Injection practice in Kaski district, Western Nepal: a community perspectiveReport as inadecuate

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BMC Public Health

, 15:435

Global health


BackgroundPrevious studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1 quantify injection usage, 2 identify injection providers, 3 explore differences, if any, in injection usage and injection providers, and 4 study and compare people’s knowledge and perception about injections between the urban and rural areas of Kaski district.

MethodsA descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions FGDs. A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held.

ResultsIn 218 households 36.33% 99 in urban and 119 in rural one or more members received at least one injection. During the three month recall period, 258 subjects 10.44% reported receiving injections with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers 34.8%, staff of medical dispensaries 37.7%, physicians 25.2%, and traditional healers 2.3% were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever p < 0.001. People preferred injections due to injections being perceived by them as being powerful, fast-acting, and longer lasting than oral pills. More than 82% of respondents were aware of, and named, at least one disease transmitted by using unsterile syringes during injection administration or when syringes are shared between people.

ConclusionsLess preference for injections and high awareness about the association between injections and injection-borne infections among the general population is encouraging for safe injection practice. However, respondents were not aware of the importance of having qualified injection providers for safe injections and were receiving injections from unqualified personnel.

KeywordsCommunity Injection practice Knowledge Needle-stick injury Nepal AbbreviationsAHWAuxiliary Health Workers

ANMAuxiliary Nursing Midwifes

CHWCommunity Health Workers

CMACommunity Medical Auxiliary

DoHSDepartment of Health Services

EAEnumeration Area

FGDFocus Group Discussion

HAHealth Assistant

HBVHepatitis B Virus

HCVHepatitis C Virus

HCWHealth Care Worker

HHHousehold Head

HIVHuman Immunodeficiency Virus

HPHealth Post

NSINeedle Stick Injury

PHCCPrimary Health Care Centers

RFRural Female

RMRural Male

SHPSub Health Post

UFUrban Female

UMUrban Male

VDCVillage Development Committee

WHOWorld Health Organization

Devendra Singh Rathore, Pathiyil Ravi Shankar, Vikash Kumar KC, Manisha Maskey and Nisha Jha contributed equally to this work.

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-015-1775-5 contains supplementary material, which is available to authorized users.

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Author: Sudesh Gyawali - Devendra Singh Rathore - Pathiyil Ravi Shankar - Vikash Kumar KC - Manisha Maskey - Nisha Jha


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