaccine volume in litres or m, plus 10%.
3.1.2
Carry out volume calculations for all syringes and safety

boxes that are kept in the dry store.
0.00
5.00
0.00
5.00
0.00
0.00
0.00
0.00
Notes:
E3:03a
CONDITION: If syringes and safety boxes (consumables) are stored at
this level.
Using data from the annual consumables arrival schedule (primary level)
and the annual consumables delivery schedule (lower levels), establish
whether the capacity of the dry store is sufficient over a one year cycle.
A Measure the net storage capacity of the dry store in litres or m.

B Enter maximum estimated diluent, syringe and safety box volumes litres
or m, plus 10%.
Notes:
3.2
Where vaccine and related consumables supplied for

supplementary use are stored in temporary facilities,
these facilities must accommodate maximum stock
levels.
3.2.1
Carry out volume calculations for all vaccines, diluents and

droppers that are kept in temporary facilities.
E3:04a
Are supplementary vaccines and consumables kept in temporary

store(s)? [Y, N]
Notes:
E3:05a
CONDITION: If there are temporary stores.
Using data from the supplementary vaccine arrival schedule and the
campaign vaccine delivery schedule, establish whether the capacity of
the +2 to + 8C vaccine store is sufficient over a one year cycle.
A Measure the net storage capacity of the +2 to +8C store(s) in litres or

m.
B Enter maximum estimated vaccine volume in litres or m, plus 10%.
Notes:
CONDITION: If there are temporary stores.
E3:06a
Using data from the supplementary vaccine arrival schedule and the
supplementary vaccine delivery schedule, establish whether the capacity
of the -20C vaccine store is sufficient over a one year cycle.
A Is any vaccine stored at -20C in this store? [Y, N]

B Measure the net storage capacity of the -20C store(s) in litres or m.
C Enter maximum estimated vaccine volume in litres or m, plus 10%.
Notes:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
3.2.2
Carry out volume calculations for all syringes and safety

boxes that are kept in temporary facilities.
E3:07a
CONDITION: If there are temporary stores AND syringes and safety

boxes (consumables) are stored at this level.
Using data from the supplementary arrival schedule (primary level) and
the supplementary vaccine delivery schedule (lower levels), establish
whether the capacity of the dry store is sufficient over a one year cycle.
Score
Max
A Measure the net storage capacity of the dry store in litres or m.

B Enter maximum estimated diluent, syringe and safety box volumes litres
or m, plus 10%.
3.3
3.3.1
0.00
0.00
0.00
5.00
0.00
0.00
0.00
0.00
0.00
5.00
Notes:
Transport capacity must be sufficient to meet maximum
demand.
Carry out transport volume calculations for vaccine
Using data from the vaccine delivery schedule, establish whether
E3:08a
distributions.
transport capacity is sufficient to meet peak demand levels.
A Measure the net storage capacity of the delivery vehicle(s) in litres or m.
B Enter peak delivery volume in litres or m, plus 10%.
Notes:
3.4
Capacity of passive containers and capacity to produce

icepacks/chilled water packs must be sufficient to meet
maximum demand.
3.4.1
Calculate whether the available icepack freezers/chilled

water pack coolers have sufficient capacity to meet the
maximum daily demand for icepacks/chilled water packs.
E3:09a
CONDITION: If cold boxes or other passive containers are used.

Using data from the vaccine delivery schedule or outreach session size
data, establish whether coolant capacity is sufficient to meet maximum
demand levels
A Is there sufficient freezing or cooling capacity to meet maximum

demand? [Y, N].
B Is there sufficient storage capacity for icepacks/chilled water packs
storage to meet peak demand? [Y, N].
3.4.2
Calculate whether sufficient passive container capacity is

available to meet maximum daily demand.
Notes:
E3:10a
Using data from the vaccine delivery schedule, establish whether there
are sufficient passive containers to meet maximum demand levels.
A Does this store stock passive containers for delivery and/or collection?
[Y, N]
B Are there sufficient passive containers? [Y, N, n/a if containers are
supplied by the receiving store].
Notes:
3.5
There must be a contingency plan to protect the vaccine

in an emergency.
3.5.1
Develop a contingency plan designed to deal with forseeable E3:11a

emergencies at each store.
CONDITION: If there is refrigeration equipment.

Vaccine store contingency planning checklist:
A Is there a satisfactory SOP which sets out a contingency plan in the

event of equipment failure or other emergency? [Y, N].
B Are emergency contact details posted in the vaccine store? [Y, N].
C Do staff know what to do in the event of an emergency? [Y, N].
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Notes:
Criteria score E3:

Maximum score:
Percentage:
E4
Buildings, cold chain equipment and transport systems enable the vaccine and consumables supply chain to function well.
4.1
The store building(s) must be conveniently sited and the

standard of construction must meet minimum
requirements.
4.1.1
The site where the vaccine store building is located must be

accessible to staff and to transport and must be secure.
E4:01a
The quality of the vaccine store building(s) must meet

minimum requirements.
Max
0.00
25.00
0%
Vaccine store site checklist:
A Can delivery vehicles easily reach the store(s)? [Y, N].

B Is the site secure? [Y, N].
Notes:
E4:02a
CONDITION: Dry storage on a separate site.
Dry store site checklist.
4.1.2
Score
A Can delivery vehicles easily reach the store? [Y, N].

B Is the site secure? [Y, N].
Notes:
E4:03a
Vaccine store or health facility building checklist:
0.00
5.00
0.00
0.00
0.00
5.00
A Is the vaccine store building suitable for the climate? [Y, N].
B Is the roof free of leaks? [Y, N].

C Are the external walls free of severe cracks or other major damage? [Y,
N].
D Are windows and external doors in good condition and secure (grilles
and/or locks)? [Y, N].
E Are floors dry and reasonably level? [Y, N].
F Are there any fire extinguishers and have they been tested in the past 12
months? [Y, N, n/a].
G Is the electrical system satisfactory? [Y, N, n/a].
H Is the drainage system working (both rainwater and foul drainage)? [Y,
N].
J Is the air-conditioning system working? [Y, N. Score 'n/a' in climates
where a/c is not required].
K Is the heating system working? [Y, N. Score 'n/a' in climates where
heating is not required].
4.1.3
The quality of the dry store building(s) must meet minimum

requirements.
Notes:
CONDITION: Separate dry store building.
E4:04a
Building checklist:
A Is the dry store building suitable for the climate? [Y, N].
B Is the roof leak-free? [Y, N].
C Are the external walls free of severe cracks or other major damage? [Y,
N].
D Are windows and external doors in good condition and secure (grilles
and/or locks)? [Y, N].
E Are floors dry and reasonably level? [Y, N].
F Are there any fire extinguishers and have been tested in the past 12
months? [Y, N].
G Is the electrical system satisfactory? [Y, N, n/a].
H Is the drainage system working (both rainwater and foul drainage)? [Y,
N].
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
J Is the air-conditioning system working? [Y, N. Score 'n/a' in climates

where a/c is not required].
K Is the heating system working? [Y, N. Score 'n/a' in climates where
heating is not required].
0.00
0.00
0.00
1.00
0.00
0.00
Notes:
4.2
Space standards within the vaccine store building must

be satisfactory.
4.2.1
The layout of the space housing the refrigeration equipment

must meet WHO-recommended recommendations.
E4:05a

Refrigeration equipment space checklist
A Is there sufficient space to maintain the equipment? [Y, N].
4.2.2
There must be space for packing vaccine for onward

dispatch. The layout of the packing area must meet WHOrecommended recommendations.
B Is the room well ventilated? [Y, N].

Notes:
E4:06a
Packing area checklist:
A Is the packing area close to the refrigeration equipment area? [Y, N].
B Are the icepack freezers or chilled water pack coolers close to the
packing area? [Y, N].
C Is there sufficient lay out space for conditioning icepacks? [Y,N, n/a if
chilled water packs or eutectic panels are used, or if container design
does not require conditioned icepacks].
D Are the empty containers stored in, or close to, the packing area? [Y, N,
n/a if containers are supplied by the collecting store].
E Is there sufficient lay out space for packing vaccines into containers? [Y,
N].
F Is there sufficient space to store packed containers? [Y, N].
G Are there working hand washing facilities in, or close to the packing
area? [Y, N].
H Can the temperature of the packing area be maintained between 15
and 25C throughout the year? [Y, N].
J Is the packing area protected against direct sunlight? [Y, N].
Notes:
CONDITION: If refrigerated vehicles are used.
E4:07a
Packing area checklist:
A Is the packing area close to the refrigeration equipment area? [Y, N].
B Are the delivery cartons or delivery crates stored in or close to the
packing area? [Y,N]
C Is there sufficient lay out space to assemble vaccine orders for packing
into delivery cartons or delivery crates? [Y, N].
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
D Can packed vaccines be loaded directly into the refrigerated vehicle? [Y,
N].
E Are there hand washing facilities in, or close to the packing area? [Y, N].
F Can the temperature of the packing area be maintained between 15
and 25C throughout the year? [Y, N].
G Is the packing area protected against direct sunlight? [Y, N].
0.00
0.00
0.00
5.00
0.00
1.00
0.00
1.00
0.00
0.00
0.00
0.00
Notes:
E4:08a
Store keeper's office checklist
A Is the office close to the vaccine storage area, packing area and loading
bay? [Y, N].
B Is the room large enough? [Y, N].
4.2.3
Provide storage space within the vaccine store for diluents

and close to the vaccine store for packaging materials,
transport containers and spare parts.
Notes:
E4:09a
Vaccine store: secondary storage space checklist.
A Is there enough storage space for diluents? [Y, N].
B Is there enough storage space for packaging cartons or packaging
crates? [Y, N, n/a].
C Is there enough storage space for cold boxes or passive containers? [Y,
N, n/a].
D Is there enough storage space for consumables (spare parts, freeze
indicators, stationary, etc)? [Y, N].
4.2.4
Provide storage space for syringes and safety boxes.
Notes:
E4:10a
Dry store: checklist
A Does the dry store have well organised shelving, pallet standing or pallet
racking? [Y, N]
B Is there suitable mechanical handling equipment, if needed? [Y, N, n/a]
Notes:
4.3
Equipment must be satisfactory in both permanent and

temporary vaccine stores.
4.3.1
Cold rooms and freezer rooms must comply with the listed
minimum standards.
E4:11a

