Huge step ahead in eliminating unsafe injection practices
RAMYA KANNAN
Photo: Bhagya Prakash. K
WRONG METHODS: The technique in giving injections could also be unsafe:
A COUPLE of months ago when the Indian Academy of Paediatrics signed an MOU with Becton Dickinson India, it took a huge step ahead in minimising the spread of infectious disease through unsafe injection practices in India.
Carrying forward the agenda of promoting safe injections throughout the country, the IAP that has already been supporting educational programmes for health care professionals, hopes to work towards a situation where safety is a key concern among those involved in giving injections.
Landmark move
Dr. Nitin Shah, President, IAP, said, "The signing of this MOU is a landmark move in the bid to eliminate unsafe injection practices in India."
While it is common knowledge that injections can be the vehicle for blood borne infections (including hepatitis and HIV) not many are aware that the technique in giving injections could also be unsafe and even lead to several complications, for instance, giving intra-muscular injections as against intra-venously.
Considering the large number of injections being given in the country — estimated at three to six billion every year — translating to 3-6 injections per person annually, safety becomes a huge cause for concern.
And going by statistics, at least 63 per cent of all injections administered in India are unsafe. In 2004, INCLEN did a study on Assessment of Injection Practices in India funded by the World Bank and Government of India, coming up with some alarming figures.
It showed 22 per cent of unsafe injections were because of reuse, 20 per cent of the unsafe injections were because of unsterile equipment and 54 per cent of the unsafe injections were because of wrong habits of injection givers.
Preferred belief
Dr. N.K. Arora, who led the INCLEN study, said most health professionals contacted believed that unsafe injections were indeed a cause for concern, but preferred to believe that it was the quacks who were using them. Dr. Arora calls to rationalise the decision to give injections.
In a clinical situation, one should be judicious in giving injections, he said, adding that almost 50 per cent of injections were being given for managing conditions like diarrhoea, cough and fever in the out patient setting, unnecessarily.
The INCLEN study, which was submitted to the government with recommendations has borne positive results since then. Notably, the immunisation sector completely uses only disposable syringes, says Raju C. Shah, Chairman, Immunisation Committee, IAP, who also chairs its National Taskforce on Safe Injection Practices.
A chain of model injection centres was set up in 20 states across the country and training programmes were also launched.
Today, a number of technologies are available that conform to safe injection practices: Auto disable syringes (used for immunisation), pre-filled devices and reuse prevention syringes for curative injections.
With over two million injection givers in India, there is no overestimating the work that has to be done in the sector. "We cannot rule out re-usable syringes. A significant proportion of the injections given today are with re-usable syringes.
"The task before us is to teach people the right methods of sterilisation and administering of injections and campaign for using disposable syringes," Dr. Shah said.
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