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Abstract
In depth interviews of healthcare providers, patients and carers of infants to identify determinants of therapeutic injections in Sindh, Pakistan
A Altaf1, M Agboatwalla2, S Luby3, Y Hutin4, Z Fatmi1, A Ajmal1, A V Reeler5
1The Aga Khan University, Karachi, Pakistan; 2Civil Hospital Karachi, Karachi, Pakistan; 3Centers of Disease Control and Prevention, Atlanta, United States; 4World Health Organization, Geneva, Switzerland; 5Axios International, Royston, United Kingdom
Background
Seventy percent healthcare in Pakistan is in the private sector. Medical doctors with MBBS degree establish small and large clinics all over the country. They are called general practitioners (GPs). Majority of population from low to middle income areas visit these GPs routinely because of easier access, less weighting time and better attitude of the staff than at public facilities. Unfortunately patients visiting these clinics in Pakistan do not access to safe therapeutic injections. As a result they are at risk of acquiring bloodborne infections such as HIV, hepatitis B & C.
Methodology
Indepth interviews were conducted with GPs-private and public (both formal and informal), dispensers, vaccinators, individual patients and carers of infants using tools developed by the World Health Organization.
Results
A total of 121 interviews were conducted with GPs, patients, carers of infants and dispensers in Sindh, Pakistan in July 2001. GPs over prescribe injections even in conditions which may be treated by oral medications. Average number of patients a GP treats in a day ranged between 40-50 and average price of treatment ranged between 30-35 rupees (US$ 0.57). GPs informed that patients demand injections and without prescribing an injection they will loose clientele. Exit interviews of patients suggest that the patients want to get well and are not sure about the need of an injection and the kind of syringe they receive. Very few patients were aware of transmission potential of HIV/AIDS, hepatitis B and C because of unsafe injections. Every dispenser was observed using a used syringe multiple times.
Conclusion
To reduce unsafe injection practices and risk of HIV and hepatitis B and C transmision in Sindh, Pakistan simultaneous education of GPs and patients is required. Key elements of patients’ education should include questioning the GP about the need of an injection and the safety of syringes used.
The XIV International AIDS Conference
Abstract no.
MoPeD3666
Suggested Citation
" A Altaf , , et al.
In depth interviews of healthcare providers, patients and carers of infants to identify determinants of therapeutic injections in Sindh, Pakistan.
Poster Exhibition:
The XIV International AIDS Conference:
Abstract no.
MoPeD3666"
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