Countries Experiences on Access to Injection Equipment

1. Countries Experiences on Access to Injection Equipment Sophie Logez WHO/BCT/DCT Phnom Penh, 24-26 October 2002

2. Strategy for the Safe and Appropriate Use of Injections • Behaviour change among patients and health-care workers • Access to safe injection equipment and infection control supplies • Appropriate management of sharps waste

3. ACCESS Access to Injection Equipment • Increased access to safe injection equipment improved injection practices: • 1999, Immunization: WHO/UNICEF/UNFPA/joint statement on the use of auto-disable syringes in immunization services • 2002, Curative services: recommendations of the 12th Expert Committee for the selection of essential medicines

4. ACCESS Countries experiences on access to injection equipment (1) • Experiences in selected AFR and WPR countries • Burkina Faso • Guinea • Mongolia • Cambodia • Interviews of the participants from 12 countries of the WPR national drug policy meeting, October 2002

5. Countries experiences in access to injection equipment (2) Burkina Faso Mongolia Cambodia Guinea Single-use equipment included in the Yes Yes Yes No national essential drug list Use of national drug procurement Yes No Yes No system for injection equipment Forecasting methods Consumption No Consumption No Independent procurement Yes Yes No N/A Joint distribution of essential drugs Yes No Yes No and injection equipment Local production No Yes No No Sterilizable injection equipment used No No Phased out Yes Reported shortages No Yes Yes Yes Unsterile injections - +/- +/- ++

6. ACCESS Situations in 12 Countries the WPRO Region WPRO NDP participants survey • Single-use equipment included in the 7/12 national essential drug list • Use of national drug procurement 11/ 12 system for injection equipment • Forecasting methods Consumption: 11/12 11/ 12 • Joint distribution of essential drugs and injection equipment 4/ 12 • Local production

7. Conclusions • A number of parameters will influence access to injection equipment and ultimately injection practices • inclusion in the essential drug list • use of the national drug procurement • joint distribution of medicines and injection equipment • local production • Access and ultimately injection practices will depend upon the number of favourable parameters • In WP region, some essential drug programmes may want to examine their procurement situation to: • identify unfavourable parameters • evaluate if shortages of equipment do not lead to unsafe practices

8. ACCESS Draft WHO procurement guide for injection Equipment • Objective of the guide: Strengthen good quality purchase of injection equipment at affordable price (quality standards) • Audience: procurement officers, programme managers • Proposing practical tools: product selection, forecasting , method of procurement and selection of suppliers