Injection safety and health care waste management
AIDSTAR-ONE/NIGERIA SUCCESS STORIES
Reducing unsafe and unnecessary injections protects patients and health care providers from HIV and other blood-borne pathogens. Health care waste management ensures that health workers, patients or the community are not exposed to contaminated medical waste, including used needles and syringes and other infectious waste.
Health care settings offer numerous opportunities for intervention against HIV transmission. With support from USAID/Nigeria, AIDSTAR-One provides technical assistance to the Government of Nigeria and PEPFAR implementing partners to carry out three well-demonstrated prevention strategies:
- Injection safety and health care waste management (IS/HCWM) - Medical transmission
- Prevention of mother-to-child transmission (PMTCT)
- Safe male circumcision (SMC)
A top priority of Nigeria's Federal Ministry of Health (MOH), infection prevention and control (IPC) measures protect patients and health care workers from infections inside a clinical setting. Injection safety (IS), an important component of IPC, prevents the medical transmission of HIV and other blood borne pathogens by reducing unsafe and unnecessary injections.
With field support from USAID/Nigeria, AIDSTAR-One/Nigeria provides technical assistance to the Government of Nigeria, U.S. Government (USG) teams, and local partners (including other PEPFAR projects) to strengthen the sustainability of IPC and IS in the six geopolitical zones with USG partners and in focal local government areas of Nigeria.
AIDSTAR-One/Nigeria's current activities include:
- Training and capacity building: AIDSTAR-One/Nigeria trains health care workers at public health facilities in IPC, IS, and HCWM. AIDSTAR-One also trains health regulatory officials as well as state- and local-government-level supervisors in supportive supervision and new infection prevention standards. To build capacity and train even more health care workers, waste handlers, and other support staff AIDSTAR-One/Nigeria has adopted a train-the-trainer model. To ensure that individuals entering the health care workforce are already trained in injection safety, AIDSTAR-One works with Pharmacist Council of Nigeria, Community Health Registration Board, and Nursing and Midwifery Council to incorporate Logistics Information Management System (LIMS) and IS/HCWM into the pre-service education curricula and trains nursing school tutors in state-of-the-art training methodologies.
- Commodity management: AIDSTAR-One provides technical assistance to the MOH to assist partners with material quantification and trains logisticians at the health centers to improve forecasting, financing, procurement, and distribution of IS supplies and waste management commodities at all levels. The project also provides technical support to local manufacturers to strengthen local production of IPC and IS commodities.
- Health care waste management (HCWM): For health centers with existing waste incinerators, AIDSTAR-One/Nigeria provides technical assistance in incinerator maintenance, waste handler training, personal protective equipment (PPE), and helping secure designated HCWM areas. AIDSTAR-One assists Lagos State Waste Management Authority (LAWMA)–a state agency for waste management. In addition the project supports USG partners in the final disposal of pharmaceutical waste.
Click here for a presentation on health care waste managment for ARVs.
- Advocacy and behavior change communication (BCC): AIDSTAR-One/Nigeria produces and distributes advocacy and BCC materials in phlebotomy and IS to policy makers, community leaders, politicians, journalists, and health facilities and conducts workshops to educate journalists on IS and HCWM issues. Accurate, community-based messages about injection safety are disseminated through the media and in interactive group to help reduce demand for unnecessary injections. Recently, AIDSTAR One was asked to develop targeted messages for the community level on promotion of PMTCT and safe male circumcision.
- Prevention of mother-to-child transmission: In 2009, only 18.7 percent of pregnant, HIV-positive women in Nigeria received antiretroviral medicines to reduce the risk of mother-to-child HIV transmission. To reduce the number of children born positive through PMTCT uptake, AIDSTAR-One/Nigeria is creating community-based messages that highlight the benefits of PMTCT.
- Safe male circumcision: Although male circumcision is highly prevalent in Nigeria (more than 98 percent of males are circumcised), it is important to promote safe medical circumcision practices. To drive uncircumcised men to seek safe male circumcision, AIDSTAR-One Nigeria is developing community-based messages that underscore the importance of safe practices.
- Policy environment: AIDSTAR-One is closely working with the Nigeria Federal Ministry of Health, the Federal Ministry of Environment, and the National HIV Prevention Technical Working Group to create an enabling policy framework by providing technical support to implement the developed HCWM plan guidelines and policies.
From the Prevention Knowledge Base:
A Collection of Research and Tools to Help You Find What Works in Prevention
- Ensuring the Availability of Safe Injection Commodities in Nigeria
- Strategy Development for Improving Safe Phlebotomy Practices in Nigeria
- Disposal of Expired ARVs and Test Kits in Nigeria
- Improving Injection Safety and Health Care Waste Management
Building on successes of USAID’s Making Medical Injections Safer (MMIS) project, USAID Missions in Ethiopia, Nigeria, and Uganda provided field support funding through AIDSTAR-One for injection safety, infection prevention and control (IPC), and health care waste management (HCWM).
- Technical Report on GIS Mapping of Health Care Waste Treatment Equipment in Nigeria: In 2012, AIDSTAR-One conducted a study using geographic information systems in order to determine the location and condition of waste treatment equipment in Nigeria's health facilities.
- Assessment of Injection Safety in Selected Local Government Areas in Five States in Nigeria: AIDSTAR-One conducted this baseline assessment of injection safety in five USAID priority states: Bauchi, Benue, Cross River, Lagos, and Sokoto.
- 2012 Follow-up Report to the Assessment of Injection Safety in Selected Local Government in Five States in Nigeria: AIDSTAR-One conducted this follow-up assessment of injection safety in five USAID priority states: Bauchi, Benue, Cross River, Lagos, and Sokoto using an adaptation of the Revised Injection Safety Assessment Tool (Tool C-Revised) developed by the World Health Organization.
- Disposal of Expired ARVs in Nigeria Presentation (PDF, 1.8 MB) Representatives from USAID/Nigeria and AIDSTAR-One/Nigeria gave this presentation at the 26th Annual Conference on Solid Waste Technology and Management in March 2011. The presentation covers minimizing pharmaceutical waste, various methods for treatment of this waste, advocacy efforts, and lessons learned. In addition, it describes the process to convert ash from the incineration of expired pharmaceutical drugs into concrete slabs and bricks that can be used in flooring and paving.