South Asia Perspective
A nationwide study conducted in India in 2012 showed that the frequency of injections was 2.9 per person per year. It was found, however, that two-thirds of all injections were unsafe. A half (52%) of these were given for common symptoms like fever, cough, or diarrhea. As unsafe injections expose patients to the risk of disability and death, there is a need to strengthen safe injection practices. The percentage of new infections due to unsafe injection practices by reusing injection devices is as follows: hepatitis B, 33%; hepatitis C, 42%; and HIV, 2%.
Pressure from patients and their relatives is also an important contributing factor for unnecessary injection practices. It was found that 70% of injections could be avoided if pressure from patients and their relatives could be prevented. Three important principles were emphasized by Indian health regulatory authorities to define safe injection practices:
1) Safe to the recipient (eg, prevention of local abscess formation).
2) Safe to the health-care provider who performs the injection (eg, prevention of needlestick injuries).
3) Safe to the community (eg, prevention of unsafe waste disposal).
The “7 R’s” rule (Right medication, Right dose, Right patient and site, Right time, Right route of administration, Right documentation, and Right disposal) is extremely important for safe injection practice.
For management that involves chronic use of injections, such as insulin therapy, there may be resistance of patients and their relatives. Addressing this barrier along with the specification of the devices used for insulin injections and needle length and gauge as well as prevention of needle reuse are crucial for subcutaneous insulin therapy.
