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Evaluation of Injection Safety and Health Care Waste Management in Nigeria

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Evaluation of Injection Safety and Health Care Waste Management in Nigeria EVALUATION OF INJECTION SAFETY AND HEALTH CARE WASTE MANAGEMENT IN NIGERIA 2009 COMPARISON REPORT SEPTEMBER 2009 This publication was produced for review by the United States Agency for International Development. It was prepared by the Making Medical Injections Safer (MMIS) project. Acknowledgements The MMIS team is grateful to the Federal Ministry of Health (FMOH) for their permission and cooperation during the time of data collection and to the management of the health centers involved in this assessment for allowing the data collectors access to their facilities and staff. Special thanks go to the MMIS/Nigeria team under the leadership of Dr. Abimbola Sowande, MMIS/Nigeria Country Director, for their participation in training, supervision, and logistical coordination. A very big thank you to the local consultants who served as study coordinators—Taiwo Adekanmbi and Toyin Akpan and to the teams of data collectors. Additional thank you to Ms. Karen Van Roekel, Senior Monitoring and Evaluation Advisor, for serving as Principal Investigator for this study as well as other staff from MMIS/HQ, Ms. Deepa Bhat Shanadi, Monitoring and Evaluation Consultant; Mr. Ethan Collins, M&E Advisor; Ms. Megan Noel, M&E Technical Officer; and Dr. Iqbal Hossain, MMIS Technical Officer,. MMIS thanks USAID and the President’s Emergency Plan for AIDS Relief whose financial support has made the survey and the MMIS interventions in Nigeria possible. This study would not have been possible without the participants who provided the information upon which the report is based. Our gratitude goes to all the service providers, supervisors, waste handlers, and patients. Assessment Team Members 2005 Data collectors Data collectors Data collectors Lagos Kano FCT Dr. Adesola Oshin: Team Leader Zubaida A Nagee: Team Leader Mr. Yakubu Mohammed Mrs. Gladys Ihunda Mrs. M. Salami Larry Okpako Mrs. Titi Obasa Muhammed Salim Chuks Okoh Mr. R. O Kelani Edo Cross River Anambra George Ayua Mr. Felix Okocha: Team Leader Dr. Anthony Okwuosah Dr. Omokhoa Adeleye Oginni Oshodi Dr. Obi Ezeaku Mohammed Salim Bassey Egbe Mrs. O. F. Adegoke Dr. Peter Idafiogho Analysis Team Report writing Logistics Team Quail Rogers-Bloch Quail Rogers-Bloch Mr. William Cobham Uche Ohawe Abimbola Sowande Maria Elejire Dr. Funke Jibowu Toyin Akpan Mr. Kunle Adegoke 2008 Team Cross River Kano FCT Mr. Felix Okocha: Team Leader Zubaida A Nagee: Team Leader Salim Mohammed Idi Perpetua Rukaiyyat Yahaya Adama Elelu: Team leaders Alice Erejuwa Bala Muazu Aminu Bashir Dr. Ngozi Agbanusi : Supervisor Roselyn Gabriela Ruth Ajayi Dr. Funke Jibowu : Supervisor Clement Akintimi : Supervisor Lagos Dr. Toriola Femi Adebayo Edo Anambra Dr. Kayode Osisanmi: Team Leaders Jamiu Ganiyu : Team leader Chuks Okoh : Team Leader Bamke Okunribido Kome Esi Glory Ezenwafor Yakubu Mohammed Kate Agbadua Eno Ajuogu Safurat Agoro Kelechi Amaefule : Supervisor Hamisu Hassan : Supervisor Omolola Adegoke Toyin Akpan : Supervisor Logistics Team Analysis Team Report writing Mr. William Cobham Taiwo Adekanmbi Toyin Akpan Maria Elejire Toyin Akpan Deepa Bhat Shanadi Deepa Bhat Shanadi Ethan Collins Dr. Funke Jibowu Megan Noel Megan Noel Abimbola Sowande EVALUATION OF INJECTION SAFETY AND HEALTH CARE WASTE MANAGEMENT IN NIGERIA 2009 COMPARISON REPORT Abstract: The United States President’s Emergency Plan for AIDS Relief (PEPFAR), through the United States Agency for International Development (USAID), has funded JSI Inc. for the implementation of the Making Medical Injections Safer (MMIS) project in Nigeria. JSI and its partners are responsible for implementing other similar projects in 10 other countries in Africa and the Caribbean. This report describes the results of the final evaluation on the status of injection safety and health care waste management, which took place in Nigeria, during the month of October 2008 in six states. Recommended citation: Akpan, Toyin; Bhat Shanadi, Deepa; Noel, Megan; Sowande, Abimbola; Van Roekel, Karen; Collins, Ethan; Evaluation of Injection Safety and Health Care Waste Management in Nigeria: 2009 Final Report, March edition. MMIS for the Office of the Global AIDS Coordinator (OGAC) and USAID. The Making Medical Injections Safer (MMIS) project is a five-year initiative funded by the President’s Emergency Plan for AIDS Relief through the US Agency for International Development. Financial support was provided through contract # GHS-I-00-03-0026-00. Making Medical Injections Safer is implemented by JSI Inc. in collaboration with the Program for Appropriate Technology in Health (PATH), the Academy for Educational Development (AED), and the Manoff Group. Development of this publication was supported by USAID, contract # GSA-GS-10F-0453. