Gluteal fibrosis, post-injection paralysis, and related injection practices in Uganda: a qualitative analysis
| العنوان: | Gluteal fibrosis, post-injection paralysis, and related injection practices in Uganda: a qualitative analysis |
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| المؤلفون: | Angela Chen, Coleen S. Sabatini, Jeffrey N. Katz, Kristin Alves, Christine L. Godwin, Daniella Akellot |
| المصدر: | BMC Health Services Research BMC health services research, vol 18, iss 1 BMC Health Services Research, Vol 18, Iss 1, Pp 1-11 (2018) |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Pediatric orthopaedics, Iatrogenic Disease, 8.1 Organisation and delivery of services, Health informatics, Health administration, 0302 clinical medicine, Health care, Safe injection, Medicine, Uganda, 030212 general & internal medicine, Child, Qualitative Research, Intramuscular, 030504 nursing, Health Policy, Nursing research, lcsh:Public aspects of medicine, Pediatric musculoskeletal health, Health Services, Middle Aged, 3. Good health, Public Health and Health Services, Health Policy & Services, Female, 0305 other medical science, Intramuscular injection, Health and social care services research, Research Article, Adult, medicine.medical_specialty, Attitude of Health Personnel, Health Personnel, Injection practices, Nursing, Injections, Intramuscular, Injections, Interviews as Topic, 03 medical and health sciences, Library and Information Studies, Clinical Research, Post-injection paralysis, Humans, Paralysis, Motivation, Modalities, business.industry, Gluteal fibrosis, Public health, Prevention, lcsh:RA1-1270, Fibrosis, Good Health and Well Being, Family medicine, Buttocks, business, Delivery of Health Care, Qualitative research |
| الوصف: | Background Iatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector. Methods We conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis. Results We identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities. Conclusion This qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement. |
| وصف الملف: | application/pdf |
| تدمد: | 1472-6963 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d66d3416cf55fac2088fd258efe76ebTest https://pubmed.ncbi.nlm.nih.gov/30477506Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....7d66d3416cf55fac2088fd258efe76eb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14726963 |
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