Guidelines for the Storage of Essential Medicines and Other Health Commodities
(2003; 114 pages) [Arabic] [Chinese] [French] [Hindi] [Russian] [Spanish] View the PDF document
Table of Contents
View the documentDeliver
View the documentAcknowledgements
View the documentRoutine Warehouse or Storeroom Management Tasks
Open this folder and view contents1. Receiving and Arranging Commodities
Open this folder and view contents2. Keeping Track of Products in Your Storeroom
Close this folder3. Maintaining the Quality of Your Products
View the documentMonitoring product quality
View the documentPreventing damaging and contamination
View the documentProtecting against fire
View the documentProtecting against pests
View the documentControlling temperature
View the documentProtecting against theft
Open this folder and view contents4. Setting Up Your Medical Store
Open this folder and view contents5. Waste Management
View the document6. Bibliography
Open this folder and view contents7. Annexes
 

Controlling temperature

Humidity

When product labels say “protect from moisture,” store the product in a space with no more than 60% relative humidity. To reduce the effects of humidity consider-

Ventilation: Open the windows or air vents of the storeroom to allow air circulation. Ensure all windows have screens to keep out insects and birds, and either have bars or are not open wide enough for anyone to climb in. Put boxes on pallets and ensure there is space between pallets and the walls of the storeroom.

Packaging: Secure all lids. Never open a new container unless necessary.

Circulation: Use a fan to circulate fresh (outside) air. In bigger storerooms you may need a ceiling fan. Standing fans are more useful in smaller storerooms. This requires electricity and some maintenance.

Air conditioners: If possible, use an air conditioner. This is costly, depends on a constant supply of electricity, and requires regular maintenance. Depending on climatic conditions, a dehumidifier may be a less costly option. However, they also need a constant supply of electricity and require regular attention to empty the water containers.

Sunlight

Some health products are photosensitive and will be damaged if exposed to light. These include multiple vitamins, furosemide, chloropheniramine maleate, hydrocortisone, latex products (such as male condoms), and x-ray film.

To protect products from sunlight-

Shade the windows or use curtains, if they are in direct sunlight.

Keep products in cartons.

Do not store or pack products in sunlight.

Use opaque plastic or dark glass bottles for products that require them.

Maintain trees on the premises around the facility to help provide shade, but check them regularly to ensure that there aren’t any branches that can damage the facilities.


Heat

Remember that heat will affect many products. It melts ointments and creams and causes other products to become useless. Following the guidelines listed earlier for protecting products from humidity and sunlight will also help protect products from heat.

It is important to have thermometers in various parts of the storeroom to monitor temperature (see section on monitoring temperature). But, even if you do not have thermometers, you can still monitor the heat. If you feel hot, your products are probably hot, too.

Monitoring

Consistently monitor the temperature of the different areas within the storeroom.

Keep thermometers in various places for monitoring.

Keep the storeroom well ventilated (see section on humidity). For better ventilation, store boxes on pallets and leave room between rows of stacked boxes (see section on arranging products).

Keep direct sunlight out of the storeroom.


Refrigerators and freezers

Refrigerators that open on the top are more efficient than vertical ones, because hot air rises while cold air falls.

The coldest part of vertical refrigerators is at the bottom.

Store products that are sensitive to freezing or very low temperatures on the upper shelves.

Always have enough frozen icepacks to transport items requiring cold storage in cold boxes and/or vaccine carriers. Use only icepacks filled with water. Do not use icepacks prefilled with other liquids, which are usually blue or green. When ordering cold chain equipment, larger facilities should reassess the needs for icepacks and icepack freezer space.

If there is enough space, place a few plastic bottles of water in the refrigerator. This will help maintain the temperature for a longer period of time if the power is cut off.

Place refrigerators and freezers with space between and about an arm’s length away from the wall. This will increase the air circulation.

Under ideal conditions, rooms with multiple refrigerators and/or freezers should have air conditioning. Refrigerators and freezers generate large amounts of heat, which can damage the equipment over time.

If it is not possible to have air conditioning, install fans around the equipment to increase airflow. If installing fans, remember to place the fans so the air also flows in the spaces behind the refrigerators.

Ideally, larger facilities should have a cold room rather than numerous refrigerators.

Power supply

Arrange for a solar panel generator or alternative supply of electricity for cold rooms and refrigerators if the main source of electricity is not reliable. If the generator is not solar-powered, maintain a stock of fuel sufficient to run the generator for at least a few days (see section on storing flammables). Run the generator on a regular basis (at least once a month) to ensure the system is working properly. Larger facilities may want to contract out the maintenance of the generator and electrical system.

If your electricity supply is unreliable, use kerosene or solar-powered refrigerators. Kerosene appliances require frequent maintenance. Trim the wick regularly so the flame is not too high, clean the chimney monthly, and keep a backup supply of kerosene (see section on storing flammables). Place the refrigerator away from the wall on a balanced and level surface. The appliance must be placed on a level surface or it will not function properly. Monitor the temperature regularly. The flame on a kerosene appliance should always be blue; if it is yellow, trim the wick.

Common terms

The following terms relate to temperature and medical supplies. It is important to follow the manufacturer’s recommended storage conditions for all products.

Store frozen: Some products, such as certain vaccines, need to be transported within a cold chain and stored at -20°C (4°F). Frozen storage is normally for longer-term storage at higher-level facilities.

Store at 2°-8°C (36°-46°F): Some products are very heat sensitive but must not be frozen. These are usually kept in the first and second part of the refrigerator (never the freezer). This temperature is appropriate for storing vaccines for a short period of time.

Keep cool: Store between 8°-15°C (45°-59°F).

Store at room temperature: Store at 15°-25°C (59°-77°F).

Store at ambient temperature: Store at the surrounding temperature. This term is not widely used due to significant variation in ambient temperatures. It means “room temperature” or normal storage conditions, which means storage in a dry, clean, well ventilated area at room temperatures between 15° to 25°C (59°-77°F) or up to 30°C, depending on climatic conditions.

Medicines with stability problems under tropical conditions:

Oral solids (tablets)

acetylsalicylic acid
amoxicillin
ampicillin
penicillin V
retinol


Oral liquids (syrups)

paracetamol


Injections/injectables

ergometrine
methylergometrine
adrenaline
reconstituted antibiotics


Source: Quick JS, Rankin JR, Laing RO, O’Connor RW, Hogerzeil HV, Dukes MN, Garnett A, (editors). 1997. Managing Drug Supply. 2nd ed. West Hartford CT: Kumarian Press.

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