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© 2018 Altaf A. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. Injection is one of the most common medical procedures in the world. Most medical injections are provided for curative reasons whereas some of the other reasons include vaccination injections, family planning and diabetic injections1. A safe injection does not harm the recipient, does not expose the provider to risk and does not result in waste that is dangerous for others2. Observing infection prevention and control procedures and use of a single injection equipment markedly reduces the risk of transmission of infection. Unsafe injection practices include an injection given with a syringe used on more than one patient, injections prepared in unclean area compromising infection prevention and control practices and injections given unnecessarily in conditions that can be treated with oral medicines for example common flue or minor aches and pains. Unsafe injections lead to transmission of blood borne infections including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immuno deficiency virus (HIV)3. A mathematical modelling study estimated that unsafe injections in health care settings transmit 1.67 million HBV infections, 315,210 HCV infections and 33,877 HIV infections4. In most medical situations an injection is provided by a front-line health care worker who could be a nurse or another trained person like a para medic (often called a dispenser or a compounder in South Asia) or a nurse assistant while in some situations a doctor also provides the injection. While unsafe injection practices rarely occur in high income countries, but they are often evident in low income country health settings where the administration of injection takes place in a variety of settings and involve a range of providers which could be trained or untrained, traditional healers and sometime relatives and neighbors providing an injection as a favor or expression of care5. A review on unsafe injections from South Asia pointed out that 5% to 50% of injections are provided with reused syringes, thus creating potential to transmission of blood-borne pathogens. Qualified and unqualified practitioners, especially in the private sector, are the major drivers behind injection use, but patients also prefer injections, especially among the rural, poor or uneducated in certain countries6.

Unsafe Injection Practices by Medical Practitioners in South Asia Associated with Hepatitis and HIV Outbreaks