Learning Objectives for this Presentation:
By the end of the presentation participants will be able to-
1. Recognize the importance of using needle crusher at outreach immunization sites
2. Appraise the policy impact of ensuring needle safety at outreach health service delivery sites


Background:
Bangladesh has proven its success through organizing community based widespread immunization outreach sites. A significant proportion of used syringes from these vaccination sites become available to be reused by injecting drug users (IDU), and also by traditional health practitioners. This serious threat to public health led to an innovative idea of needle crushing at outreach sites, immediately after their use for vaccination. In Bangladesh, the first ever trial was given in the program site of Save the Children and the results showed prospect of national level scaling of the idea of crushing and recycling of used needles.


Setting:
In May-June 2005, EPI program worked on piloting the use of needle crusher at outreach immunization sites within Save the Children's operational area which includes 312 outreach vaccination sites.


Population:
In all these sites, approximately 12000 children received immunization yearly.


Project Description:
Vaccinators at outreach vaccination sites in Nasirnagar Sub-district of Bangladesh received relevant training and orientation on use of needle crusher at outreach sites.
Formative reports from discussion and interviews with field workers and community members were examined to assess the advantage-disadvantages of needle crushers at field level.


Results/Lessons Learned:
Majority of field vaccinators (84%) provided positive feedback as the needle-crusher was user-friendly. Only a few (16%) vaccinators reported it as an extra workload and it took more time to report on used and crushed needles plus to send back the crushed needles.
Field lessons revealed the wide acceptance and usability of the needle crusher at national scale. Policy dialogue and decision would help preventing the emerging threats of public health as well as environmental hazards in Bangladesh.