Author(s): Mesfin Haile Kahissay*, Teferi Gedif, Efrem Engedawork and Tsige Gebre Mariam
According to the recent WHO report, it is estimated that injection cause an estimated 8-16 million cases of hepatitis B, 2.4-4.5 million cases of hepatitis C virus and 80,000 to 160,000 cases of Human Immunodeficiency Virus (HIV) infections annually worldwide. In Ethiopia, only a handful of studies have attempted to examine the safety of medical injections and vaccinations at health facilities. Besides, such efforts focused mainly at health facilities owned and operated by the government. The aim of this study was to assess injection practices and perception of the providers towards injections in Dessie and Dessie Zuria Woredas. Institutional based cross sectional study was conducted from March to October 2007. For this study the government owned health facilities were surveyed. All hospital and four health centers were selected by purposive sampling methods. Standard survey instruments were adapted from the WHO safe injection global Network (SIGN) for the purpose of this study. From the health facilities study the information generated through the use of different survey instruments and approaches revealed that an alarmingly high proportion of the injections provided at the health facilities were potentially unsafe. Although at the time of observation all the injections were provided using disposable or auto-disable injection equipment, the safety of injection practices was largely compromised due to unsafe practices of handling needles before and after injection, such as failure of proper collection, storage and disposal of syringe/needles, as well as, failure of proper reconstitution of medical injections or vaccines. As a result, the majority of the injections were provided in a manner that predisposes the patient, the health worker or the community to risk of accidental-needle stick injuries. The widespread misuse of puncture proof sharp collection boxes (safety boxes) and inappropriate use of incinerators were among the behavior of health workers that need to be targeted for intervention. There was an established perception among health workers that injection medications were more powerful and effective than oral medications, and thus they believe that most patients prefer injections to oral medications. It is concluded that an extremely high proportion of injections are administered in a potentially unsafe manner. Lack of essential supplies in the health facilities, such as safety boxes, as well as, inadequate skill and attitude among health workers and other personnel are the major obstacles against provision of safe injections. Accordingly, these gaps should be bridged through sustained provision of the necessary supplies coupled with training programs that promote appropriate behaviors and attitude among personnel working in health care facilities.