Cold room and freezer room checklist
A Are all cold room and freezer room enclosures in good condition at time
of inspection? [Y, N].
B Do all rooms have continuous temperature recorders? [Y, N].
C Are all cold rooms and all freezer rooms fitted with dual refrigeration
units? [Y, N].
D Can doors be locked from the outside but freely opened from the inside?
[Y, N].
E Are all rooms fitted with sufficient good quality shelving? [Y, N].
F Cold climates only. Do cold rooms EITHER have low temperature
protection OR are they located in a permanently heated room? [Y, N.
Score 'n/a' if low temperature protection is not required].
4.3.2
Provide protective clothing for staff working in cold rooms

and freezer rooms and train staff in safe working practices.
Notes:
E4:12a
Checklist for working in cold rooms and freezer rooms:
A Is warm clothing available for cold store workers? [Y, N].

B Have workers received training in safe working in cold stores? [Y, N].
Notes:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
4.3.3
Freezers and refrigerators must comply with the listed

minimum standards.
E4:13a
CONDITION: If there are refrigerators and/or freezers

Vaccine freezer/refrigerator checklist.
Result
Score
Max
A Do all vaccine freezers comply with the WHO specifications that were in
force at date of purchase, including correct climate zone? [Y, N. Score
n/a if no freezers].
B Do all vaccine freezers have continuous temperature recorders? [Y, N.
Score n/a if no freezers].
C Do vaccine freezers have a working thermometer stored with the
vaccine? [Y, N. Score n/a if no freezers].
D Do all vaccine refrigerators comply with the WHO specifications that
were in force at date of purchase, including correct climate zone? [Y, N.
Score n/a if no refrigerators].
E Are all ice-lined refrigerators fitted with the correct vaccine storage
baskets? [Y, N, n/a]
F Do all vaccine refrigerators have continuous temperature recorders or
refrigerator loggers or freeze indicators? [Y, N, n/a].
G Do all vaccine refrigerators have a working thermometer stored with the
vaccine? [Y, N. Score n/a if no refrigerators].
H Where applicable, are there sufficient reserve supplies of kerosene
and/or gas? [Y, N, n/a].
J Where applicable, is kerosene or gas always available? [Y, N, n/a].
K Cold climates only. Do vaccine refrigerators EITHER have low
temperature protection OR are they located in a permanently heated
room? [Y, N. Score 'n/a' if low temperature protection is not required].
4.3.4
The use of CFC gases in refrigeration equipment must be

phased out in accordance with UNICEF/WHO policy.
0.00
0.00
0.00
1.00
0.00
0.00
Notes:
E4:14a
Inspect refrigeration equipment:
A How many refrigeration units are there (dual CR and FR units count as
2, refrigerators and freezers count as 1 each)?
4.3.5
In primary and large sub-national vaccine stores there must

be a standby generator, with automatic start-up. Preferably
the generator should serve the vaccine store alone.
B How many of these are CFC-free?

Notes:
E4:15a
Standby generator.
A Is a generator required at this store? [Y, N]

B Is a standby generator installed? [Y, N]
Notes:
E4:16a
CONDITION: If a generator is required and installed.
Standby generator checklist:
A Is the generator in working order? [Y, N].
B Can the generator start all the connected equipment in the vaccine
store? [Y, N].
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
C Is the fuel tank large enough? [Y, N].
4.3.6
Provide voltage regulators for all refrigeration equipment

wherever voltage fluctuations exceed +/- 15% of rated
voltage (or the refrigeration equipment manufacturer's
voltage tolerance, whichever is lower).
D Are there sufficient reserve supplies of fuel? [Y, N].

E Is the generator in a secure compound? [Y, N].
Notes:
Is the voltage fluctuation sufficiently severe to require voltage regulation
E4:17a
equipment? [Y, N, n/a if solar refrigeration or cold boxes/vaccine carriers
are used to store vaccine].
0.00
0.00
0.00
1.00
0.00
0.00
0.00
1.00
0.00
5.00
Notes:
E4:18a
CONDITION: If voltage regulation is required.
Voltage regulator checklist.
A How many freezer rooms are there?

B How many are attached to a functioning voltage regulator?
C How many cold rooms are there?

D How many are attached to a functioning voltage regulator of the correct
type?
E How many vaccine freezers and refrigerators are there?
F How many are attached to a functioning voltage regulator of the correct
type?
4.3.7
Temperature alarms must be fitted to all refrigeration

equipment used to store vaccine.
Notes:
Temperature alarm equipment checklist for freezer rooms and cold
E4:19a
rooms.
A
B
C
D
Notes:
E4:21a
4.3.8
National telecommunications links (including mobile

networks) must be sufficient to manage vaccine arrivals,
delveries and other vaccine management issues.
4.4
Transport and transport containers used to distribute

vaccines down to the next level in the cold chain must
be satisfactory.
4.4.1
Provide a reliable and sufficient transport infrastructure at all E4:22a

locations where vaccines and consumables need to be
distributed down the supply chain.
How many freezer rooms are there?

How many have functioning alarm systems?
How many cold rooms are there?
How many have functioning alarm systems?
Are telecommunications links working? [Y, N Score 'N' if there is no
provision].
Notes:
CONDITION: If vaccine transport is directly operated by this store.

General vehicle checklist (includes refrigerated vehicles):
A Is every vehicle, for which the programme is responsible, in good

mechanical condition? [Y, N].
B Does every vehicle, for which the programme is responsible, have its
own user logbook? [Y, N].
C Does every vehicle, for which the programme is responsible, have an up
to date maintenance and service record (including a record of
refrigeration unit servicing where applicable)? [Y, N].
Notes:
CONDITION: If refrigerated vehicles are used
E4:23a
Refrigerated vehicle checklist.
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
A Are vehicles and refrigeration units in good mechanical condition [Y, N]
B Do the refrigeration units maintain a temperature of +2C to +8C? [Y,

N].
C Are refrigerated bodies fully insulated with a certified standard of
insulation (k value) (roof, walls and floor)? [Y, N]
D Are vehicles equipped with a self-sustained diesel refrigeration unit
which can operate when the vehicle's engine is switched off? [Y, N]
E Do refrigeration units have a standby electrical power system that can be
plugged into a mains supply? [Y, N]
F If any refrigerated compartment is more than 6 metres long, does it have
an air ducting system? [Y, N, n/a]
G Are vehicles equipped with a thermometer which can be read in the
driver's cab? [Y, N]
H Are vehicles equipped with a temperature recorder which can produce
hard copy output? [Y, N]
4.4.2
Provide suitable transport containers to protect vaccines

during distribution.
0.00
0.00
0.00
1.00
Notes:
E4:24a
Transport container checklist:
A CONDITION: If passive containers are used.
Do passive containers used at this level comply with WHO
specifications? [Y, N]
B CONDITION: If refrigerated vehicles are used.
Refrigerated vehicles: are the disposable cartons or reusable crates
used to transport vaccine fit for purpose. [Y, N]
Notes:
Criteria score E4:

Maximum score:
Percentage:
E5
Maintenance of buildings, cold chain equipment and vehicles is satisfactory.
5.1
Planned preventive maintenance to buildings,

equipment and transport must be carried out.
5.1.1
Buildings: Establish a planned preventive maintenance

programme and provide evidence that this plan is being
followed.
E5:01a
0.00
27.00
0%
Planned preventive maintenance checklist for buildings:
A Is there a written multi-year planned preventive maintenance (PPM)

programme. [Y, N]
B Is there documentary evidence that the programme is being followed. [Y,
N]
C Is there visual evidence that maintenance is taking place. [Y, N]
5.1.2
Equipment: Establish a planned preventive maintenance

followed.
0.00
5.00
Notes:
E5:02a
Planned preventive maintenance checklist for refrigeration equipment:
A Is there a written planned preventive maintenance (PPM) programme.

