(1996; 157 pages)
4.6 Source of injections
Indicator Ie aimed at providing insight into the source of the injections received at household level. It can be calculated in various ways.
(Ie) Frequency of injection administration per health facility.
In the Ugandan questionnaire it was asked where the last injection in the household had been given. In Busoga there was one and in Ankole there were two households where an injection had never been administered. These households are excluded for the calculation of this indicator. In analyzing the source of injections, a distinction was made between formal and non-formal facilities. The formal health care system comprises public facilities (including hospitals and health centres) and private facilities (including NGO units and registered private clinics). Non-formal facilities include drugshops and unregistered 'clinics'. Injections may also be given at home by a family member, neighbour or informal provider.
Based on findings for the source of the last injection received, it can be concluded that the private and informal sector are important providers of injections in Uganda (Figure 10). In both regions non-formal providers had administered some 30% of the last injections, most of these were given 'at home'. With respect to the importance of the public versus the private health sector, there are significant differences between both regions. In Busoga, 35% of households (127/359) received their last injection at a government facility and 36% (130/359) at a private facility. In Ankole 47% households (169/358) received their last injection at a private facility, and only 23% (81/358) at a government facility (*p=0.01).
In Indonesia, based on the data collected on health-seeking behaviour of all household members who reported illness in the past two weeks, it can be calculated where these injections had been given (Figure 11). Both in Lombok and Lebak most injections originated in the public sector, particularly in the health centres (puskesmas). With respect to the other sources, differences were found. In Lombok, relatively speaking, more injections originated from private practices of doctors, while in Lebak more injections were received from informal sources. Almost a quarter of all injections in Lebak came from nurses in their (illegal) private practices. The differences between the two regions are highly statistically significant (**p=0.001).
Who administered the injections? According to the respondents in the household questionnaire, most injections in public and private facilities had been administered by nurses and/or midwives. Administration by doctors came second, and interestingly enough, seven respondents in Lombok and one in Lebak reported that the injection had been given by 'other personnel' (including drivers).
Figure 10. Source of last injection (Percentage of last injection received according to source - Household survey - Uganda) - Busoga
Figure 10. Source of last injection (Percentage of last injection received according to source - Household survey - Uganda) - Ankole
N = all the house where injection was ever received
Busoga n = 359; Ankole n = 358
Figure 11. Source of injection received in past two weeks (Percentage of injections received in the last two weeks according to source - Household survey - Indonesia) - Lebak
Figure 11. Source of injection received in past two weeks (Percentage of injections received in the last two weeks according to source - Household survey - Indonesia) - Lombok
N = total number of injection received
(Some patients received more then one injection)
Lebak n=244; Lombok n=260