Calculating requirements
Target population is used in making the requirements calculations, including number of sessions to be conducted by a facility e.g calculate for-
i. Vaccines: - target population x target coverage x no. of doses x WF.
ii. Syringes: - total doses of injectable vaccines x 1.1 WF.
iii. Dilution syringes: - doses of injectable vaccines/no. of doses per vial.
iv. Safety boxes: - number of syringes (AD+ dilution)/100.
NB WF: wastage factor.
3.4 TYPES AND METHODS OF STERILIZATION OF EQUIPMENTS
3.5 MAINTENANCE OF MATERIALS AND EQUIPMENTS
3.6 MEDICAL WASTE DISPOSAL IN IMMUNIZATION
ENSURING SAFETY DISPOSAL OF INJECTION EQUIPMENT
Used needles and syringes should be placed in safety boxes immediately after administration of injectable vaccines. Close the nearly (approximately ¾) fill box securely with the latch provided and store the box in a safe place until it can be properly disposed of. Closing the box securely prevents infecting the health care worker, other health care workers and the community from injury. To avoid an occupational hazard, safety boxes should not be more than ¾ full.
One box can hold 100 syringes and needles. If for any reason the safety boxes run out at post, used injection equipment can be disposed of in a puncture resistant container with a lid, such as a bucket.
INJECTION WASTE TREATMENT AND DISPOSAL
All filled safety boxes should preferably be disposed by high temperature incineration.
STEPS FOR BURNING IN A HIGH TEMPERATURE INCINERATOR
1- Take filled safety boxes to a high temperature incinerator if one is available in the health facility.
2- The incinerator should be pre-heated to about 600 degrees.
3- The safety boxes are introduced into the incinerator and burnt between 800 degrees to 1000 degrees.
4- The residual ash should be disposed of in a protected ash pit.
5- Where there is no incinerator, waste should be disposed by drum burning, not to be buried and no pit burning.
6- Take filled safety boxes to a high temperature incinerator if one is available in the health facility.
7- The incinerator should be pre-heated to about 600 degrees.
8- The safety boxes are introduced into the incinerator and burnt between 800 degrees to 1000 degrees.
9- The residual ash should be disposed of in a protected ash pit.
9. Where there is no incinerator, waste should be disposed by drum burning, not to be buried and no pit burning.
Do not dispose other types of waste in the safety boxes. Instead, other types of waste should be disposed in a bin and burned regularly along with the safety boxes.
TRANSPORTATION AND DISPOSAL OF CONTAMINATED SHARPS
Ensure adequate transport is made available to collect the safety boxes at the end of each day, from each fixed post. All vehicles used to transport injection waste must be disinfected after completion of the circuit.
HANDLING BOXES
Contaminated sharps should not be transferred from container to container and must not be left in a public area of the post or health facility. All filled safety boxes must be kept in a safe location, preferably locked until disposal.
3.7 PROBLEMS THAT COULD BE ENCOUNTERED AT EACH NODAL POINT OF THE CHAIN
1- Vaccines are at risk due to inadequate temperature monitoring and maintenance system.
2- Lack of trained officer to handle the vaccine at the nodal point.
3- Lack of reliable vehicle for transportation.
4- Lack of requesting only enough vaccine to do the work.
5- Allowing people to use the vaccine refrigerator to store food and drinks.
6- Lack of sufficient cold chain equipment’s e.g. refrigerator, deep freezers etc.
REMEMBER
• The safety boxes should be properly assembled according to instructions printed on the boxes.
• Open safety boxes containing contaminated syringes are a source of infection and can be dangerous.
• Designate someone to be responsible for overseeing the burning process.
• Since it is unlikely that someone will be at the site all the time, display a sign warning people to steer clear of the burning site.