INJECTION PRACTICES IN MWANZA REGION, TANZANIA - PRESCRIPTIONS, PATIENT DEMAND AND STERILITY

This paper describes prescription and sterilization practices in Mwanz a Region, Tanzania, before the introduction of interventions aiming at reducing HIV transmission by injections. Sixty-six health facilities from Mwanza Region were included in the study. Data were collected in interviews and questionnaires, through structured observation, bacteri ological culture and record analysis. Criteria for-avoidable injection s were based on recommendations of the Essential Drugs Programme and o n a regional consensus workshop. One in 4 out-patients received an inj ection 70% of which were avoidable. Most were given for acute respirat ory infections, skin diseases and urinary tract infections. Forty per cent of cultures taken from sterilized needles and syringes yielded gr owth of microorganisms. Of 120 patients interviewed most preferred to be treated with injections for almost any complaint. Patient demand fo r injections was felt to be a problem in 85% of the health facilities and may have contributed to overprescription of injectables. Consensus treatment and sterilization guidelines as well as a health education programme were developed and introduced to all health workers through seminars.