Assessment of Injection Safety Practices among Health Workers in Ekiti State, Nigeria

Assessment of Injection Safety Practices among Health Workers in Ekiti State, Nigeria

KOLUDE, Olufunmilola1, EMMANUEL, Eyitayo E1, MARCUS, Oluwadare1, OGUNLAJA, Omotunde1, AJAYI, Paul1, ILESANMI, Mary1, IBIKUNLE, Funmi2, ONWU, Victor A2, ONYIBE, Rosemary3, SUME, Gerald4, BRAKA, Fiona4

1World Health Organization, Ekiti State Field Office, Ado Ekiti, Nigeria; 2State Ministry of Health, Ado Ekiti, Ekiti State, Nigeria; 3World Health Organization, Southwest Zonal Field office, Ibadan; 4World Health Organization, Nigeria Country office, UN House, plot 617/618, Diplomatic, Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria.

Safety of injections been administered on daily basis is becoming of significant Public Health importance considering the increasing prevalence of complications and the negative impact this could have on the overall good intention of the Healthcare providers. It is on the basis of this that we assessed the level of awareness and compliance with injection safety practices among Healthcare workers in Ekiti State.

A descriptive cross-sectional study was conducted using multistage sampling technique to recruit 582 HCWs across the State. In Stage One, 2 LGAs were selected from each of the 3 senatorial districts by simple random sampling technique through balloting and in stage two, a list of all the Health Facilities (Public and Private) in the selected LGAs was compiled and all were included in the study. In Stage three, A cluster sampling method was used to select all the staff who are eligible to administer injections in the selected HFs at the time of survey. A semi-structured questionnaire and an observational checklist was used for data collection. Data analysis was done using SPSS version 21.

A total of 582 HCWs were interviewed and 151 HFs were directly observed for compliance with Injection safety procedures. The mean age of the respondents was 38.2 ± 9.6 years. Females constituted about 86.8% while 83.5% were married. Majority of the respondents were CHEW, Nurses, Doctors and Health Attendants. Awareness of injection safety was generally high as about 93.6% of respondents were aware. However, only about 62.9% of them has ever had any form of training on Injection safety. Only about 3% of the respondents have not reused syringes, while only about 41% has ever used an AD syringe, among whom about 32% always use AD syringes. Safety boxes were available and used in about 93% of the HFs, however, the final method of sharp waste disposal is transportation to a predetermined site for onward final disposal in about 50% of the HFs. Similarly, general waste disposal is predominantly by Open burning. Recapping of needles is still being practiced occasionally by about 78.5% of the respondents, while about 13% are still regularly recapping needles. Hand washing with soap and water was a regular practice among about 88% of the HWs before attending to patients and about 93.1% after attending to patients. On the contrary, only about 20.5% of those observed actually washed their hands before/after giving injections. Majority (75.4%) of the prescribers preferred oral medications for the treatment of uncomplicated malaria, while exit interview revealed that about 34.2% of the patients preferred injections to other forms of treatment.

Although the awareness of the HCWs on injection safety is generally high, compliance with the standard safety precaution still needed to be accorded greater attention. Practices such as needle recapping, open burning of waste, poor hand hygiene, reuse of syringes and non-adherence to multidose vial policy should be totally discouraged. Regular training and unscheduled assessment of compliance could ensure that these instructions are clearly adhered to and confidence of the consumers could be built again.

Keywords: Injection safety, Nosocomial infections, injection neuritis, Ekiti state

Free Full-text PDF

How to cite this article:
KOLUDE, Olufunmilola, EMMANUEL, Eyitayo E, MARCUS, Oluwadare, OGUNLAJA, Omotunde, AJAYI, Paul, ILESANMI, Mary, IBIKUNLE, Funmi, ONWU, Victor A, ONYIBE, Rosemary, SUME, Gerald, BRAKA, Fiona. Assessment of Injection Safety Practices among Health Workers in Ekiti State, Nigeria.International Research Journal of Public Health, 2020; 4:42. DOI: 10.28933/irjph-2020-01-0305