[Y, N]
B Is there documentary evidence that the programme is being followed. [Y,
N]
C Is somebody assigned to carry out routine maintenance [Y, N]
D Is there evidence that cold rooms/refrigerators/ freezers have recently
been cleaned and defrosted? [Y, N]
E Is there evidence that kerosene refrigerator wicks have been trimmed
and chimneys cleaned? [Y, N, n/a]
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
F Is there evidence that solar refrigerator battery electrolyte has been

checked and solar panels cleaned? [Y, N, n/a]
G Are all solar panels completely unshaded by buildings, trees and

overhead cables? [Y, N, n/a]
5.1.3
Transport: Establish a routine maintenance and overhaul

followed.
0.00
5.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Notes:
E5:03a
Transport maintenance and overhaul checklist:
A Are vehicles maintained in accordance with the manufacturer's service

manual? [Y, N]
B Is there documentary evidence that the service manual is being
followed. [Y, N]
C Is there a written planned overhaul programme. [Y, N]
D Is there documentary evidence that the overhaul programme is being

followed. [Y, N]
Notes:
5.2
Arrangements must be made to carry out prompt repairs

in the event of equipment or vehicle breakdown.
5.2.1
Equipment: make arrangements to ensure that cold chain

equipment is repaired within 7 days of breakdown. Record
these repairs.
CONDITION: If freezer room(s) or cold room(s) are used

Cold room and freezer room refrigeration unit maintenance checklist:
E5:04a
A How many refrigeration units are there?

B How many were fully operational at the time of inspection?
Notes:
CONDITION: If vaccine is stored at the facility AND there are
E5:05a
refrigerators/freezers
Vaccine refrigerator and vaccine freezer maintenance checklist:
A How many vaccine refrigerators and freezers are there (all types,
including solar)?
Notes:
E5:06a
CONDITION: If there are dedicated icepack freezers/cool water pack
coolers
Maintenance checklist for freezer rooms, cold rooms, freezers and
refrigerators only used for freezing icepacks or cooling cool water packs:
A How many icepack/cool water pack units are there?

5.2.2
Transport: make arrangements to ensure that planned

vaccine distributions are not affected by vehicle breakdown
or poor maintenance planning.
Notes:
E5:07a
Transport availability checklist:
A During the review period, how many vaccine collections, distributions or

outreach immunization sessions were planned?
B How many were cancelled or seriously delayed because of mechanical
failure in the vehicle fleet?
Notes:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Criteria score E5:
Maximum score:
Percentage:
E6
Stock management systems and procedures are effective.
6.1
Standardized recording and reporting of all stock

transactions must be carried out. Preferably this should
be computerized at primary level and in all other large
stores.
6.1.1
Where a computerized stock control system is used, the

E6:01a
Is a computerized stock control system in use? [Y, N].
software and computer equipment must be suitable for the
task and well-maintained and staff must know how to use the
Notes:
system.
CONDITION: If computerized stock control is used.
E6:02a
Computerized stock control checklist:
Score
Max
0.00
10.00
0%
A Is the software fit for purpose [Y, N]
B Is the software package supported by the software developer [Y, N]

C Is there up-to-date anti-virus software on the computer [Y, N]
D Has the storekeeper received training in its use [Y, N]
E Is the computer suitable for its purpose and in working order? [Y, N].
F Is the printer in working order and supplied with paper? [Y, N]
G Is the computer equipment connected to the standby generator? [Y, N]
H Are stock records printed out and filed as a permanent record at least
once a month? [Y, N].
J Are stock records backed up at least once a week? [Y, N].
6.1.2
Ensure that all stock transactions are recorded in the stock

records by the end of the working day.
6.1.3
Arrival. Accurately record incoming vaccines, diluents, and

other consumables.
Notes:
E6:03a
Are all vaccine arrivals and vaccine dispatches recorded and stock
balances updated within one working day of the transaction? [Y, N].
0.00
0.00
0.00
5.00
0.00
5.00
0.00
5.00
Notes:
E6:04a
Do the stock records record the following information for all vaccines:
A
B
C
D
E
F
G
H
Type of vaccine [Y, N]

Vaccine presentation (vial size) [Y, N]
Quantity received in doses [Y, N]
Vaccine manufacturer [Y, N]
Manufacturing batch or lot number [Y, N]
Expiry date of each vaccine batch [Y, N]
VVM status where applicable [Y, N, n/a]
Location in the store [Y, N, n/a]
Notes:
E6:05a
Do the stock records record the following information for all diluents that
are packed separately from the vaccine to which they belong:
A
B
C
D
E
F
G
Type of diluent [Y, N]

Diluent presentation (vial size) [Y, N]
Quantity received in doses [Y, N]
Diluent manufacturer [Y, N]
Manufacturing batch or lot number [Y, N]
Expiry date of each batch [Y, N]
Location in the store [Y, N, n/a]
Notes:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
6.1.4
Distributions. Operate an effective system for receiving,

checking and reporting on distributions.
E6:06a
Does the programme prepare routine reports on internal vaccine

distributions, and do these reports summarise the details of each and
every transaction? [Y, N].
6.1.5
6.1.6
6.1.7
6.1.8
Dispatch: Establish a pre-delivery or pre-collection

notification system.
Result
1.00
Notes:
E6:07a
Are vaccine requisition forms used for ordering and receiving vaccine?
[Y, N].
0.00
1.00
Notes:
Is there an effective pre-delivery, or pre-collection, notification system in
E6:08a
place? [Y, N]
0.00
1.00
0.00
1.00
Notes:
E6:10a
Can the storekeeper make exceptions to the EEFO rule (e.g. because of
VVM status)? [Y, N].
0.00
1.00
Notes:
E6:11a
Based on a representative sample, does the issuing store have a
completed issue voucher for every delivery sent out during the review
period ? [Y, N].
0.00
5.00
Notes:
E6:12a
Do the vaccine quantities recorded on the sampled issue vouchers
consistently match the relevant entries in the stock records? [Y, N].
0.00
5.00
0.00
1.00
0.00
1.00
0.00
5.00
Notes:
Arrival: When vaccines and consumables arrive at the
E6:13a
Does the issuing store have a completed arrival voucher for every
receiving store, carry out arrival checks and record results on
delivery which took place during the review period? [Y, N].
the arrival section of the issue voucher. Return a copy of the
arrival section to the issuing store.
Notes:
E6:14a
Does a representative sample of these completed arrival sections
indicate that arrival checks were carried out correctly? [Y, N].
6.1.9
Disposal. Safely dispose of damaged or expired stock in

accordance with standing orders.
Max
0.00
Notes:
Dispatch. Issue and use vaccines, diluents and other dateDo stock records and/or stock in hand demonstrate that vaccine is
E6:09a
limited products in Earliest Expiry - First Out (EEFO) order. If
issued according to the 'earliest-expiry-first-out' (EEFO) principle? [Y,
VVM status indicates that some vaccine vials should be used
N].
ahead of its correct EEFO order, this may be done, but the
reason for doing so must be recorded.
Dispatch: Prepare an issue voucher for all vaccines and

consumables that leave the store. Record quantities of
outgoing stock in the stock records.
Score
Notes:
E6:15a
CONDITION: If vaccine is stored at the facility
Checklist for management of damaged or expired stock:
A Is the stock control system designed to record vaccine and diluent

wastage due to expiry, freezing or heat-exposure? [Y, N]
B If 'yes', do the records show that the system is being used? [Y, N. Score
n/a if there have been no losses in the review period]
C Do staff know that expired and damaged vaccine should be clearly
labelled and stored out of the cold chain until final disposal? [Y, N]
D If 'yes', is there evidence that the procedure is followed? [Y, N. Score n/a
if there have been no losses in the review period]
Notes:
CONDITION: If there is a functioning system for recording damaged or
E6:16a
expired vaccine.
Select a freeze-sensitive vaccine. Establish how many doses have been
discarded during the review period due to freezing or exposure to high
temperature.
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
A Enter choice of vaccine:

B Record number of doses of chosen vaccine issued during the review
period.
C Record number of doses of chosen vaccine discarded because of
incorrect storage temperatures.
0.00
0.00
Notes:
Are disposal facilities and procedures in accordance with WHO and/or
E6:17a
national norms? [Y, N].
0.00
1.00
Notes:
E6:18a
Have records of discarded vaccine been kept for at least three years, or,
if for a lesser period, since the immunization programme adopted the
EVSM or EVM? [Y, N]
0.00
1.00
Notes:
Are internal reviews of the vaccine loss/damage records carried out at
E6:19a
least twice a year? [Y, N]
0.00
5.00
0.00
5.00
0.00
5.00
0.00
5.00
Notes:
6.2
Stocks of vaccines and consumables must be

maintained between the safety stock level and the
maximum stock level.
6.2.1
Establish a maximum stock level, a reorder level and a

E6:20a
safety stock level for each vaccine and for each consumable.
Assess stock level policy:

