Dr. Koku Kazaura, Prevention Team Lead, CDC - Tanzania

Evaluation of a National Program to Improve Infection Prevention and Control (IPC) and Injection Safety

(IS) in Tanzania

 

Center for Global Health

Division of Global HIV/AIDS

The situation and context

In 2004, PEPFAR supported the Making Medical Injection Safer (MMIS) program with the Ministry of Health and Social Welfare (MOHSW) in public health facilities in Tanzania

MMIS portfolio aimed to: Improve injection safety practices through training and building capacity of health

care providers Ensure availability of safe injection commodities through commodity and supply

management Reduce unnecessary injections via advocacy and IEC/BCC Contribute to establishing a safe HCWM system Increase health care worker safety by developing effective injury prevention

modalities

Target population included health care providers, supervisors, & waste handlers

Background

An evaluation was conducted to assess interventions and describe current conditions and injection safety practices Seven hospitals forming the core of the MMIS expansion plan were

purposefully selected Baseline and follow up surveys in 2005 and 2007 using WHO Injection

Safety Assessment tool adapted for Tanzania

Survey units and target populations: General Outpatient Department General Medicine Pediatrics Gynecology - Obstetrics Surgery Laboratories

Methods

The situation and context (2)

Key findings from the evaluation

Was the injection preparation done on a visibly clean, dedicated working table or tray where the contamination of the equipment with blood, dirty swabs or other biological waste is unlikely?

Did the injection provider wash his/her hands with soap and running water or clean them with an alcohol-based hand sanitizer before beginning the injection?

For each injection given, were the needle and syringe either taken from a sterile unopened package or fitted with two caps?

After the completion of each injection or blood draw, was the used needle recapped?

After each injection observed, did the provider immediately dispose of the used needles and syringes in an appropriate sharps container or use a needle remover?

0% 20% 40% 60% 80% 100%

92.4%

52.8%

94.2%

2.1%

89.4%

70.1%

34.0%

88.8%

37.2%

73.0%

Baseline (n=197) Follow up (n=109)

Observations of injection administration practices (% who responded “yes”)

*

*

*

*

* p<.05

Conclusion and Lessons Learned Evaluation findings reveal significant improvements in injection

safety practices including, but not limited to progress made in Infection prevention and control in health care settings

National programs that support safe injection policy and utilize a package of interventions may improve injection safety practices in resource-constrained settings

More research is needed to determine an optimal intervention model and assess the short and long-term impact of national injection safety programs

Although our interventions yielded improvements, we may need to consider programs and policies to support universal Hepatitis B vaccination for healthcare workers

Special thanks to our collaborators

John Snow Inc. (JSI) Making Medical Injections Safer (MMIS) Ernest Chenya

Ministry of Health and Social Welfare – United Republic of Tanzania Henock Ngonyani

US Centers for Disease Control and Prevention Tom Pyun Irene Benech Dejana Selenic

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Center for Global Health

Division of Global HIIV/AIDS