1. Plan of Action to improve injection Safety Within the EPI

2. Overall objective To ensure the safety of all EPI injections by 2006

3. Strategies - 1 Use of AD syringes in all immunization services by the end of 2002. Ensure the safe collection, disposal and destruction of used injection equipment using safety boxes and appropriate high temperature incinerators. Investigate alternative methods for the safe disposal of used injection equipment. Expand training and improve the knowledge of health workers and managers on injection safety.

4. Strategies - 2 Establish reliable estimates for equipment requirements, minimum stock levels and effective supply and distribution systems for injection and disposal equipment. Institute monitoring and supervision procedures to ensure adequate supplies at all levels and correct practices by health workers. Secure the required budget for injection safety including safe disposal and destruction of used equipment.

5. injection equipment  Autodisable syringe for all EPI injections  Disposable syringe for reconstitution of vaccines

6. requirements The basis for the calculation is based on the planned number of injections with 10% wastage A buffer stock of 25% of the annual routine requirement is needed to reduce the risk of stock-outs. Calculations for safety boxes are based on 100 syringes per box

7. Requirements of Safe injection equipment for routine EPI

8. Training Training requirements include the following: The correct use of AD syringes and safety boxes as per national policy The appropriate disposal and destruction of used injection equipment The accurate calculation of supply requirements and monitoring of stock The routine reporting of equipment supply levels to EPI managers

9. Advocacy requirements A strategy for advocating issues related to injection safety and safe disposal and destruction of used injection equipment is to be developed targeting all levels. A specific plan of action for advocacy and communication should be developed by the end of 2003.

10. Monitoring and indicators Supervisory visits will include an assessment of injection safety and disposal practices. In addition, surveys when necessary will validate the information from data collected during supervisory visits. Indicators will be based on the following targets: 100 % of Provinces with adequate access to appropriate disposal system 100 % of Districts with 100% AD use for all EPI vaccines and safe disposal practices

11. Budget estimates and funding

12. Plan to improve injection safety within the curative area Pham Duc Muc Dept.of Therapy-MOH-SRV

13. Back ground - Hos.system consists of 970 hospitals, approximately 120.000 beds, -Public hospitals accounts for 98.5%. -Injection Safety is a major concern -MOH, NNA,EPI &WHO promote SIGN in VN

14. Initial achievements - Pilot study conducted in Hanoi (2001) - NNA launched a National SI campaign (2001) - Technical transfer for producing AD products - Involvement of all concern institutions

15. The overall objective is to: Reduce risk to patients, HCWs and public

16. Strategy to reduce risk to patients - Eliminate reuse of syringes - Reduce unnecessary injections

17. Elimination of reuse

18. Strategy to reduce risk for HCWs & public 1. H andle of needles properly 2. Use appropriate technology for sharp waste disposal (safety boxes, needle removers, & Incinerators

19. Reduce risk to the HCWs & Public

20. Plan for the next 1. Production of AD syringes locally & Use of AD products. 2. Implementation of a nation-wide assessment 3. Development of policies to monitor the practice of Injection safety 4. Advocacy for SIGN through workshops & publications

21. Thank you