An evaluation of clinical waste management in Gaborone city council healthcare facilities

Abstract

The management of clinical waste is of great importance due to its infectious and hazardous nature that can cause risks on environment and public health. The study was conducted to evaluate clinical waste management practices and to determine the amount of waste generated in five purposively selected healthcare facilities in Gaborone City Council. The surveyed healthcare facilities were of different size, specialization and category and included a referral hospital, two clinics and two health posts. To examine clinical waste management practices the study employed a range of methods including questionnaire survey which targeted 105 stratified randomly selected healthcare workers and ancillary staff, formal interviews with facility managers, field observations and literature reviews. Compliance with the Botswana Clinical Waste Management Code of Practice, 1996 and Waste Management Act, 1998 and other related documents were used as standards to assess clinical waste management practices. The waste management practices were analysed for a week in each healthcare facility to capture the daily management practices. The generated clinical waste was weighed to compute the generation rates and was followed through the various management practices to the final disposal. Findings of the study revealed that clinical waste generation rates were: 0.75kg/patient/day for Princess Marina Hospital and 0.1 - 0.3kg/patient/day for clinics and health posts. Numerous aspects of clinical waste management were found to comply with the expected rules and standards at Princess Marina Hospital, but the clinics and health posts had less appropriate practices. Clinical waste generated at Princess Marina Hospital is quantified in reliable records and dedicated Infectious Control Officers are responsible for monitoring the management of clinical waste. The study revealed that clinics and health posts do not quantify clinical waste and there are no officers responsible for monitoring clinical waste and there are no documents for monitoring the management of clinical waste. The main treatment method of clinical waste for the surveyed healthcare facilities is incineration and it is being done properly. The study established that at least 80% of healthcare workers and ancillary staff have been vaccinated against hepatitis B and have received training in clinical waste management. Recommendations are given with the aim of improving clinical waste management practices in Gaborone City Council healthcare facilities.