A Is a maximum stock level set for each vaccine and commodity? [Y, N]
B Is a reorder level set for each vaccine and commodity? [Y, N]
C Is a safety stock level set for each vaccine and commodity? [Y, N]
D During the review period, did the stock of each and every vaccine
remain within its EVM recommended maximum? [Y, N]
E During the review period, did the stock of each and every vaccine
remain within its EVM recommended minimum? [Y, N].
6.2.2
There must be no stockouts
Notes:
E6:21a
Check stockouts and related events during the review period:
A Were vaccine stocks sufficient throughout the review period (no
stockouts)? [Y, N]:
B Was the facility always able to supply all the lower level stores? [Y, N,
score n/a if this is a health facility]
Notes:
6.3
Periodic physical inventories must be conducted.
6.3.1
Carry out a physical inventory of vaccine, diluent and dropper E6:22a

stocks at least once every three months at primary level and
at least equal to the planned supply frequency at lower
levels.
Physical inventory frequency checklist:
A Enter the planned vaccine supply period, in months

B Enter number of recorded physical counts of vaccine stocks carried out
during the 12 month review period
Notes:
E6:23a
Choose a sample freeze-dried vaccine and diluent. Enter name.
A Carry out a physical count of the sample vaccine. Enter number of

doses counted:
B Carry out a physical count of the sample diluent. Enter number of doses
counted:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Score
Max
C Check stock records for sample vaccine. Enter number of doses

recorded as currently in stock:
D Check stock records for sample diluent. Enter number of doses
E Scoring: Score 4 if stock count and records match exactly AND vaccine
and diluent quantities are within 1% of one another (see results). Use
your judgement to adjust the score between 0 and 4.
6.3.2
Carry out a physical inventory of other consumables (AD

syringes, safety boxes, consumables, spare parts, etc.) at
least once every three months at primary level and at least
equal to the supply frequency at lower levels.
0.00
5.00
0.00
1.00
0.00
1.00
0.00
1.00
0.00
1.00
Notes:
CONDITION: If consumables are held in this store.
E6:24a
Choose a sample consumable. Enter it in the box below :
A Choose a sample consumable. Enter name.

B Carry out a physical count of the sample consumable. Enter number of
items counted:
C Check stock records for sample consumable. Enter number of items
D Scoring: Score 4 if stock count and records match exactly. Use your
judgement to adjust the score between 4 and 0 for mismatches.
Notes:
6.4
Good warehousing practices must be followed.
6.4.1
Storage: store all vaccines, diluents and droppers securely

and correctly in the vaccine store.
E6:25a

Checklist for vaccine storage arrangements:
A Is the vaccine stock secure? [Y, N]

B Are contents labels fixed to all cold chain equipment indicating vaccine
type, lot no. and expiry date [Y, N, n/a].
C Are vaccines correctly stored? [Y, N].
D Is vaccine laid out in in EEFO order, by type and by lot number? [Y, N]
6.4.2
Storage: store all syringes and safety boxes securely and

correctly in the dry store.
E Is the vaccine store clean, dry and pest-free? [Y, N]

Notes:
CONDITION: If consumables are held in this store.
E6:26a
Checklist for dry storage arrangements:
A Are dry goods secure? [Y, N]
B Are dry goods correctly stored? [Y, N].
C Are dry goods laid out in an orderly fashion and in EEFO order where
applicable? [Y, N]
6.4.3
Data security: keep all records secure.
D Is the dry store clean, dry and pest-free? [Y, N]

Notes:
E6:27a
Are the records secure? [Y, N]
Notes:
E7
Distribution between each level in the supply chain is effective.
7.1
Distribution reports must demonstrate compliance with

the planned delivery schedule.
342344985.xls
Criteria score E6:

Maximum score:
Percentage:
19 of 49
0.00
68.00
0%
01/12/2017
EVM #
EVM REQUIREMENTS
Q no.
7.1.1
Maintain a programme for the distribution of vaccine from the E7:01a

issuing store to the each receiving store. The programme
must be flexible enough to accommodate variations in
demand from the receiving stores.
EVM QUESTION
Result
During the review period, did the issuing store send a distribution
programme to each receiving store setting out dates for the delivery
and/or collection of vaccines? [Y, N]
Score
Max
0.00
5.00
0.00
1.00
0.00
1.00
0.00
1.00
0.00
0.00
0.00
0.00
0.00
0.00
Notes:
E7:02a
CONDITION: If a distribution programme exists.
Assess actual deliveries/collections against the programme:
A Enter number of deliveries/collections (to all receiving stores) that were

scheduled during the review period?
B Record the number of deliveries/collections made during the review
period.
Notes:
E7:03a
Assess the timeliness of a sample of deliveries/ collections:
A How many deliveries/collections were scheduled during the sample

period?
B How many deliveries/collections actually took place during the sample
period?
7.1.2
Notes:
Establish an effective reporting system which monitors actual E7:04a
vaccine distributions and compares these with anticipated
During the review period, was there a reporting system which monitored
distributions.
actual vaccine distributions and compared these with planned
distributions? [Y, N]
Notes:
7.2
A system for managing short shipments must be in

place.
7.2.1
Establish an effective system for managing short shipments

to receiving stores.
E7:05a
Assess number of short shipments during the review period and check if
they were followed up and corrected.
A Where there any short shipments? [Y, N]
B CONDITION: If there were short shipments.
Evaluate the effectiveness with which short shipments were managed
and score on a scale of 0-4].
Notes:
7.3
Vaccines must be correctly packed for transport, either

in passive containers or in refrigerated vehicles
7.3.1
Transport vaccine in passive containers which have a cold- E7:06a

life (or in cold climates, a warm-life) sufficient for the longest
expected journey.

Assess knowledge of coolant preparation and packing of cold boxes,
vaccine carriers and other passive containers:
A Icepack conditioning or cooling of chilled water packs is in accordance

with WHO guidelines? [Y, N]
B Is packing in accordance with appliance labelling or SOP? [Y, N]
7.3.2
Pack vaccine into refrigerated vehicles in accordance with

the standard operating procedure for the vehicle.
Notes:
E7:07a
CONDITION: If refrigerated vehicles are used.
Assess knowledge of refrigerated vehicle packing.
A Is the refrigerated vehicle pre-cooled before loading [Y, N]

B Is there an SOP showing how the vehicle(s) should be packed? [Y, N]
C Is packing carried out in accordance with the SOP? [Y, N]
Notes:
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EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
E7:08a
Cold climates only. Do staff know how to prevent vaccine freezing during
transport? [Y, N, n/a].
Score
Max
0.00
5.00
0.00
0.00
0.00
1.00
0.00
5.00
0.00
5.00
Notes:
7.4
Freeze indicators and VVMs must be used correctly to

monitor the quality of the distribution system, and data
must be recorded.
7.4.1
Dispatch: Record VVM status for each batch of vaccine. If a

freezing risk exists, insert a freeze indicator in every
shipment of freeze-sensitive vaccine sent from the issuing
store to the receiving stores.
Are freeze indicators required for the transport of freeze-sensitive

vacines? [Y, N ]
E7:09a
Notes:
CONDITION: If freeze indicators are required.
E7:10a
Were freeze indicators packed with deliveries of freeze-sensitive
vaccines during the review period?
Scoring: Score on a scale of 0-4 where 4 indicates that freeze indicators
were used on all deliveries and 0 indicates that they were never used.
7.4.2
Notes:
Arrival: The receiving store must return the arrival section of E7:11a
Select a one month sample of issue vouchers.
the issue voucher and must record VVM and freeze indicator
status (where applicable) at the time of arrival.
A How many vouchers were issued by the issuing store?
B How many arrival sections of the sampled issue vouchers have been
returned to the issuing store?
C How many of the returned vouchers record VVM status? (If vaccines do
not have VVMs enter n/a)
D CONDITION: If freeze indicators are required.
How many of these vouchers also record freeze indicator status?
Notes:
7.5
In case of cold chain failure during distribution, damage

must be reported and effective action taken.
7.5.1
Replace damaged vaccine as soon as possible.
E7:12a
Assess vaccine losses caused by freezing or heat exposure during

transport from the issuing store:
A The EVM target is a total loss of less than 1%. (Score Y if this target was
achieved, otherwise score N).
B CONDITION: If 1% loss target was exceeded.
Was the damaged vaccine replaced within a reasonable period of
notification to the issuing store? [Y, N] .
7.5.2
Notes:
Develop a contingency plan designed to deal with forseeable E7:13a
Distribution contingency planning checklist:
emergencies on each and every distribution route.
A Is there a written transport contingency plan which describes how to deal
with emergencies during distribution? Preferably there should be a plan
for each distribution route. [Y, N].
B Do drivers have a radio or mobile phone to contact the supplying store
and/or the receiving store during transit? [Y, N].
C Do drivers know what to do in the event of an emergency? [Y, N].
Notes:
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Criteria score E7:
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0.00
01/12/2017
EVM #
EVM REQUIREMENTS
Q no.
EVM QUESTION
Result
Maximum score:
Percentage:
E8
Appropriate vaccine management policies are adopted and implemented.
8.1
Knowledge of vaccine handling must be good.
8.1.2
Knowledge of the shake test is good.
E8:01a
Score
Max
24.00
0%

Assess knowledge of the shake test:
A Does the storekeeper or health worker know how to conduct the shake
test? [Y, N]
B Does the storekeeper or health worker know when to conduct the shake
test? [Y, N]
C Has the storekeeper of health worker carried out a shake test in the last
12 months? [Y, N. Score n/a if there were no events that required a
shake test]
0.00
5.00
0.00
1.00
0.00
5.00
0.00
1.00
0.00
5.00
0.00
5.00
Notes:
8.2
8.2.1
VVM knowledge and practice must be good.

