1. Synergy and Partnership for Injection Safety: the Senegal experience Jules Millogo, MD, MSc Immunization Advisor BASICS II A USAID-financed project administered by the Partnership for Child Health Care, Inc. Academy for Educational Development, Emory University, John Snow, Inc., Johns Hopkins University, Management Sciences for Health, The Manoff Group, Inc., Program for Appropriate Technology in Health (PATH), Save the Children Federation, Inc., TSL 1600 Wilson Boulevard, Suite 300  Arlington, VA 22209  USA  Phone: 703-312-6800 Fax:: 703-312-6900

2. Background Population increasingly scared of risks of HIV transmission through unsafe injections Injection Safety still a low priority for Government coalition of partners formed for injection safety HIV program used as entry point to improve injection safety

3. The World Bank… Catalyst for injection safety Support to Multisectoral AIDS control Program (MAP) 2002-2006 Help to put injection safety in Government priorities Key elements of MAP includes: Infection control, including injection safety Health care worker protection

4. USAID…Technical coordinator for injection safety Building and coordination of members of Coalition for injection safety Organization of an initial assessment Preparation of a workshop on development of injection safety policy

5. PATH/CVP…Promoter of injection waste management Organization of workshop and demonstration on incinerators Support to initial assessment Leveraging government for injection policy development

6. UNICEF & WHO… Provision of funds for initial assessment Technical support to develop guidelines Equipment Note: Important role of SIGN +++

7. Risks for the patients 23% of vaccination injections prepared in unsafe conditions 19% of therapeutic injections non sterile 15% of health workers said that they reused injection equipment without sterilization

8. Risks for injection providers 50% of health workers practice two-handed recapping 70% of health facilities use an open container to collect sharp wastes 70% of health workers reported accidental needlesticks in the last 12 months

9. Risk for the community Sharp wastes around 45% of health facilities 67% of health facilities with poor waste disposal practices

10. Preparing next steps Maintain the coalition Conduct workshop on injection policy and action plan development Implement policy: forthcoming measles campaign

11. Thank You