An Investigation of injection practices in selected health centres of Lusaka and Kafue Districts

Abstract

This study investigated the safety of injection practices in immunization activities and factors that contribute to unsafe practices. The study was done by finding out the type of injection equipment available in the MCH department and immunization activities in particular, the knowledge that nurses have of the use of the injection equipment as well as their knowledge of the critical use and disposal procedures.Data was collected both quantitatively and qualitatively by administering a standardized pre-tested questionnaire to each of the 84 nurses. In addition focus group discussions were conducted with 40 mothers of children brought for immunizations. A checklist was also used in participatory observation of immunization activities in process. Specific method of data collection consisted of a cross sectional survey of 84 nurses working in MCH departments and involved in immunization activities in their respective health centres. The nurses were selected by systematic random selection as well as the 40 mothers who were involved in the focus group discussions. The mothers were included in the study to establish their knowledge of what constitutes unsafe injection practices. The findings show that injection equipment was inadequate in the respective MCH departments and in particular immunization activities. This was especially so in the health centres which did not have a budget and supply policy since 78% of the respondents whose health centres did not have a budget and supply policy reported not having adequate stock of injection equipment. A test of statistical significance confirms this association (P = 0.019).The study however revealed that there was no association between adequacy of injection equipment and the number of times it was recycled through sterilization (P=0.705). The result suggests that nurses were accustomed to recycling injection equipment regardless of it being abundantly in stock or out of stock. This may be so because they were used to this practice since the equipment is most of the times out of stock. No association was observed between supervisory visits and the number of times the equipment was recycled (P = 0.085). This result suggests the practice had become traditional because nurses have become accustomed to the culture of inadequate supplies of disposable injection equipment. This implies that there is need to improve the supply of disposable injection equipment most especially autodestruct syringe needle, in immunization activities in order to improve the safety of injection practices and hence reduce the risks to children acquiring iatrogenic infections such as HIV/AIDS as well as injection abscesses from over recycled needles.The interventions should therefore include ensuring adequate supplies of disposable injection equipment to MCH departments of health centres which should comprise of autodestruct syringe needles coupled with strict enforcement of the critical use and disposal procedures through enhanced supervision.