Injection Practices in the Developing World - Results and Recommendations from Field Studies in Uganda and Indonesia - EDM Research Series No. 020: Appendix 3: Tools used in the injection practices research: Appendix 3.G Standards for hygienic assessment Uganda

Injection Practices in the Developing World - Results and Recommendations from Field Studies in Uganda and Indonesia - EDM Research Series No. 020
(1996; 157 pages)

Table of Contents

Executive summary
Acknowledgements
1. Introduction
	1.1 Background to the injection practices research
	1.2 Injection practices research: objectives and approach
	1.3 Development of the injection practices research
	1.4 Contents of this report
2. Towards a rapid assessment methodology for injection practices research
	2.1 General considerations regarding methodology
	2.2 Sampling
	2.3 Use of indicators
	2.4 Use of tracer conditions
	2.5 Studying injection providers' practices
	2.6 Conclusion
3. Background: the social and cultural context of injections
	3.1 The prevalence of injection use: a literature review
	3.2 Injection use: explaining their popularity
	3.3 Injections and medical practice
	3.4 Injections and human relations
	3.5 Conclusion
4. The prevalence of injection use in Uganda and Indonesia
	4.1 Health care context in Uganda and Indonesia
	4.2 Prevalence of injection use at the household level
	4.3 Illness-related injection use at the household level
	4.4 Type of injections
	4.5 Injection use by age and sex
	4.6 Source of injections
	4.7 Injection rates at health facilities
	4.8 The distribution channels of injections
	4.9 Conclusion
5. The popularity of injections in Uganda and Indonesia
	5.1 Explaining the popularity of injections
	5.2 Conclusion
6. The appropriateness of injection use in Uganda and Indonesia
	6.1 Medical appropriateness of injection use
		6.1.1 Injection use in actual tracer conditions
		6.1.2 Preferences for injections in tracer conditions
		6.1.3 Popularity of specific medicines in tracer conditions
	6.2 Hygienic appropriateness of injection use
		6.2.1 Hygienic practices in Uganda
		6.2.2 Hygienic practices in Indonesia
	6.3 Conclusion
7. Conclusions and recommendations
	7.1 Summary of conclusions of the injection practices research
	7.2 Recommendations for interventions
		7.2.1 Discussion of the recommendations for interventions
		7.2.2 Next steps
References
Appendix 1: Indicators for injection use and for assessment of hygienic practices
	Appendix 1.A Specific research questions³⁵
	Appendix 1.B Indicators³⁶
	Appendix 1.C Revised/simplified WHO-Guidelines for evaluating the hygienic aspects of injection administration³⁷
Appendix 2: Methods applied in the injection practices research
	Appendix 2.A Overview and assessment of user-oriented methods
	Appendix 2.B Overview and assessment of provider-oriented methods
Appendix 3: Tools used in the injection practices research
	Appendix 3.A Household survey Uganda
	Appendix 3.B Household survey Indonesia
	Appendix 3.C Questionnaire for providers Indonesia
	Appendix 3.D Treatment form for providers Uganda
	Appendix 3.E Form for patient chart review, Indonesia
	Appendix 3.F Questionnaire for exit interviews at health facilities, Indonesia
	Appendix 3.G Standards for hygienic assessment Uganda

Appendix 3.G Standards for hygienic assessment Uganda

Overview of various standards and indicators used to assess hygienic practices in Busoga and Ankole, Uganda

	Busoga (n=21)	Ankole (n=14)
BEFORE ADMINISTRATION
• syringes and needles flushed with water after use and before sterilization	-	+
• both needles and syringes sterilized	+	+
• steam sterilization at correct temperature (121°C) for 15 minutes	+	+
• equipment is boiled for 20 minutes after last contaminated piece of equipment is put in boiling water	+	+
• inject only sterile solutions	+	-
• wash hands with soap	+	-
• disinfect the rubber top of the ampoules/vials	+	-
DURING ADMINISTRATION
• can anything not in an aseptic condition contaminate the injection fluid	-	+
• does the person injecting touch the needle with his/her finger	+	+
• does the needle come in contact with any other non aseptic surface	+	+
• are several patients injected with the same needle	+	+
• are several patients treated with the same syringe	+	+
AFTER ADMINISTRATION
• are disposable syringes and needles placed into a final disposal container	+	+
• are disposables recapped before disposal	+	+
• are disposable syringes and needles disposed of and not reused	+	+
• observe patient for about 30 minutes after injection	+	-
• are sterilizable syringes and needles flushed with water after use	+	+

Date	No.	Patient name	Age	Relation	Symptoms	Inject. (tick)	Type & amount	Other med. type & amount	Cost
	1
	2
	3
	4
	5
	6
	7
	8
	9
	10
	11
	12
	13
	14
	15
	..
	30