Injection Practices in the Developing World - Results and Recommendations from Field Studies in Uganda and Indonesia - EDM Research Series No. 020: Appendix 1: Indicators for injection use and for assessment of hygienic practices: Appendix 1.A Specific research questions 35

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 des matières

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 1.A Specific research questions³⁵

³⁵Injection practices research, WHO/DAP/92. 9: 9-11.

During the first workshop of the Injection Practices Research (1990), the following research questions were formulated:

Concerning the types of health care providers administering injections:

1a - Which health care institutions and which practitioners are administering injections in a certain region?

1b - Which institutions and practitioners - both formal and informal - are most often visited by people for injections?

Concerning the distribution channels of injections:

2a - Where do the institutions and practitioners obtain the injections that they administer to patients? Do they obtain the injections from a government source, or from the commercial private sector?

Concerning the indications for which injections are generally used:

3a - What are the main indications for which the health care providers are administering injections?

3b - What are the disorders for which people seek injection treatment?

3c - Why are injections chosen for these indications?

Concerning the appropriateness of injection use:

4a - To what extent do people use injections to treat tracer conditions, defined as:

• cough and common cold in any age

• acute diarrhoea, less than five watery stools per day, in children under five and an additional three indications identified by the country teams, which do not warrant injection treatment?

4b - Why are injections administered in the above five tracer conditions, while their use is not medically justified?

4c - Which types of injections are used in the treatment of the five tracer conditions?

4d - To what extent are injections administered in sub-standard hygienic conditions?

Concerning the reputed efficacy of injection use:

5a - What is the expected effect/or experienced effect of the injectable medication?

If appropriate:

5b - Why did the provider choose an injection instead of an oral medication?

5c - Why did the user prefer an injection instead of an oral medication?

5d - Why are injections administered in an unhygienic manner? Do people lack training? Do they lack resources?

Appendix 1.A Specific research questions35

Appendix 1.A Specific research questions³⁵