The VVM policy is correctly implemented by national EPI.
E8:05a
Are written instructions on the use of VVMs, such as posters and

stickers, available to storekeepers and health workers? [Y, N].
Notes:
E8:06a
Do storekeepers/health workers know how to read VVMs? [Y, N].
Notes:
8.4
Monitoring and data collection must take place at all

levels and the data must be used effectively.
8.4.1
There is a vaccine wastage monitoring system.
8.4.2
When vaccines are ordered, wastage rate information is

used to establish the quantities required.
E8:12a
Review the periodic immunization reports and/or any other reporting

forms that are used to monitor vaccine wastage. [Score 0 if there is no
reporting. Score on a scale of 1-4 if formal reporting exists. Use
commentary to elaborate].
Notes:
E8:13a
Wastage calculation checklist:
A Do you calculate wastage rates for each vaccine? [Y, N]
B Is there a standard form used to record wastage? [Y, N]
C Is there a complete set of wastage records for the review period? [Y, N]
D Are these data used to monitor vaccine management performance? [Y,
N]
8.4.3
Regular supportive supervision takes place.
Notes:
E8:14a
Does the facility receive regular supportive supervision? [Y, N]
Notes:
Criteria score E8:

Maximum score:
Percentage:
E9
Information systems and supportive management functions are satisfactory.
9.1
Standard operating procedures must be in place.
9.1.1
Standard operating procedures must be presented in a form E9:01a

Is there a Standard Operating Procedures (SOP) manual? [Y, N].
which can be easily understood by all staff who carry out the
procedures.
Notes:
CONDITION: If there is an SOP manual.
E9:04a
Does the facility have a copy of the SOP manual? [Y, N]
0.00
22.00
0%
0.00
1.00
Notes:
9.3
Field data must be collected and used to support

management decision-making.
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EVM REQUIREMENTS
Q no.
EVM QUESTION
9.3.1
Use an evidence-based method to forecast the need for

vaccines and consumables.
E9:07a
Checklist for vaccine needs forecasting:
Result
Score
Max
A Is a standard method used to estimate annual vaccine need? [Y, N]
B Is evidence-based target population data used in the calculation? [Y, N]

C Is evidence-based coverage data used in the calculation? [Y, N]
D Is evidence-based vaccine wastage data used in the calculation? [Y, N]
Notes:
Is an evidence-based method used to forecast need for syringes and
E9:08a
safety boxes? [Y, N]
Notes:
342344985.xls
Criteria score E9:

Maximum score:
Percentage:
23 of 49
0.00
5.00
0.00
5.00
0.00
11.00
0%
01/12/2017
Guidance notes for assessors
C
a
t
s
c
o
r
e
Answers to this question switch later indicators on and off.
Including solar refrigerators.

Select 'Y' if there is equipment in the store used exclusively for freezing or cooling icepacks. Ignore
fridge/freezers with icepack compartments or freezer rooms/cold rooms that are also used to store vaccine.
It is common for syringes and safety boxes to be stored in separate buildings either in the vaccine store
compound, or elsewhere - these sites and buildings need to be checked.
Syringes and safety boxes may enter the immunization supply chain at a lower level than the primary store if they
are received direct from the manufacturer or from another government department or agency. These products
will always be stored at lowest delivery and health facility levels.
Other passive containers' includes insulated roll containers or palletized containers. These may be used at
primary and sub-national levels.
Enter all options that apply. 'Vehicle' includes motorcycles, cars, trucks, boats and aircraft.
Transport' means any type of vehicle, including motorcycles, cars, trucks, boats and aircraft.
PPP = public-private partnership. 3PL= third party logistics contractor.
Official' transport is one or both of A and B
List all transport types: government-operated, parastatal or private.
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Freezer rooms and cold rooms should be temperature mapped at the time of commissioning to:
1) Establish the air temperature profile throughout the room both when empty and when fully loaded;
2) Define areas which are unsuitable for vaccine storage; e.g. close to cooling coils;
3) Establish the holdover time after a power failure;
Mapping should be repeated whenever changes are made which increase loading or affect air circulation, or
when refrigeration equipment is replaced.
Enquire whether mapping has been repeated and record in notes box.
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Knowledge of correct storage temperatures is vital. If the respondent gives any incorrect answers, score 'No'. ###
Note also:
1) If s/he says that freeze-dried vaccines should be stored at -20C record this as 'Yes'. Current WHO advice is
to store these vaccines at +2 to + 8C, but storage at -20C will not damage these vaccines.
2) If s/he say that freeze-dried vaccines packed with diluents can be stored at -20C, this answer MUST be
scored as 'No'.
3) At service point level, it is correct to say that all vaccines can be stored at +2 to +8C
It is essential that respondents know which of the vaccines should not be exposed to temperatures below 0C. It###
is not important that they know the precise freezing temperature of each of these vaccines.
Training should cover the following minimum topics: 1) correct storage temperatures; 2) vaccines damaged by ###
freezing; 3) vaccines which can be frozen; 4) vaccines which must be frozen; 5) VVM reading; 6) shake test; 7)
temperature monitoring using the range of available devices; 8) storage of diluents; 9) how to arrange vaccines in
cold rooms, freezer rooms, refrigerators and freezers; 10) icepack conditioning; 11) cold box/vaccine carrier
packing.
This question applies all in health facilities with active refrigeration. It does not apply in health facilities where ###
cold boxes or vaccine carriers are used to store vaccine temporarily.
Manual records are necessary because this is the only way to be sure that temperatures are checked at least
twice a day. 'Complete' means that there should be no missing' record sheets or electronic temperature traces
and that the entire review period should be covered for each appliance.
This question only applies in in health facilities with freezer rooms and/or cold rooms.
###
This question only applies in health facilities which use refrigerated vehicles.
###
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Select a random 7 day period for each appliance (not the same period for each). Check the twice daily
temperature records against the corresponding times on the temperature trace. If the record is consistently
within 2C of the trace, this is acceptable. If there are significant discrepancies, especially if the temperature
record is uniform and the trace is not, interview staff to establish the reasons.
Countries should be encouraged to retain such records for tracing purposes. If records are not available for
three years, review the records kept since the immunization programme adopted EVSM or EVM.
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There must be a written record of these reviews which identifies problems and records actions taken. A verbal
assurance is not sufficient.
Check whether records are reviewed and recorded. 'Excursions' are temperatures below +2C or above +8C for
cold rooms and vaccine refrigerators, and above -5C for freezer rooms and vaccine freezers.
Interview the responsible person. Discuss and evaluate remedial actions taken.
###
Since calibration is a relatively complex and technical process it should be avoided wherever possible by
###
choosing temperature monitoring devices which retain their calibration for extended periods, or which can be
recalibrated automatically - e.g. by replacing a digital sensor.
For service delivery level equipment calibration is impractical. However stem thermometers hold their calibration
well and Fridge-tags are effectively calibrated for life (2-3 years). Bi-metallic dial thermometers loose calibration
quite easily and are now excluded from PQS.
Collect site data, then use the sidebar tool to perform these calculations.
The store capacity, taking account of utilisation factor, is acceptable if it is greater than the maximum estimated ###
volume of vaccine to be stored, +10%.
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Collect site data, then use the sidebar tool to perform this calculation.
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Collect site data, then use the sidebar tool to perform this calculation.
The dry store is often housed in a separate building and may be used to store other products in addition to EPI
syringes and safety boxes, etc. Judgement and enquiry is needed to establish whether capacity is sufficient.
Ignore diluents in the volume calculation if the dry store is only used to store syringes and safety boxes. Diluents
should be stored in the vaccine store itself.
Temporary facilities could be a commercial cold room or warehouse with space leased on a short-term basis. Or
it could be a government facility - for example an airport cold room.
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Collect site data, then use the sidebar tool to perform these calculations.There must be sufficient freezing or
cooling capacity to produce an adequate flow of icepacks/chilled water.
Icepack freezing or cooling may sometimes take place in another facility. If this is the case, the capacity of the
other facility needs to be checked.
Peak demand' is the maximum weight of icepacks/chilled water packs required in a day.
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Check total vaccine storage capacity of available passive containers and compare against delivery schedule. If
containers are always supplied by the receiving store this question is not applicable here but must be assessed
at the next level down in the supply chain.
Answer 'Y' if the store keeps a stock of passive containers. If delivery and collection dates are staggered, the
same containers may be used for both purposes.
If some containers are in use, check the container inventory to establish how many there should be.
###
Contingency plans are context-specific, but should include the following minimum elements:
1) Identify the major sources of risk (e.g. power failure, flood, earthquake, etc.).
2) Prepare a written contingency plan.
3) Post emergency contact details on the noticeboard in the vaccine store.
4) Staff must know that the universal safe storage temperature for ALL vaccines in an emergency is +2C to
+8C.
5) Identify at least two alternative cold storage locations. Inspect them to make sure they are large enough, wellmanaged, and can maintain correct temperatures.
6) Ensure that there is a written agreement with the selected emergency providers. If payment will be required,
make sure that this can be funded.
7) Regularly rehearse the contingency plan with store staff and the emergency providers.
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A secure site requires a fenced compound with 24 hour guarding or surveillance.
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Vaccine store' in this context includes service point health facilities.
Suitable' means one of the following:
1) Cold or temperate climates: Thermally insulated and heated.
2) Hot, wet climates: Naturally ventilated or air-conditioned. Well protected against rain penetration.
3) Hot, dry climates: Naturally ventilated or air-conditioned and/or passively protected against excessive heat
build up. Protected against dust penetration.
Roof leaks': Check for damp stains on ceilings.
Reasonably level': The floor should not be visibly sloping and it should be smooth enough for small wheeled
pallet trucks.
Fire extinguishers should be tested and certified annually. There should be a label on each one showing the test
date. Fire extinguishers are unlikely to be found in small health facilities, so enter 'n/a'.
Satisfactory' means that wiring, circuit breakers, electrical sockets and light fittings are in good condition and
securely fixed in place. All circuits should be properly earthed. In a full inspection the earthing of sockets can be
checked with a ring main tester. If there are any doubts, a professional inspection should be carried out.
Service point facilities may have no electricity. If this is the case, score 'n/a'.
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If there is more than one 'other' building, use this checklist and the notes box to cover them all.
Suitable' - see previous question.
Fire extinguishers should be tested and certified annually. There should be a label on each one showing the test
date.
Some health facilities may have no electricity.
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Ventilation requirements are climate-dependent and also depend on the type of refrigeration equipment installed.
Refrigerators, freezers and cold/freezer rooms with monobloc cooling units discharge waste heat into the room
and must be well ventilated. Split system cooling units discharge waste heat to the outside air, which avoids
waste heat build up in the room. Natural ventilation works best if there is a low level air inlet and a high level
outlet, preferably on opposite sides of the room.
Note: Ventilation will only lower the room air temperature if the outside air is cooler than the inside air. During the
daytime in hot dry climates, natural ventilation may actually increase the internal air temperature. In these
climates nightime ventilation is the most effective way to cool a room naturally.
###
It is rather difficult to assess packing area temperature as it depends on climate, building design building
construction and time of inspection. In temperate climates there is unlikely to be a problem. In cold
winter/temperate summer climates, the presence of a permanent heating system should ensure correct
temperatures. In cold winter/hot summer (continental) climates heating is needed in winter and airconditioning is
likely to be needed in summer. In hot humid climates indoor temperature is likely to be similar to the outdoor
shade temperature unless there is airconditioning.
Working' hand washing facilities means that at least cold water comes out of the tap.
###
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A minimum of 7.5m is recommended for a single storekeeper. The room needs to be larger if there is more that###
one person working in the office.
Note: This is not the same as the 'dry store' which is used for syringes and safety boxes.
Diluents should be stored as close as possible to the vaccine.
Packaging should be kept close to the packing area.
Cold boxes should be kept close to the packing area.
Consumables need to be accessible, but iit is not essential for them to be kept in the vaccine store itself.
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Suitable' mechanical handling equipment means pallet lifters in pallet standing stores and forklifts in high rise
(pallet racking) stores. High rise shelving stores require safe and stable step ladders as a minimum.
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Ignore any equipment which is out-of-service for a legitimate reason - for example because it is being serviced or
repaired. Check that any vaccine that was stored in the out-of-service equipment is being kept under safe
conditions.
Good condition' means free of corrosion, with all panel joints properly sealed and no sign of excessive
condensation or ice build-up on the face of the panels.
Shelving should be strong enough to support the vaccine without sagging. Preferably it should be supplied by
the cold room manufacturer.
In the winter in cold climates there is a risk that the vaccine will freeze inside the cold room. To prevent this, the ###
cold room should EITHER have a low temperature protection circuit OR the room in which the cold room is
located should be permanently heated.
See: User's handbook for vaccine cold rooms and freezer rooms. WHO/V&B/02.31. Without warm clothing it is
unsafe to work in a cold room or freezer room for extended periods. Some tasks, such as physical stock counts,
cannot be carried out without this protection.
###
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Check that the equipment's climate rating is correct for the site.
Continuous temperature recording in freezers is only mandatory at primary store level.

