Injection Practices in the Developing World - Results and Recommendations from Field Studies in Uganda and Indonesia - EDM Research Series No. 020: 1. Introduction: 1.2 Injection practices research: objectives and approach

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

Índice de contenido

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

1.2 Injection practices research: objectives and approach

The main objectives of the injection practices research project were to ²:

• estimate the extent to which injections are used as a route for the administration of medications,

• determine the type and degree of improper and unsafe practices in the process of administration of injections,

• gain insight into why injections are so popular,

• develop a simple, and rapid survey methodology for future assessments of inappropriate injection use.

²Adapted from the Provisional Research Protocol published in the Report of an Informal Workshop on Injection Practices Research, (WHO/DAP/91.8) Geneva 1991.

For the first two objectives, specific research questions were formulated (Appendix 1.A) and quantitative and qualitative research methods have been used (Appendix 2.A and 2.B). The third objective required in-depth anthropological research which was not possible within the scope of the present study. To explore this issue, a literature reviewed was performed, complemented with exploratory interviews with key informants and focus-group discussions in the field studies. The research design was flexible, allowing country teams to adapt the design to their local context. A number of common injection use measures were developed on the prevalence and the evaluation of injection use in order to assure comparison. These indicators are given in Appendix 1.B. The standards used for assessing hygienic practices are presented in Appendix 1.C.