India Injection Safety CoalitionIndia 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

• 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

Key Issues for IndiaKey Issues for India

• 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

Main Gaps Main Gaps

To work as a national network of concerned organizations / stakeholders and bring injection safety issues on the national health agenda

Started in March Started in March 20022002

MissionMission

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

Objectives Objectives

Progress thus far…Progress thus far…

- 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…

Formation of a Core Group at national level

• 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

Activities Activities

• 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 – Immunization: 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 : Agenda

• 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 – Curative: Activities under way

• “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 - Agenda:

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

Formation of coordinating groups for:

o Communication / Advocacy

o Implementation – Model projects, curricula development and inclusion, workshops

o Toolkit Development

o Evaluation

Activities, contd.Activities, contd.

• 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

Results So FarResults So Far

ChallengesChallenges

Partners remain committed and resource base is expanded to fund regular and planned activities

All partners continue ownership for Coalition agendas and activities

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

• 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……

Roadmap of next stepsRoadmap of next steps