1. Planning for a safe syringe disposal system for Immunization Service Delivery Part I Options for syringe waste disposal Part II Weighing the options

2. Transmission risks & disposal upatient to patient transmission of infection due to the re-use of syringes, upatient to health-worker transmission due to needle- stick and upatient to community transmission due to unsatisfactory final disposal. Safe Sharps Waste Disposal Systems

3. Options for syringe waste disposal ucollecting used syringes umethod of final destruction ulocation of final destruction umonitoring safe disposal of syringes

4. Options for collecting used syringes 1. Place needles and syringes in a safety box immediately after use

5. Options for collecting used syringes 1. Place needles and syringes in a safety box immediately after use 2. Separate needles from syringes before placing the syringe in a safety box

6. Options for final destruction 1. Incinerating filled safety boxes (best method)

7. Options for final destruction 1. Incinerating filled safety boxes (best method) 2. Burning safety boxes in a drum, protected hearth or pit (next best method)

8. Options for final destruction 1. Incinerating filled safety boxes (best method) 2. Burning safety boxes in a drum, protected hearth or pit (next best method) 3. Burying safety boxes in the ground (least safe method) This option should only be used: If no incinerator is available and If burning is not acceptable or possible and If suitable land is available: The land should be inaccessible to the community. The water table should be at least 1.50m below the base of the pit, even during the wet season. The ground should not be too hard.

9. Options for the location of final destruction 1. At the site of outreach immunization

10. Options for the location of final destruction 1. At the site of outreach immunization 2. At the health center

11. Options for the location of final destruction 1. At the site of outreach immunization 2. At the health center 3. At a location remote from the health center

12. Options for monitoring safe disposal of syringes uCount and record: 1. the total number of syringes supplied to the facility and the number of safety boxes filled with syringes or 2. Count and record the total number of injections given and the number of safety boxes filled with syringes or 3. Count and record the total number of injections given and the number of syringes destroyed

13. PART II Designing your disposal system

14. Designing your disposal system Step 1: Collect data and map the district Step 2: Identify facilities with access to incineration now Step3: Identify strategic locations for new incineration facilities Step 4: Identify the remaining health centers and decide their policy for destruction

15. Example map of facilities

16. Example planning grid

17. Merci !