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.