India Injection Safety Coalition
”If you have an apple and I have an apple and we
exchange these apples then you and I will still each
have one apple. But if you have an idea and I have an
idea and we exchange these ideas, then each of us will
have two ideas.”
George Bernard Shaw
Key Issues for India
• Injections one of the most common
health care procedures
• Heavy burden of disease caused by unsafe injections
• More than 40 % injections given in India estimated to
be unsafe
• Growing cause for spread of HBV, HCV, HIV/AIDS
Main Gaps
• Evidence of uneven quality of sterilization &
injection equipment compromising injection safety
• Reuse of disposable syringes /needles caused by
breaks in supply of adequate volume of equipment
• Low awareness of risks from sharps / needle-stick
injuries - health workers / waste handlers /
community
• Need for appropriate equipment / strategy for
safe disposal of sharps and infected waste
Mission
To work as a national network of
concerned organizations / stakeholders
and bring injection safety issues on the
national health agenda
Started in March 2002
Objectives
 Work with policy makers to formulate safe
injection policies
 Assist implementation of safe injection practices
and waste disposal
 Provide tool kits and resource material to
organizations / institutions to improve injection
safety in their establishments
 Advocate and disseminate information on
injection safety issues in the Indian context
 Take injection safety to the states, districts where
it is most needed
Progress thus far…
Formation of a Core Group at national level
-
All India Syringe & Needle Manufacturers’
Association (AISNMA)
MoH, Govt. of India
Indian Medical Association
INCLEN
Indian Academy of Pediatrics
Nursing Council of India
PATH Program for Appropriate Technology in
Health (Secretariat)
Srishti
UNICEF
WHO India & SEARO
World Bank
Others…
Activities
•
Formation of 3 Sub-Groups for defining specific
agendas
- Immunization
- Curative
- Waste Disposal
•
Core Group meetings
•
Sub-group meetings / interaction on agenda
•
Drafting of sub-group agendas
Sub Group – Immunization: Agenda
•
A solution exists in AD syringes. Assist / encourage
GoI to transition to AD’s for all immunization in a
phased manner
•
Focus on public sector health facilities
•
In areas with greater private sector involvement –
encourage move to AD’s through IAP, IMA, etc.
•
Work with government / industry to augment
domestic production and supply of quality AD
syringes in standard / non-standard sizes
•
Advocate to highlight risks to providers from unsafe
injections to motivate health workers / providers in
safe injection practices.
Sub Group – Curative : Agenda
• Advocacy efforts to focus on rational use of
injections
• Work closely with IAP/IMA on safe injection
practices among providers in the private sector
• Policy statement on rational and appropriate
use of injections from IMA to all members
• Work to include injection safety in medical
curriculum at various levels
• Involve HIV prevention stakeholders
Sub Group – Curative: Activities under way
• Evolve safe injection guidelines for
implementation by hospitals / nursing homes/
clinics & public health infrastructure for
curative injections
• Organize lectures / presentations to medical
colleges especially SPM departments on
injection safety
• Bring out special issues on injection safety
through medical journals at national and state
levels
• Include RMPs in advocacy on rational & safe
injections
Sub-Group Waste Disposal - Agenda:
• “First do no harm” principle to be widely
advocated
• Disposal must take into account both health and
environmental concerns
• Disposal strategies need to address challenges in
various settings – urban vs. rural; fixed vs.
outreach, immunization vs. curative, etc.
• Look for viable non-incineration solutions
Sub-Group Waste Disposal - Activities
• Develop model projects in existing interventions of
partners
• Develop/adapt self assessment tool kit for health
facilities, with a resource guide
• Include members from Ministry of Environment &
Forests, Central Pollution Control Board
• Work with MOH & MOEF on policy for safe sharps
disposal relevant to different settings
• Work with state governments in policy dissemination
and implementation
Activities, contd.
Formation of coordinating groups for:
o
Communication / Advocacy
o
Implementation – Model projects, curricula
development and inclusion, workshops
o
Toolkit Development
o
Evaluation
Results So Far
• Expanding network at implementation level
through partners networks at state and district
levels (e.g. UNICEF & EC, IAP, IMA, “individual
champions”)
• Fostered collaboration and coordination among
partners and brought together on a single
platform to speak with a common voice
Challenges
 Partners remain committed and resource base is
expanded to fund regular and planned activities
 All partners continue
agendas and activities
ownership
for
Coalition
 Build inter-departmental coordination within the
government – all departments of health, pollution
control, and environment must come together to
develop an effective policy and agree upon
regulatory changes for injection safety – both
centrally and at state levels
Roadmap of next steps
•
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•
•
•
•
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•
•
Regional Workshops
Model projects in selected health facilities / districts
Medical facility self-assessment tool kit and resource guide
Rating of medical facilities
Sponsored publications in professional journals
Advocacy with news media to raise issue – especially
vernacular / regional
Media spots for general population [cinema halls, TV (?), ]
Website
Others……