Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 1326
Country/Region: Botswana
Year: 2008
Main Partner: John Snow, Inc
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: HHS/CDC
Total Funding: $1,900,785

Funding for Biomedical Prevention: Injection Safety (HMIN): $1,900,785

08.P0401 John Snow - Technical assistance on Injection Safety

With USG support, JSI and its subcontractors, PATH and AED are supporting the MOH to strengthen the

existing injection safety systems and promote the safety of healthcare workers, patients, and the

community. The Making Medical Injections Safer (MMIS) program is currently working in four districts and

the BDF Health Corps. MMIS and its partners plan to scale up interventions (except for distribution of

retractable syringes) to ten additional health districts in FY2008.

The primary focus for the procurement and distribution of injection devices (retractable syringes) has been

ensuring adequate and continuous availability of retractable syringes for Kgatleng and Lobatse districts

where MOH and MMIS are piloting the use of retractable syringe technology to reduce exposure to needle-

stick injuries. Results drawn from this pilot will be used by the MOH to make an informed decision whether

retractable syringes should be procured for the administration of injections in Botswana.

2007 accomplishments

From FY2005 to June 30, 2007, 4,082 healthcare workers including doctors, nurses, student nurses,

laboratory and dental staff, pharmaceutical staff, lay counselors, environmental health staff, industrial class

workers and ambulance drivers had been trained in infection prevention and control and injection safety

(IPC/IS). Senior district health managers from the current districts received regional capacity building

training in infection prevention, healthcare waste management, logistics, and behavior change. Training

extended to diabetic patients who self administer injection at home.

According to the mid-term review of the injection safety project in March 2007, preliminary results indicate

that prevalence of injuries and use of unnecessary injections have been reduced by half, and management

of healthcare waste are improving.

During FY2007, MMIS focused on establishing logistics management information system tools in Gaborone,

Kanye/Moshupa and BDF at service delivery points to promote appropriate management of injection

equipment. MMIS supported MOH (CMS, the Botswana Essential Drug Action Program, and the Drug

Management Unit in revising the 2000 Botswana Drug Management Guidelines.

MMIS supports the GOB (MOH, Ministry of Local Government, and Ministry of Environment, Wildlife and

Tourism) to enforce its 1996 Code of Practice for Clinical Waste Management/Healthcare Waste

Management. The Code is the Government of Botswana's implementation document that provides

standards and procedures of managing clinical waste at facility as well as central level.

The country-wide review of the injection safety policy that drew healthcare workers from all districts was

concluded during the first quarter of FY2007. The policy is being put in recommended government format

and will be presented to MOH for approval before the end of FY07. The policy articulates and advocates for

institutional administrative procedures and IPC/IS guidelines to improve healthcare worker safety.

2008 plans

Approximately 260,000 people have been reached with injection safety messages. As a strategy of scaling-

up injection safety interventions, a multi-year advocacy and BCC strategy for injection safety has been

developed. It is anticipated that 700,000 people will be reached by the end of FY2008.

MMIS will assess the effectiveness of retractable syringe use and conduct a follow-up assessment in health

facilities of the pilot districts to gather information on the effectiveness of the intervention. A baseline

assessment in the districts identified for expansion and scale up of program activities is also planned.

Supervision visits will be conducted on a quarterly basis with results reported to HHS/CDC/BOTUSA, MOH

and MMIS/HQ.

The project will explore areas of collaboration and develop synergies with other projects. Possible areas

being explore with the NBTS and SBFA is infection prevention and safety training. JSI will also explore

areas of linkages with Supply Chain Management Systems (SCMS) implemented by Crown Agents Inc in

areas of procurement of injection safety related commodities in Botswana.

Subpartners Total: $0
Program for Appropriate Technology in Health: NA
Academy for Educational Development: NA