Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110777

Richard S. Hughes, MA¹, Christopher Mazimba, Mmed(ob/gyn)², Answell Chipukuma, Higher Diploma³, Martha Ndhlovu², Matildah Matipa Zyambo, mcips⁴, Kuhu Maitra, MBBS, DCH, MD⁵, and Michael N. Favin, MA, MPH⁶. (1) Zambia Country Office, JHPIEGO Corporation, c/o USAID, 351 Independence Avenue, PO Box 32481, Lusaka, Zambia, +260-1-254555, rhughes@jhu.edu, (2) Prevention of medical transmission of HIV program, JHPIEGO Corporation, PO Box 32481, Lusaka, Zambia, PO Box 32481, Lusaka, Zambia, (3) Manoff Group inc., Prevention of medical transmission of HIV program, P.O Box 36873, Ngumbo Road, LongAcres, Lusaka, Zambia, (4) Zambia Injection Safety, Chemonics International, P.O. Box 36873, Lusaka, Zambia, (5) International Health Group., Chemonics International Inc, 1133 20th St., NW, Washington, DC, DC 20036, (6) The Manoff Group, 2001 S Street, NW, Washington, DC 20009

Gaps in prevailing injection safety practices and attitudes create avoidable risks of transmission of HIV and other blood-borne diseases. The Zambian Central Board of Health (CBOH) and the USAID-funded Prevention of Medical Transmission of HIV Program conducted a rapid assessment of injection safety practices in two districts in Zambia that identified shortcomings in injection safety through observation of provider practices.

The team believed that provider practices could be improved through a combination of providing essential commodities and a simple intervention to sensitize providers to gaps, orient them to standards, and encourage them to improve their practices. Applying an approach called “Trials of Improved Practices” (TIPS), the team identified a set of practices that could be improved to close performance gaps and a list of essential supplies required. They observed 44 providers in two districts, discussed their observations with the providers, and negotiated agreements to try to improve their performance on selected behaviors. The districts were provided with essential commodities, and a follow-up observation of providers assessed the degree to which they were able to improve their performance.

Noticeable improvements in were observed during the follow-up visit. For example, unnecessary prescription of injectables (from 45% to 23%), recapping of needles (26% to 4%), reassuring patients on the use of sterile syringe and needle (37% to 75%), washing hands (10% to 66%), and overfilling sharps disposal boxes (25% to 9%).

The results demonstrate that rapid improvements in provider practices are achievable, using a simple and straightforward methodology.

Learning Objectives: Participants attending this session will be able to

• Describe the “Trials of Improved Practices” (TIPS) methodology;
• Identify a range of simple injection safety interventions that together can positively influence provider behavior; and
• Discuss the pros and cons of using the TIPS methodology as an implementation strategy

Keywords: Quality of Care, Disease Prevention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.