In Ankole, out of the 14 provider facilities visited which administered injections at the time of the visit,11 72% of them did not observe minimum hygienic conditions before injection administration, while 50% and 64% of them respectively did not observe minimum hygienic conditions during and after injection administration (see Table 13).
11 In Ankole, 16 providers were included in the provider study. Two did not administer injections at all during the visit of the researchers. Here, they are excluded because their hygienic practices could not be assessed. The remaining 14 provider facilities in Ankole were: 2 government hospitals, 10 private facilities, and 2 drugshops (informal providers).
Table 13: Percentage of providers who did not observe minimal standards, before, during and after administration of an injection using the WHO standards (see Appendix 2) in Ankole Region
| |
Ankole
(Western Uganda) (n=14) |
Before administration |
72%
(10) |
During administration |
50%
(7) |
After administration |
64%
(9) |
The poor hygienic practices include use of saucepans instead of sterilizers, handpicking the boiled needles and syringes, improper disposal of needles and syringes or giving the equipment to the patient to carry home. The providers who fall below standards in the category ‘before injecting’ are those who use saucepans as sterilizers and encourage patients to keep and sterilizetheir own equipment at home. Those who fall under the category ‘during injecting’ pick up the needles and syringes with their hands from the sterilizers/saucepans and/or use unsterilized swabbing material to clean the injection site. Those in the ‘after injecting’ categorydid not flush needles and syringes with water after use or took a long time before putting them back into the sterilizer/saucepan and/or reused disposable equipment.
An important observation made in Ankole was that many providers encourage users to carry and/or keep personal needles and syringes at home. Among the private practitioners this practice was encouraged so as to keep the cost of injection administration as low as possible, but also to avoid any blame that may arise regarding the unhygienic administration of injections. Fuelling this practice is the AIDS scourge which has brought an increasing demand from users to keep personal injecting equipment, which they either use at home or carry to provider facilities when seeking injection treatment.
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