All freezers should have a stem or dial thermometer.
Check that the equipments's climate rating is correct for the site. PIS and PQS pre-qualified equipment should
have a sticker to show the climate rating.
ILRs must always be fitted with baskets so that vaccine does not come into contact with the bottom or walls of
the unit because this can freeze vaccine.
Continuous temperature recorders or refrigerator loggers (FridgeTag type) are essential at primary level.
Refrigerator loggers are desirable at SN, LD and SP levels.
Sufficient' reserve supplies means at least one spare jerrycan of kerosene or at least one spare full gas bottle.
###
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There should always be a standby generator at the primary store unless mains electricity is completely reliable
and/or has a backup supply from a separate transformer. The same requirement applies at sub-national stores
equipped with cold rooms. Generators are not required in small sub-national stores, lowest distribution level and
service point stores where ice-lined refrigerators are used and there is at least 8 hours electricity per day.
Generators are also not required where kerosene, gas or solar refrigerators are used or where a health facility
uses cold boxes or vaccine carriers for storing vaccine.
If a generator is installed but is not required then the generator questions are switched off and need not be
answered.
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The sidebar tool can be used to help with these calculations.
The starting load for a refrigeration compressor is much higher than the running load. Ask for a demonstration to
prove that the generator is able to cope with the combined starting load of all connected refrigeration units.
Well-designed systems may have 'smart switching' which reduces the starting load by automatically phasing in
the individul refrigeration units.
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72 hours continuous running is recommended, but this is context-dependent. If power cuts are short and/or fuel
is readily available, a smaller capacity will be acceptable.
The way to assess this is as follows: 1) Establish the longest power cut experienced during the review period. 2)
Check the generator fuel consumption in litres per hour. 3) Check the capacity of the fuel tank. If tank
capacity/consumption per hour is less than the longest power cut then the tank capacity is too small.
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Voltage regulation equipment on all refrigeration equipment is essential if voltage fluctuations exceed 15%.
Obtain information from an electrical engineer, or from the local supply company.
If there is no refrigeration equipment in a particular category - e.g. 'freezer room', enter 0 for the equipment
number and 0 for the voltage regulator number.
There may be a single central voltage regulator for the vaccine store or some sharing arrangement across
multiple appliances. In this case score on the basis that every piece of equipment has a regulator and make a
note in the comment box.
Note: Solar refrigerators do not require voltage regulators. Absorption refrigerators require a different type of ###
voltage regulator to those used for compression refrigerators. This needs to be checked during the inspection.
Ideally alarm systems should also have an external flashing light and/or alarm sounder so that security guards
are alerted after working hours.
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Telecommunications links include telephone, internet and radio. At least one of these must be working well.
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This checklist is written with road vehicles in mind. Some programmes may own and operate boats. If this
situation is encountered, evaluate boats using this indicator. If transport is provided by a parastatal or private
sector contractor try to inspect their vehicles, especially if refrigerated vehicles are used.
Ignore vehicles that are scheduled for disposal.
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Check that all vehicles in the fleet comply. Only score an indicator as 'Y' if all vehicles in the fleet have the
feature. Most countries will only have refrigerated vehicles at primary level, but some may use them at subnational level.
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Refrigerated vehicles may not be directly operated by the vaccine store. However, they are such a critical
element in the supply chain that their specification and condition must be checked, even if they are operated by a
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parastatal, PPP or 3PL.
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The level of insulation required is climate and application dependent. But it should be stated in the vehicle
specification.
Needed to equalise temperatures in long vehicles.
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Passive containers include cold boxes, vaccine carriers and palletised or roll containers. Identify products by
using the PQS or PIS catalogue.
No standard set. Use judgement to assess quality. Most important is the way in which cartons or crates are
packed and restrained.
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This question is primarily about planned preventive maintenance (PPM). However, it is possible that the building
is in good condition because it is being informally maintained. 01:C covers this option.
An effective planned preventive maintenance programme for buildings should cover several years into the future
and should set target dates for routine maintenance such as re-decoration, electrical safety inspections, fireextinguisher maintenance, etc.
If the score to question A is 'N' then the score for Question B must also be 'N'. PPM activities should be
monitored and recorded.
If an effective maintenance programme is in place, the building should be in good condition. Indicators of poor ###
building maintenance include broken light bulbs, leaks and damp stains, blocked drains, flaking paintwork, etc.
See answers to E4:04a.
In this context, 'planned preventive maintenance' (PPM) is as set out in the cold chain equipment manufacturers'
service manuals. Both the need for and the timing of PPM can be foreseen.
PPM should be recorded in a maintenance record book or worksheet.

