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IJSTR >> Volume 2- Issue 11, November 2013 Edition

International Journal of Scientific & Technology Research  
International Journal of Scientific & Technology Research

Website: http://www.ijstr.org

ISSN 2277-8616

Assessment Of Injection Safety Practices In Health Facilities In Bongo And Talensi Districts In The Upper East Region Of Ghana: Part 1-Injection Safety Practices

[Full Text]



Abdul Aziz, Reuben K. Esena, Winfred Dotse-Gborgbortsi



Index Terms: Auto-disable Syringe, Antenatal Clinic, Child welfare Clinic, Safety Boxes, District Health Management Team, Community Health Nurse, Outpatient Department, Puncture-proof Container.



Abstract: Injections are one of the most common health care procedures, and each year about 20 billion injections are administered world-wide [WHO, 2010]. Most injections (about 90 to 95%) are given for therapeutic purposes, and only 5 to 10% are given for immunization. In this study, a cross-sectional design was adopted in the two districts - Bongo and Talensi. Personnel giving injections in the prevention and curative sections as well as the heads of the facilities were observed and interviewed. The waste disposal systems and disposal sites of the facilities were also assessed. A total of thirty-one (31) staff were observed and interviewed in 8 health facilities. Twenty-one (21) were observed and interviewed in Bongo and ten (10) in Talensi districts. Twenty-two (78.6%) prepared injections on clean table and tray. Fourteen (50%) respondents reused mixing syringes for reconstitution and 4(17.9%). Eight (17.9%) had shortage of cotton wool. Community Health Nurses who experienced shortage of cotton wool used syringe wrappers in place of cotton wool after injection. Two hand recapping was observed in 3 (10.7%) respondents. Two (25%) of facilities had sharps scattered at the disposal site. Two facilities that have incinerators were not using them at the time of the visit. The challenges to injection practice were the use of improvised items, reuse of syringes for reconstitution, shortage of logistics and supplies, unattended, open and unrestricted disposal sites leading to sharps scattered around disposal site and non-use of incinerators. It has been recommended that the Regional EPI coordinator must conduct quarterly assessments on availability of EPI logistics and supplies in the districts and facilities.



[1]. Antwi Agyei et al, (2003). Injection safety and Healthcare waste assessment in Ghana - K.O 2003

[2]. Children’s Vaccine Program at PATH: www.childrensvaccine.org/html/safe_injection.htm

[3]. Dicko M, Oni AQ, Ganivet S, Kone S, Pierre L, Jacquet B. (2000). Safety of immunization injections in Africa: not simply a problem of logistics. Bulletin of the World Health Organization; 78:163-9.

[4]. GAVI (2009). Achieving effective sharps waste management in GAVI host countries,

[5]. Hauri, AM; Armstrong, GL; Hutin, YJ. (2004). The global burden of disease attributable to contaminated injections given in health care settings. Int J STD AIDS. 2004;15:7–16. doi: 10.1258/095646204322637182. [PubMed] http://www.worldbank.org/data/countrydata/aag/khm_aag.pdf

[6]. Hutin, Y; Hauri, A; Chiarello, L; Catlin, M; Stilwell, B; Ghebrehiwet, T; Garner, J. (2000). Injection Safety Best Practices Development Group. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections. Bull World Health Organ. 2003;81:491–500. [PubMed]

[7]. Hutin, YJ; Hauri, AM; Armstrong, GL. (2000). Use of injections in healthcare settings worldwide, 2000: literature review and regional estimates. BMJ. 2003;327:1075. doi: 10.1136/bmj.327.7423.1075. [PubMed]

[8]. Immunization Essentials (2003). A Practical field Guide. 2003

[9]. Immunization Newsletter (2008). vol xxx, number 3, June

[10]. Jagger J, Hunt EH, Brand-Elnaggar J, Pearson, R.D. (1988). Rates of needle-stick injury caused by various devices in a university hospital. N Engl J Med 1988; 319: 284–288.[Abstract]

[11]. Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M. (1999). Transmission of hepatitis B, hepatitis C and human immuno-deficiency viruses through unsafe injections in the developing world: Model-based regional estimates. Bulletin of the World Health Organization 1999, 77:801-807.

[12]. Kenya (2005). Injection Safety and Immunization Waste Management Plan Of Action, 2001 – 2005.

[13]. Lakshmi R. (2005). India’s vaccines come with risk: dirty needles used for immunization can spread other diseases. The Washington Post. February 9, 2005:A18.

[14]. Logez, S. (2001). the proceedings of the 3rd Annual International SIGN meeting: 30–31 August 2001. New Delhi, India. WHO; 2001. Increased access to injection equipment in Burkina Faso; pp. 35–35.

[15]. Muller N, (2005). United States Agency for International Development (USAID). Evaluation of a Disposable Needle-Removal Device in Uganda. A HealthTech Report. Seattle: PATH; 2005.

[16]. Nazareth S, Rathi MK; Poking; (1998). Danger: sharps handling and disposal [fact sheet]. New Delhi: Srishti.

[17]. PATH Preventing needle sticks injuries, (Program for Appropriate Technology in Health),

[18]. Prüss-Üstün A, Rapiti E, Hutin Y . (2003). Global Burden of Disease from Sharps Injuries to Health-care Workers. Geneva: WHO;. WHO Environmental Burden of Disease Series, No.3.

[19]. Safe Injection Global Network (SIGN) www.injectionsafety.org

[20]. WHO Strategy regarding injection safety. http://www.who.int/injection_safety/about/strategy/en/

[21]. WHO, (2001). Safe Injection Global Network. Injection Safety: First Do No Harm. WHO/BCT/DCT/01.3. Geneva: WHO;.

[22]. WHO. Strategy regarding injection safety. http://www.who.int/injection_safety/about/strategy/en/

[23]. WHO. (2001). Tool for the Assessment of Injection Safety: Basics II. Geneva: WHO, 2001 (WHO/V&B/01.30).

[24]. WHO. (2002) Injection Practices: rapid assessment guide.. http://www.who.int/injection_safety/toolbox/en/RARG.pdf

[25]. WHO. (2005). Management of Solid Health-Care Waste at Primary Health Care Centers: A Decision-Making Guide. IVB/PHE/WSH. Geneva: WHO; 2005.

[26]. WHO (2005). Safe Healthcare Waste Managemen: Policy Paper. Geneva: WHO; 2004. Available at: http://www.healthcarewaste.org/en/160_hcw_policy.html. Accessed November 11, 2005.

[27]. WHO (2008), Working Paper No: 10

[28]. WHO (2010). WHO Best Practices for injections and related procedures toolkit WHO/EHT/10.02

[29]. WHO/V&B/0.2.26 "First, do no harm" Introducing auto-disable syringes and ensuring injection safety in immunization systems of developing countrieshttp://www.who.int/vaccines-documents/DocsPDF02/www704.pdf

[30]. http:// www.sharpsinjury.com/hiv.htm Proposed Approach with Estimates of Costs, PATH, June 2009.