Injection Practices at Primary Healthcare Units in Bangladesh

BackgroundIndiscriminate usage of injections and lack of safe practices during injection administration have been reported worldwide. Unnecessary and unsafe injection usage not only increases the financial burden but are also responsible for spreading blood borne diseases including HIV, HBV and HCV. To attain a better understanding of the situation of injection usage in Bangladesh, a study was conducted at six Upazilla Health Complexes (UHCs), which are primary healthcare units in Bangladesh.Method  The study involved the retrospective collection of treatment sheets of 1048 in-patients at six UHCs from January 2009 to June 2009.  The data was then analyzed using statistical tests. ResultsAmong the patients investigated, 60.11% of the patients received injections and among them the male population received more injection than the female population (males vs. females = 62.50% vs. 55.85%). Patients below 12 years of age received the highest proportion of injections and highest usage of injections was observed in the month of March. The average number of injection(s) prescribed to a patient was 2.44 incurring a prescription cost of 280.22 Taka (USD 3.92 approx.). Injections were mostly prescribed in patients who were diagnosed with physical assault and acute watery diarrhea where intravenous fluids and antibiotics were most widely prescribed. Non-compliance to recapping of used injections was very common which accounted for 22.22% needle stick injuries.ConclusionThe data suggest that indiscriminate and unsafe injection practices were occurring in all UHCs.  Such practices resulted in financial losses as well as compromising safety for healthcare providers and patients.