A permanent member of the facilty staff must be formally assigned to carry out the tasks below. They should not
be left to ancillary staff such as cleaners.
Check for excessive ice accumulation on evaporator units or the inside lining. Ice accumulation or condensation
along the panel joints in cold rooms and freezer rooms is a sign that panel joints are leaking or poorly designed.
Frequent trimming and replacement of wicks in kerosene refrigerators is absolutely essential. Chimneys also
need to be cleaned regularly, especially if kerosene quality is poor.
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Some flooded batteries are not sealed and require regular checking of electrolyte levels and topping up with
battery acid. All solar panels should be cleaned from time to time to maintain efficiency. This is particularly
important in dusty areas and in countries where there is snow.
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the original installation as trees grow, new buildings are built and new overhead cables are erected.
This indicator only applies to government-operated vehicles - see E0:04a.A.
The maintenance regime in the manufacturer's service manual must be followed.

Documentary evidence' may be a service log book or a stamp in the service manual supplied with the vehicle.
Overhaul' means the dismantling or replacement of major components, such as clutch linings, engines,
transmissions, etc. The timing may vary between similar vehicles, but the need can be foreseen.
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If the cold room or freezer room has standby refrigeration units, count the number of units.
Ignore equipment that has been officially decommissioned. Include any equipment that is temporarily switched off
because it is not needed. Check that it operates.
Check if the unit has been out of operation for more than 7 days. If so, record this in the notes box.
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Include all vaccine refrigerators and freezers in the store, unless it is clear that broken units are genuinely being
kept for spare parts or disposal.
Check if the unit has been out of operation for more than 7 days. If so, record this in the notes box. With
kerosene units, check that the burner has been assembled correctly.
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Include all units in the store unless it is clear that broken units are genuinely being kept for spare parts or
disposal.
Check if the unit has been out of operation for more than 7 days. If so, record this in the notes box.
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As a general rule, under EVM recommendations, distribution vehicles should not be out of operation for more
than 7 days. This question helps establish whether transport availability is high or low.
Outreach immunization sessions' in this context means sessions that required a motorcycle, car or 4WD.
Cancelled' means that the distribution or immunization session did not occur during the planned working week. ###
'Vehicle' includes motorcycles, cars, 4WD, trucks and small boats. Air and rail links (if used) are assumed to be
outside the programme's control.
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Fit for purpose' means that it can handle the full range of vaccines and commodities, has sufficient data capacity
for the country's needs, and records the minimum data set listed in E6:04a and E6:05a
Anti-virus software is essential.
Paper records are needed as a backup and for quality assurance and review purposes.
Backup should be on a flash drive,secondary hard drive, CD/DVD or on a secure web-based backup site. Ideally###
the device should be kept off site.
The practice of batch processing arrival and delivery slips should be discouraged because it leads to out of date ###
stock records.
A record of location in the store is essential at primary level and in larger sub-national stores. It is unnecessary in
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small sub-national stores and at health facility level.
A record of location in the store is essential at primary level and in larger sub-national stores. It is unnecessary in
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small sub-national stores and in health facilities
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These should be monthly or quarterly depending upon the distribution frequency.
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See model SOP on requisitioning for guidance on good practice. Assess content of existing form(s) against the ###
content of the model forms.
Effective' means that the system is understood and used by the receiving stores and that deliveries or collections###
are reliably made on or near a day that has been arranged well in advance.
Unless VVMs on later-dated stock show Stage 2 exposure, vaccines should always be issued in EEFO order.
Health worker use of EEFO is covered by question E8:09.
In PR, SN and LD stores, the stock records should contain the data needed to demonstrate compliance.
Otherwise physically check the stock. In health facilities it may be easier to check the stock in hand.
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If VVMs on later-dated stock show Stage 2 exposure whilst early-dated stock is still at Stage 1, the heat-exposed###
later-dated stock should generally be issued first.
Select a complete set of issue vouchers for one distribution period. There are unlikely to be any legitimate
reasons for missing issue vouchers.
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Use the same sample as for E6:012a and check the issue vouchers against entries in the stock records. If the ###
answer to E6:11a is 'N' score 'N'.
Use judgement. If the review period has just ended, the arrival slip for recent deliveries may not yet have been ###
received by the issuing store. There may be other legitimate reasons for missing forms. The important point is
that the incomming goods must be checked and the form must be signed by the receiving store.
As with temperature records, suspiciously 'correct' forms may conceal lax practices. If vaccines are put in
quarantine for any reason, these vaccines should be ignored.
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Question does not apply if there is no refrigerated storage at the facility. For example, at health facilities using
cold boxes and vaccine carriers.
If vaccine has to be discarded, any associated diluent must also be discarded. Failure to do this can lead to a
stockpile of 'orphaned' diluent.
If the stock records show that there have been no losses during the review period, ask the storekeeper to confirm
whether or not this is true.
Damaged vaccine must be clearly labelled and stored outside the cold chain to prevent it being issued in error.
Check that there is no damaged/expired vaccine in the store.
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Carry out this check even if the storekeeper reports that no vaccine has been lost.
A score of 5 is only achieved if the percentage of vaccine lost is no more than 1% of the doses issued during the
review period. Exposure to freezing must have been confirmed by a shake test. Exposure to high temperature
must have been confirmed by VVM colour changes.
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This indicator can only be assessed if stock records are accurate, informative and truthful. If there is no method ###
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to record vaccine damage, the score is 0.
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Refer to Guidelines for Safe Disposal of Unwanted Pharmaceuticals in and after Emergencies.
WHO/EDM/PAR/99.2
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Use the stock records to assess whether the store held excessive and/or insufficient stock during the review
period.
A maximum stock level should be set to control over-stocking. Overstocking makes store management difficult
and increases the risk of expiry.
A reorder level is needed to take account of delivery lead-time so that safety stocks are not breached
A safety stock level needs to be set to reduce the risk of stockouts.
Note: The EVM maximum recommended stock level for each vaccine is its defined maximum stock level plus
10%.
Note: The EVM minimum recommended stock level for each vaccine is its defined safety stock level minus 10%.###
Note: If no records are available, interview the storekeeper and make a judgement.
A stockout occurs when the demand or requirement for an item cannot be fulfilled from the currently available
inventory. It does not necessarily mean that there is zero stock. Cases may occur where there is a stockout, but
this does not affect deliveries because a new vaccine arrival occurs before the next delivery has to be made.
Question B covers this situation.
Deliveries to lower level stores are not applicable at health facility level.
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Primary stores should carry out a physical count at least 4 times a year. Lower level stores and health facilities ###
should carry out a count at the time of each incoming delivery. The scoring logic assumes this frequency.
This question does not apply if there is no refrigerated storage at the facility. For example, at health facilities
using cold boxes and vaccine carriers.
The following checks are carried out:
1) If the diluent count differs from the vaccine count by >1% a 'Mismatch' message appears. Otherwise a
'Match' message appears.
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2) If the vaccine stock records = the vaccine count an '=' sign appears. If they are different, the warning 'Not ='
appears.
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Scoring: Ideally, the physical count and the stock records should always match at the end of the working day. ###
However, there may be discrepancies during the day if the stock records are not updated immediately; check with e
the storekeeper. There are legitimate reasons why diluent quantities may differ from vaccine quantities. One of
these is that vaccine manufacturers sometimes over-supply diluent. Therefore, if there is slightly more diluent
than vaccine, there may be no problem. If there is much more, or much less diluent, than vaccine, there must be
a problem.
3) If the diluent stock records = the diluent count an '=' sign appears. If they are different, the warning 'Not ='
appears.
Scoring: See notes to E6:22a.
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Check for labels on the lid of feezers and refrigerators, or on the edge of the shelves in freezer rooms and cold
rooms. Score 'n/a' where labelling is not needed. Labels are not required at health facility level unless there are
several refrigerators.
No freeze-sensitive vaccines stored close to cold room evaporators, stored close to the ice lining in ILRs or
stored close to the evaporator plate of service point refrigerators. No vaccines should be kept in the door shelves
of domestic refrigerators.
Ask which vaccines of a particular type are going to be picked first and check whether these items have the
shortest expiry date.
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Correct' means that stocks should be neatly stacked on pallets so that they are accessible and are not affected
by floor washing.
Syringes have expiry dates and must therefore be organised in EEFO order. Ask which stock is going to be
picked first and check whether these items have the shortest expiry date.
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Records should be stored in lockable filing cabinets.
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Throughout this section, the issuing store is the store which is being assessed.
Scoring: Actual deliveries must be within 80% to 120% of planned deliveries. If no distribution programme
exists, the score is 0.
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Sample period is context dependent. For example, if deliveries are made four times a year over two week
periods, the chosen sample should be one of these two week periods.
Scoring: Algorithm ensures that score is always <1 if actual deliveries/ collections do not match the number
scheduled.
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Compare requisition quantities with actual delivery quantities. Question the storekeeper on the actions s/he has
taken to reduce the impact of short shipments when they occur.
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Ask whether a systematic temperature monitoring, or journey profiling, study has been carried out. Coolant
preparation includes icepack conditioning, preparation of cool water packs and preparation of coolant for
palletized or wheeled passive containers.
For palletized or wheeled containers, follow the manufacturer's instructions.