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of OGAC or USAID. Making Medical Injections Safer MMIS Headquarters John Snow, Inc./Nigeria John Snow, Inc. 90,Nelson Mandela Street, 1616 N. Fort Myer Drive, 11th Floor Asokoro, Arlington, Virginia 22209 USA Abuja Tel: 1 (703) 528-7474 Tel: +234 7034051033 Email: [email protected] www mmis.jsi.com www.mmis.jsi.com Office of the Global AIDS Coordinator U.S. Agency for International Development SA-29, 2nd floor Bureau of Global Health 2201 C. Street NW Office of HIV/AIDS Washington, DC 20522-2920 USA Ronald Reagan Building Tel: 1 (202) 663-2708 1300 Pennsylvania Avenue NW www.pepfar.gov Washington, DC 20523 USA Tel: 1 (202) 712-4810 Email: [email protected] www.usaid.gov TABLE OF CONTENTS ACKNOWLEDGEMENTS...............................................................................................................................................3 TABLE OF CONTENTS .................................................................................................................................................7 LIST OF ABBREVIATIONS..........................................................................................................................................11 EXECUTIVE SUMMARY ..............................................................................................................................................13 1. GENERAL INTRODUCTION ....................................................................................................................................21 2. METHODOLOGY......................................................................................................................................................23 2.1 OBJECTIVES OF THE STUDY..................................................................................................................23 2.2 SAMPLING.................................................................................................................................................23 2.3 DATA COLLECTION TOOL .......................................................................................................................24 2.4 DATA COLLECTION .................................................................................................................................25 2.5 ORGANIZATION AND COORDINATION OF THE DATA ENTRY AND ANALYSIS..................................25 2.6 LIMITATIONS.............................................................................................................................................25 3. DESCRIPTION OF THE ATTAINED SAMPLE.........................................................................................................27 4. RESULTS OF THE STOCK OF INJECTION EQUIPMENT AND PRODUCTS IN THE MAIN STOCKROOMS OF THE HEALTH FACILITIES...........................................................................................................................................29 4.1 ANALYSIS OF THE STOCKCARDS: AVAILABILITY, UPDATE, AND EVIDENCE OF STOCKOUTS BY PRODUCT .................................................................................................................................................29 4.1.1 SAFETY BOXES .......................................................................................................................................29 4.1.2 STANDARD DISPOSABLE SYRINGES....................................................................................................30 4.1.3 DISPOSABLE SYRINGES WITH FEATURES THAT PREVENT REUSE.................................................31 4.1.4 DISPOSABLE SYRINGES WITH FEATURES THAT PREVENT REUSE AND ACCIDENTAL NEEDLESTICK INJURIES .........................................................................................................................31 4.2 COMPARISON OF STOCK OF SAFETY BOXES WITH THE STOCK OF SYRINGES...............................34 4.3 PRESENCE OF ORAL FORMULATIONS OF COMMON MEDICINES .......................................................34 5. OBSERVATIONS ON MATERIALS, EQUIPMENT, AND WASTE MANAGEMENT..........................................37 5.1 PRESENCE AND USE OF SAFETY BOXES IN LOCATIONS WHERE INJECTIONS ARE ADMINISTERED................................................................................................................................37 5.2 INDIVIDUAL INDICATORS OF THE DISPOSAL OF USED SHARP OBJECTS .......................................37 5.3 STORAGE OF FULL SAFETY BOXES ........................................................................................................39 5.4 TIGHTLY SEALED SAFETY BOXES ...........................................................................................................39 5.5 WASTE SEGREGATION..............................................................................................................................40
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