Rapid assessment of injection practices in Mongolia.
BACKGROUND
Anecdotal reports suggest that unsafe injections may transmit blood-borne pathogens in Mongolia.


METHODS
The Ministry of Health of Mongolia collected information on injection practices, their determinants, and their consequences through interviews and observations of a small convenience sample of prescribers, injection providers, and members of the general population.


RESULTS
The 65 members of the general population reported receiving an average of 13 injections per year. New, single-use injection devices were used in the 20 health care facilities visited. There were breaks in infection control practices while administering injections, including observations of 500-mL intravenous infusion bottles used as multiple-dose diluent vials and 8 of the 28 providers (28%) reporting reuse of device on the same patient. Injection providers reported 2.6 needle-stick injuries per year. Contaminated sharps were burned in a drum. Among persons interviewed, 19 of the 21 prescribers (90%) and 49% of the population were aware of the potential risk of HIV transmission through unsafe injections.


CONCLUSIONS
A multidisciplinary initiative is necessary to achieve safe and appropriate use of injections in Mongolia through (1) behavior change, (2) increasing availability of injection devices and sharps boxes, and (3) appropriate sharps waste management.
Logez
Sophie
S
Department of Essential Drugs and Medicines Policy, World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
Soyolgerel
Gochoo
G
Fields
Rebecca
R
Luby
Steve
S
Hutin
Yvan
Y
D005260:Female; D006801:Humans; D017053:Infection Control / Q000592:standards*; D007267:Injections / Q000009:adverse effects / Q000379:methods* / Q000592:standards*; D008297:Male; D008986:Mongolia; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care