1. Orji EO, Fasuba OB, Onwudiegwu Uche, Dare FO, Ogunniyi SO. Occupational health hazards among health care workers in an obstetrics and gynaecology unit of a Nigerian teaching hospital. J ObstetGynaecol. 2002 Jan;22(1):75–78
2. WHO Department of Vaccines and Biologicals. Tool for the assessment of injection safety. Geneva, World Health Organization, 2001
3. Sudesh Gyawali, Devendra Singh Rathore, Ravi Shankar and KC Vikash Kumar. Strategies and challenges for safe injection practice in developing countries. J Pharmacol Pharmacother. 2013 Jan-Mar; 4(1): 8-12
4. WHO. Injection Safety, Questions & Answers. WHO/HIS/SDS/2016.18
5. Vong S, PerzJF, Sok S, Som S, Goldstein S, Hutin Y, et al. Rapid assessment of injection practices in Cambodia, 2002. BMC Public Health 2005; 5:56
6. IPEN Study Group. Injection practices in India. WHO South East Asia J Public Health 2012;1:189-200
7. WHO. WHO guideline on the use of safety-engineered syringes for intramuscular, intradermal and subcutaneous injections in health care settings. WHO; Infection prevention and control. 2016
8. Alonge, I.A.O., Akinwola, M.O. Post-injection Sciatic Neuropathy: A five-year review of cases managed in a paediatric hospital in Ibadan, Nigeria. AJPARS Vol. 2, No.1, June 2010, pp. 10-13
9. Pruss – Ustunn A, Raph E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharp injuries among health –care workers, Am J Ind Med, 2005; Vol. 48 (pg. 482-490)
10. International Health Care Worker Safety Center. Estimated Number of U.S. Occupational Percutaneous Injuries and Mucocutaneous Exposures to Blood or at risk Biological Substances. Advances in Exposure Prevention, 1999;4(1), 3
11. Sudesh Gyawali, Devendra Singh Rathore, P Ravi Shankar, Vikash Kumar Kc, Nisha Jha and Damodar Sharma. Knowledge and Practice on Injectrion Safety among Primary Health Care Workers in Kaski District, Western Nepal. Malays J Med Sci. 2016 Jan; 23(1): 44-55
12. Li Q, Ou JM, Zeng G; A cross-sectional survey on injection safety in health facilities in Wulong county, Chongqing city. Europe PMC 01 Mar 2003, 24(3):176-179
13. Adejumo P.O.,DadaF.A. A comparative study on knowledge, attitude, and practice on injection safety among nurses in two hospitals in Ibadan, Nigeria. doi: 10.3396/ijic.v9i1.004.13
14. Oladimeji Akeem Bolarinwa, AdekunleGaniyuSalaudeen, Sunday AdedejiAderibigbe, OmotosoIbraheem Musa, TanimolaMakanjuolaAkande, James OlusegunBamidele. Injection safety practices among primary health care workers in Ilorin, Kwara state of Nigeria. Health Sci J. 2012 JulSept;6(3):496-508
15. District Health Information System (DHIS) II. A open software for reporting, analysis and dissemination of data for all health programmes. Available at
16. Oluwadiya KS. A study on sample size considerations, Module 2 (2017). Available at
17. Musa IO. Injection Safety Practice among Health Workers in Static ImmunisationCentres in an Urban Community of Nigeria. Niger Postgrad Med J. 2005; 12(3): 162-7.
18. Oguamanan OE,Kelvin CD. Knowledge perception and practice of injection safety and healthcare waste management among teaching hospital staff in southeast Nigeria: interventional study Pan African medical journal, 2014;17:218. doi:10.11604/pamj.2014.17.218.3084.
19. Obionu CN. Primary Health Care for developing countries. 2007. 2nd Ed. Enugu. Ezu books Ltd, 1 – 24
20. Eyam Sunday Eyam, Eyam Lilian Eberechukwu, Ofor Igri Inyang. Level of awareness and adherence to injection safety practices among primary healthcare providers in Calabar, Cross River State, Nigeria. International Journal of Contemporary Medical Research 2019;6(2):B13-B18.

Terms of Use/Privacy Policy/ Disclaimer/ Other Policies:
You agree that by using our site, you have read, understood, and agreed to be bound by all of our terms of use/privacy policy/ disclaimer/ other policies (click here for details). This site cannot and does not contain professional advice. The information on this site is provided for general informational and educational purposes only and is not a substitute for professional advice. Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals. We do not provide any kind of professional advice. The use or reliance of any information contained on this site or our mobile application is solely at your own risk. Under no circumstance shall we have any liability to you for any loss or damage of any kind incurred as a result of the use of the site or our mobile application or reliance on any information provided on the site and our mobile application. We may publish articles without peer-review. Published articles of authors are open access. Authors hold the copyright and retain publishing rights without restrictions. Authors are solely responsible for their articles published in our journals. Publication of any information in authors’ articles does not constitute an endorsement by us. We make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, availability or completeness of any information that authors provided. more..

This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.