Cold boxes, vaccine carriers and other passive containers are designed to suit a particular size of icepack.
###
Sometimes the correct size is not available. In such circumstances it is essential that store staff know what to do.
Refrigerated vehicles must be packed so that temperature distribution remains even throughout the load. In
addition, the load must be correctly tied down to prevent damage on bumpy roads.
It is essential that refrigerated vehicles are pre-cooled before packing.
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Refer to SOP on freeze prevention for details.
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Freeze indicators are NOT required if cool water packs are always used in passive containers and there is no risk
of freezing in winter months. Freeze indicators MAY be required when vaccine is transported in refrigerated
vehicles with poor temperature control or limited monitoring equipment. Freeze indicators ARE required when
freeze-sensitive vaccines are packed with frozen ice packs, even if these have been conditioned. They are also
recommended in very cold climates where warm water packs are needed to prevent vaccine freezing during
transport.
If freeze indicators are used, there must be an effective zero-reporting system to record the state of the freeze ###
indicator on arrival at the receiving store.
If no system is in place, leave all cells blank. The score will be zero. Note absence of system in notes box.
Scoring algorithm ensures that only returned and fully completed vouchers count towards the score.
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This is a difficult indicator to assess, unless the stock records are transparent and honest. 100% score is
achieved if there are no losses. If losses occurred and damaged vaccine was replaced in a 'reasonable' time,
the score is 50%.
Reasonable period' depends upon the level in the cold chain and the established supply interval and the extent of
the vaccine damage. The country should have a clear policy to cover this and the assessment should be made
against this policy.
If there is no fixed policy, use judgement. For example, at service point level, if the set supply interval is 4 weeks,
###
then 2 weeks would be reasonable. If the supply interval is 2 weeks, then one week would be reasonable.
Transport contingency plans are context-specific, but should include the following minimum elements:
1) Identify the general sources of risk (e.g. vehicle breakdown, refrigeration unit failure, lack of fuel).
2) Identify specific risks on each route (e.g. poor roads, flooded roads, snow and ice, security risks).
3) Prepare a written plan for each route giving relevant contact details, location of emergency cold stores,
sources of ice, etc.
4) Provide each driver with a plan for the routes he covers.
5) Ensure that the information in each plan is kept up to date.
6) Ensure that all drivers know that the universal safe storage temperature for ALL vaccines in an emergency is ###
+2C to +8C.
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C
a
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s
c
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e
This question is not applicable at health facility level in situations where there is no refrigerator
Check knowledge against the Shake test learning guide

Check knowledge against the Shake test learning guide
Only score n/a if you are sure that there were no events in the review period that required a shake test.
###
###
Use dummy VVMs and/or sticker samples to check knowledge. To score 'Y', all those responsible in the facility ###
must answer correctly.
At national level this question should be adressed to the EPI Manager. At lower level stores wastage rates may ###
not be calculated. However, the information needed for the calculation should be collected and reported up the
supply chain. For example, number of children immunized, doses used and doses lost, destroyed or expired.
At national level this question should be adressed to the EPI Manager.
###
Ask staff when the last supervisory visit took place and how regular these visits are. Answer yes if the level of
support is suitable, taking account of the general knowledge of the facility staff.
###
Check that relevant SOPs are available. For example there is no need to have an SOP for looking after cold
rooms at lowest distribution level.
###
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Use one of the options described in the Mid-level Management training series. Namely:
1) At primary and sub-national levels: Target population or previous consumption data.
2) At service point level: Session size.
Check to ensure that there is compatibility/convergence with the method used in developing the country's
comprehensive multi-year plan (cMYP).
s
c
o
r
e
Standard method' means the UNIICEF vaccine forecasting tool or equivalent. 'Evidence-based' means that data
have been systematically collected - for example national population census, updated as necessary.
Calculations can be based on target population data and assumed vaccine wastage rates, but it is much better to
use evidence-based wastage data collected from the field.
Coverage data will generally be taken from the routine reporting system. Ideally these data should be verified by
periodic coverage surveys.
Calculations can be based on target population data, coverage data and assumed vaccine wastage rates, but it ###
is much better to use evidence-based wastage data collected from the field.
See previous guidance note.
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E2
E3
E4
E2: Temperature
E3: Storage capacity
E4: Buildings, equipment, transport
E5: Maintenance
E6: Stock management
E7: Distribution
E8: Vaccine management
E9: MIS, supportive functions
Buildings
Capacity
Target %
% score
E1
Criteria
E5
E1: Vaccine arrival
Summary data
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
Categ
E6
E7
E8
E9
B
C
Equipment
Management
Repairs/maintenance
Training
Vehicles
Categories
E
M
R
T
V
80%
0%
80%
0%
80%
0%
80%
0%
80%
0%
Charts
0
0
0
0
0
Criteria Scores
1
20%
40%
60%
80%
100%
0.8
0.6
0.4
0.2
0
E1
% score
E2
Row 101
E3
E4
Row 101
E5
Row 101
E6
E7
Target %
E8
Grid
E9
Category Scores
1
0.8
0.6
0.4
0.2
0
B
% score
C
Row 101
E
Row 101
M
Row 101
R
Target %
T
Grid
Charts
Criteria Scores
E1: Vaccine arrival

E9: MIS, supportive functions
E2: Temperature
E8: Vaccine management
E3: Storage capacity
E7: Distribution
E4: Buildings, equipment, transport
E6: Stock management

E5: Maintenance
Row 101
Row 101
Row 101
% score
Target %
Category Scores
Buildings
1
0.8
Vehicles
Capacity
0.6
0.4
0.2
0
Training
Equipment
Repairs/maintenance
Row 101
Row 101
Row 101
Management
% score
Target %

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Sumatera Utara (1SN01) (Version 1)

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Effective Vaccine Management Initiative

EVM Assessment Tool

Supply chain level:

Sub-national store (1)

Unique code for this facility:

Maximum temperature at site C:

Minimum temperature at site C:

Facility assessment start date:

Facility assessment finish date:

Assessed records start date:

Assessed records finish date:

Assessment team members:

Permanently employed staff in the facility

Qualifications (see note 1)

On-line climate database

Experience (see note 2)

Complete these facility-specific questions before continuing

Answers to these questions switch indicators below on

What type of cold chain equipment is used in the store?

B Vaccine storage and dry storage in the same building? [Y, N]

A Government agency [Y, N]

The quality of the cold chain must be systematically and

CONDITION: If there are freezer rooms and/or cold rooms.

Continuous temperature records must be kept, and

Store all vaccines and diluents at the correct temperature

Maintain complete temperature records for every freezer

Can the storekeeper(s) or health worker(s) give the correct storage

Keep temperature records in a safe place for a minimum of

CONDITION: If there are freezer rooms or cold rooms

Temperature recording devices must be accurate to +/0.5 deg C.

Provide evidence that temperature recording devices comply E2:13a

CONDITION: If there are freezer rooms or cold rooms or refrigerated

Criteria score E2:

Storage capacity must be sufficient for maximum stock

Carry out volume calculations for all vaccines, diluents and

CONDITION: If there is refrigeration equipment

A Measure the net storage capacity of the +2C to + 8C store(s) in litres

CONDITION: If there is refrigeration equipment

A Is any vaccine stored at -20C in this store? [Y, N]

Carry out volume calculations for all syringes and safety

A Measure the net storage capacity of the dry store in litres or m.

Where vaccine and related consumables supplied for

Carry out volume calculations for all vaccines, diluents and

Are supplementary vaccines and consumables kept in temporary

A Measure the net storage capacity of the +2 to +8C store(s) in litres or

A Is any vaccine stored at -20C in this store? [Y, N]

Carry out volume calculations for all syringes and safety

CONDITION: If there are temporary stores AND syringes and safety

A Measure the net storage capacity of the dry store in litres or m.

Capacity of passive containers and capacity to produce

Calculate whether the available icepack freezers/chilled

CONDITION: If cold boxes or other passive containers are used.

A Is there sufficient freezing or cooling capacity to meet maximum

Calculate whether sufficient passive container capacity is

There must be a contingency plan to protect the vaccine

Develop a contingency plan designed to deal with forseeable E3:11a

CONDITION: If there is refrigeration equipment.

A Is there a satisfactory SOP which sets out a contingency plan in the

Criteria score E3:

The store building(s) must be conveniently sited and the

The site where the vaccine store building is located must be

The quality of the vaccine store building(s) must meet

Vaccine store site checklist:

A Can delivery vehicles easily reach the store(s)? [Y, N].