Health facilities are places where people go to heal and get well. Proper injection safety and health care waste management (HCWM) practices are critically important to protect patients against accidental injuries and illness while they are seeking care. Often, health facilities do not follow good HCWM practices, which leads to unnecessary and harmful injections, failure to minimize waste, poor waste segregation, and unsafe waste handling, storage, and disposal. Unsafe HCWM creates an environment where health care staff, clients, and communities are vulnerable to needle-sticks and other routes of disease transmission.
In order to prevent the medical transmission of HIV and other bloodborne pathogens around the world, JSI is providing healthcare providers, waste handlers, and community members with the most responsive, cost-effective, and high quality support to strengthen safe injection and HCWM practices in the context of infection prevention and control (IPC).
Building on the successes of the Making Medical Injections Safer (MMIS) project, USG Missions in Ethiopia, Nigeria, and Uganda have provided field support funding through AIDSTAR-One since 2009 in the areas of injection safety, healthcare waste management, and IPC.
Recent JSI and AIDSTAR-One injection safety and healthcare waste management achievements include:
Commodity supply management
- AIDSTAR-One/Ethiopia developed a standardized and prioritized list of infection prevention and patient safety (IPPS) commodities for all levels of health care facilities, and quantified the annual need of IPPS commodities for the four levels of health care facilities in Ethiopia.
- AIDSTAR-One/Nigeria provides seed stock – a short term supply of HCWM, injection safety, and phlebotomy commodities– to its implementing partner sites to ensure availability of these necessary supplies, while building capacity for sustainable effective commodity management.
Capacity building and behavior change communication (BCC)
- AIDSTAR-One/Ethiopia developed an infection prevention and patient safety training resource package with the Ethiopian Federal Ministry of Health to serve as a training guide for health service providers and managers.
- AIDSTAR-One/Nigeria has developed community-focused messaging to encourage the use of oral alternatives to injections and also to increase participation in safe male circumcision activities.
Healthcare waste management
- In June 2013, USAID/Nigeria commended JSI on AIDSTAR-One/Nigeria for “consistently meeting the PEPFAR COP targets and improving country capacity to appropriately manage medical waste.”
- In 2012, AIDSTAR-One Nigeria conducted a geographical information system (GIS) mapping of healthcare waste management equipment in order to determine the location and condition of waste treatment equipment in Nigeria’s health facilities.
- AIDSTAR-One/Uganda is engaged in a public private partnership (PPP) with the MOH and a local waste management company, Green Label Services Limited (GLSL), to establish a centralized healthcare waste disposal facility in eastern Uganda. This PPP was established to respond to challenges where health facilities are managing high volumes of patients with no appropriate disposal facilities.
- AIDSTAR-One/Uganda also provides technical assistance in the areas of capacity-building, development of HCWM plans, specification and evaluation of final disposal units such as incinerators, disposing of expired pharmaceutical products, and quantifying waste management commodities. By recognizing and highlighting the importance of HCWM in Uganda, USAID—through AIDSTAR-One—has been able to catalyze stronger national planning and adoption of improved HCWM to better protect health center staff and patients from infections.
- With SCMS, AIDSTAR-One/Nigeria coordinated a “waste drive” to dispose of expired ARVs, HIV test kits, and laboratory chemicals.
Advocacy and policy development
- AIDSTAR-One/Nigeria developed, in collaboration with the Federal Ministry of Health (FMOH), a National Strategy on Phlebotomy, which was launched in 2011.
- As a result of AIDSTAR-One/Uganda’s advocacy efforts, the Uganda MOH is vaccinating all health workers in the country against hepatitis B.
Reinforcing M&E components through supportive supervision
- As part of a broader activity to strengthen the IPC systems and to ensure the sustainability of IPC practices at the facility level, AIDSTAR-One/Ethiopia provides technical support to local IPC committees through supportive supervision visits to health facilities.
- AIDSTAR-One/Nigeria routinely conducts training and other capacity building activities for health workers and waste handlers in the context of IPC, including cascade and training-of-trainer approaches. In 2012, the project conducted a follow-up assessment in 80 public sector health care settings and laboratories.