Keeping workers and communities safe: Safe needle disposal options for diabetics in Guyana

Used needles put patients, health workers and communities at risk; yet options for safe needle disposal present significant challenges in resource-poor settings. In 2007, the USAID-funded Guyana Safer Injection Project (GSIP) conducted an assessment of insulin home-use and needle

disposal practices. It found that clients disposed of used syringes in household pits, latrines, municipal trash and neighborhood canals, putting municipal workers and communities at risk. GSIP and the Ministry of Health

pilot tested options for safe insulin needle disposal in three government hospitals and two private clinics from January 1 to June 30, 2008.

Methods tested centered on home-use of sharps containers and return of containers to facilities for disposal. Disposal methods tested included: 2.5L safety boxes, needle clippers, empty tablet containers, and client-sourced

containers. Providers were trained to counsel clients, dispense containers and safely handle full containers at the facility. Facility waste handlers were trained to dispose of client-returned containers with sharps waste.

An evaluation of the pilot program conducted in July 2008 found that all disposal methods tested were effective and safe; however, used tablet and client-sourced containers were most cost effective and sustainable. Nurses,

pharmacists and waste handlers felt safe handling the disposal containers; no incidents of damage, puncture or injury were observed or reported.

Clients, health workers and waste handlers felt the system was safe and practical. As a result of this pilot, the Guyanese Ministry of Health is scaling up the system and is developing a national policy on insulin needle distribution and disposal.