REDUCING THE RISK OF UNSAFE INJECTIONS IN IMMUNIZATION PROGRAMS - FINANCIAL AND OPERATIONAL IMPLICATIONS OF VARIOUS INJECTION TECHNOLOGIES

The unsafe use and disposal of injection equipment continues to put pa tients, health care workers, and the general community at risk of infe ctions such as hepatitis B virus and human immunodeficiency virus. Alt hough the potential for unsafe injection practices varies substantiall y with the type of equipment that is used, technology alone cannot tot ally eliminate the risk. A knowledge of the cost, practicality and, mo st importantly, the potential for misuse, is critical for selecting th e most appropriate injection equipment for each immunization setting. Four types of injection equipment are currently available for administ ering vaccines: sterilizable needles and syringes; standard disposable needles and syringes; autodestruct needles and syringes; and jet inje ctors. In general, the cost per injection is lowest with sterilizable equipment and highest with autodestruct. However, only autodestruct sy ringes virtually eliminate the risk of unsafe injection practices. Owi ng to differences in cost and programme factors, in some settings it m ay be appropriate to use a combination of equipment. For example, auto destruct syringes may be used in areas where it is difficult to ensure adequate supervision, while in medium-sized, fixed-site clinics with safe injection practices, sterilizable equipment will be the most cost -effective.