Around 81 percent of the private health facilities providing immunisation services are not using the World Health Organization recommended refrigerators to store vaccines, a report published by the Ministry of Health and Population shows.

The study, “Assessment of Immunisation Services in the Private Sector in Kathmandu Valley”, carried out by a consortium of Atlanta’s Center for Disease Control and Prevention, Johns Hopkins University, John Snow Institute and the Health Ministry shows that these health facilities have been storing crucial vaccines in normal refrigerators, which cannot ensure the quality of vaccines.

As per the recommendations of the UN health agency, pre-qualified refrigerators should be used to store vaccines to ensure performance, quality and safety.

"The perception over the service quality of private health facilities may not be true in the cases of immunisation," Dr Shyam Raj Upreti, who led the study, told the Post. "Even the renowned private hospitals like the Grande International Hospital is not storing the vaccines in the WHO-recommended refrigerator."

Lal Devi Maharjan, nursing director at the hospital, said that her hospital did not know that specific WHO pre-qualified refrigerator is needed to store vaccines.

“It is not a big deal to have a WHO-recommended refrigerator for a hospital like ours,” said Maharjan. “We use the normal refrigerator, as we did not know about the requirements and have kept in contact with the concerned government officials about the matters.”

She claimed her hospital had been regularly monitoring the temperatures of vaccines stored in their refrigerators.

Of the 1,445 private health facilities operating in the Kathmandu Valley, 52 health facilities are providing immunisation services. 

Dr Upreti said that the quality of vaccines could be compromised if not stored in the WHO-recommended refrigerator.

Likewise, 67 percent of the private health facilities, which have been offering immunisation services, have been found to be not monitoring the temperature of the refrigerators. The immunisation service providers need to monitor the temperature of their refrigerators twice a day and keep their records. Experts say live vaccines do not work if the proper temperature is not maintained.

Similarly, most of the private healthcare facilities offering immunisation services are not providing all vaccines on the government’s regular immunisation list, which increases the chances of children missing out on crucial vaccines.

The study showed that 50.6 percent of people having the upper middle income (annual household income of $ 3956-$12,235), 38.8 percent people having lower middle income (annual household income $ 1,000-$ 3,955) and 10.6 percent people having the higher income (annual household income of more than $ 12,235) were receiving immunisations service from private centres.

Among them, 70 percent chose private healthcare facilities since they were located close to their homes; 37.5 percent perceived a better quality of service in private health facilities; 17.5 percent said they went to private health facilities because of convenient timings; and 6.2 percent said the private health facilities were close to their workplace.

"Our studies show chances of missing the regular vaccines are very high in private centres," said Upreti. "Some health facilities are providing vaccines not included in regular immunisation list for which they could charge a fee."

Similarly, more than 69 percent of health facilities do not have a defaulter tracing system for drop-out children (children who do not receive all vaccines on the regular immunisation list).

The study also shows that patients are being charged for free vaccines taken from the concerned agencies under the Health Ministry.

Additionally, private healthcare facilities were found to be using normal syringes instead of auto-disable syringes.