Assessment of Injection Safety Practice in Health Care Settings: a Case from the Gambia

Unsafe injection practices transmit bloodborne pathogens on a large scale worldwide and thus the Ministry of Health was assisted in conducting an assessment of injection safety in the Gambia in 2021. Interviews and observation of injection practices in all of the public health facilities and a sample of private health facilities including NGO. A total of 81 health facilities had been involved. Sterilisation of injection material observed in 3 facilities (3.7%) for therapeutic injection. Vaccinations, used either AD syringe (83.7%) or disposable syringes (16.3%). Re-used injection equipment without sterilisation in facilities was 8.6%. Proportion of health facilities in lack of AD syringes is 6.3%. 87.3% of the health facilities the availability of AD syringes was over than 50 units. Lack of disposable syringes was 17.3% of the health facilities. In 46 health facilities (56.8%), the availability of disposable syringes was over 20 units. Lack of safety box in facilities was 50.6% (n=41). Needle stick injuries have been observed in 79.7% (n=74) of the health facilities. A proportion of 70.9% of vaccinators and 52.1% of curative injection providers reported experiencing at least one needle-stick injury. Lack of safety boxes and waste disposable facilities, unsafe behaviours and poor sharp waste management lead to unsafe injection practices in the Gambia, exposing patients, health care workers and community to bloodborne infections. A coordinated strategy, training of health workers, and encouraging of the proper disposal of sharp required to prevent injection-associated infections in the Gambia. Keywords: AD syringes, Injection, Needles, Safety boxes.