Development of Development of Injection Safety Injection Safety

Assessment ToolboxAssessment Toolbox

Rebecca FieldsThe CHANGE Project/USAID

Rationale for Assessments and Toolbox

• Assessments identify local issues so as to design effective, efficient interventions

• Data provide baseline information, suggest indicators for monitoring

• Data open the door to dialogue among players potentially involved in IS

Toolbox Addresses Conceptual Framework

Injection AdverseEvent

Injection Overuse

Unsafe InjectionPractices

Providers

System

Toolbox Takes into Account:

LogisticsManagement

Sharps/waste

Management

Behavior ChangeStrategies

SafePractices

Components of Toolbox

• Qualitative research on determinants of behavior

• Frequency and source of injections• Health facility survey of injection

practices• Cross-sectional study of association

between infections and injections

Toolbox Development Process

• Kit components drafted early 2000• 3-day workshop at BASICS in March

2000 to review/re-think toolbox• New tool on “contextual

assessment” prepared• Tool on injection/infection

association deemed “optional”

Pilot Use of Tools

• Burkina Faso - health facility assessment

• Niger - health facility assessment• Albania - contextual assessment• Pakistan - qualitative research• Uganda (planned) -

frequency/source of injections

Conclusions (1) Choices Must be Made

• Scope: specific program (EPI) vs. PHC vs. all percutaneous procedures

• Feasibility vs. quality of data• Local adaptation vs. comparability• Turnkey instructions vs. broad

guidelines

Conclusions (2)Toolbox and Tools Will

Change

• Adaptation to local circumstances is essential

• New tools may be added

Conclusions (3)Gold Standards are

Not Created...

• …they evolve• Pilot testing, feedback, revision are

essential to make the toolbox useful