Injection Practices in the Developing World - Results and Recommendations from Field Studies in Uganda and Indonesia - EDM Research Series No. 020: 1. Introduction: 1.4 Contents of this report

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

1.4 Contents of this report

This synthesis report of the injection practices research aims to:

• review existing literature on the prevalence of injections and the reasons for their popularity;

• compare the methods used in the country studies, review the problems in the implementation of the study, and assess the usefulness of the various methods;

• present and compare the results of the country studies concerning:

- prevalence of injection use (Indicators Ia-If),

- appropriateness of injection use both in biomedical and hygienic terms (Indicators IIa-IIf),

- the popularity of injections;

• assess the usefulness of the indicators in describing inappropriate injection use.

The methods used to investigate injection use in both countries are assessed in Chapter 2. Since the development of simple and rapid methods to estimate the prevalence of injection use is an important objective of the research, the sampling frame and the various quantitative and qualitative methods are presented and problems encountered during the research phase are highlighted. The reasons for the popularity of injection therapy are discussed in Chapter 3, based on areview of the literature. The results of this literature review complemented with some exploratory data from the field studies shed some light on this surprising phenomenon: the almost universal popularity of injection therapy. The research results of the country studies are presented in the rest of the report. Firstly, in Chapter 4, after a brief introduction to the local contexts, attention is paid to the prevalence of injection use. Some explanations for the popularity of injections in Uganda and Indonesia are discussed in Chapter 5. Then, the results on the appropriateness of injection use are presented in Chapter 6. Indicators referring to the medical appropriateness of injection use (using tracer conditions) are assessed, followed by a discussion of the results of the observation of minimal hygienic standards. General conclusions and recommendations are formulated in Chapter 7. Appendix 1 gives the research questions, the indicators and the guidelines for evaluating hygienic practices; in Appendix 2 a critical assessment is given of the methods used in the research while the research tools are presented in Appendix 3.