PEPFAR hands over safer injection project to GPHC
THE Guyana Safer Injection Project (GSIP), which will cease to be funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) in March, was handed over to  Georgetown Public Hospital Corporation (GPHC) on Thursday last.
Against that background, Assistant Director of Nursing Services, Mr. Owen John acknowledged that GSIP has left a framework for sustainability in place.
“GSIP has worked with us, hand in hand, to identify and solve problems. They helped us identify approaches and develop models to address different issues,” he admitted, pointing out that, apart from knowledge sharing in delivery, GSIP bolstered the health care process by providing equipment to assist.
According to him GSIP offers GPHC improved quality and institutional strengthening.
Quality Assurance Officer, Mrs. Coletta Benn-Alphonso said, for their achievement,  the main strategies employed included patient education; ensuring a consistent supply of appropriate injections and water disposal equipment; provision of personal and protective gear; establishing pre and post exposure prophylaxis and training of health workers.
She said a total of 464 out of 486 providers, 78 of 88 prescribers, 99 of 102 waste handlers, 20 of 24 personnel in logistics and 34 of 40 supervisors were trained.
Benn-Alphonso said, for that success to be realised, partnership between the GPHC and GSIP was quintessential.
She said the GPHC roles entailed releasing staff for training, monitoring staff practices for workers’ safety, ensuring a system for workers’ compliance with pre and post prophylaxis and working with supervisors and providers to monitor health promotion activities.
On the other side, GSIP undertook training of all providers, procurement of injection safe supplies, provision of information, education and communication (IEC) posters and support for supervisors to monitor for compliance.
Benn-Alphonso maintained that sustainability of injection safety practices depends on adherence to policies, ongoing monitoring of staff status relative to the pre and post prophylaxis programme (vaccination) and supervision.
Other mechanisms to assure sustainability of safe injection practices includes the use of IEC materials to support behaviour change, consistent supply of equipment and budget management through support from superiors.

Continuous education
A must in this regard is continuous education, both formal and informal, Benn-Alphonso said.
The GSIP Chief of Party, Ms. Audrey Hudson concurred and underscored that, in handing over to GPHC, sustainability of practices at the institution is of key importance.
She said this will ensure that the health care delivery environment is safer and injection safety is at Guyana’s premier institution.
“From March 2010, GSIP will no longer be in existence. We are handing over the project into capable hands,” Hudson stated.
Prior to the change, she said GPHC was GSIP’s biggest challenge, with more than  800 staffers to be trained and monitored to ensure that safe injection practices continue.
However, she added that, with cooperation from management, an action plan was developed and key staffers were trained as trainers to guarantee continuity of the programme.
Hudson said, to date, there are approximately 10 trained trainers to advance the work of GSIP.
Another result of the collaboration is the piloting of a supervisory and monitoring tool at GPHC, now in use by the Nursing Services Department to generate data that can be analysed and be the basis for action.
“The objective of the injection safety programme is to ensure that there are reduced incidents of sharps injuries amongst health care workers. With exposure to sharps injuries and medical waste, many other complications can arise,” Hudson cautioned.
She explained that the project began as an initiative of the Ministry of Health and, later in 2005, was funded by PEPFAR, as a pilot study aimed at analysing injection safety practices at 15 sites in four Administrative Regions.
“Coming out of that project, we were able to understand what is happening on the ground as it relates to management of waste and safer injection practices,” Hudson reported.
She disclosed, however, that, over the years, the programme has been able to touch all 10 Administrative Regions.
“We were able to ensure that injection safety practices have found a home in our hospitals and health centers,” Hudson said.
GSIP is designed to prevent the medical transmission of HIV by reducing unsafe and inappropriate injections in Guyana. The project developed a national strategy to improve injection safety, improve health care waste management and educate the general public about precautions that will reduce accidental transmission of blood borne diseases.
The rationale is that a safe injection does not harm the recipient, expose the provider to any avoidable risk, or result in waste that is dangerous to the community.