Healthcare waste management, quantification and intervention in Addis Ababa City Administration health bureau public health facilities

Abstract

Healthcare waste management is very important due to its hazardous nature that can cause risk to human health and the environment. The study wished to determine the amount of healthcare waste generated in 15 public health centres and 3 hospitals and evaluate the healthcare waste management practices in Addis Ababa City Administration. The aim of the study was to develop a manual for healthcare facilities based on the findings on healthcare waste management practice, quantification and intervention. Data was obtained from questionnaires distributed to 636 randomly selected healthcare professionals, ancillary staff and managers and by means of surveying the facilities. The mean HCW generation rate was 10.64 + 5.79 kg/day, of which 37.26% (3.96 + 2.017kg/day) was general waste and 62.74% (6.68 + 4.293 kg/day) was hazardous waste from the surveyed health centres. HCW generation and quantification was not measured and documented in any of the HCFs. Quantifying HCW would help determine the type of waste as well as the HCFs that generate the highest and lowest HCW, which could have implications for resource allocation in managing HCW. Segregation of different types of wastes was not regularly done. Some HCFs had separate storage areas for HCW and separate containers for hazardous and nonhazardous waste. In some instances, however, the containers were not clearly marked. Regarding storage, some of the HCFs had interim storage sites and HCW disposal sites. Several interim storage facilities lacked security and surveillance and were not cleaned after collection. In addition, HCW remained at the interim storage facilities for more than 48 hours before final disposal. The main forms of on-site treatment of HCW before disposal were burning, crushing sharps, sterilisation and chemical disinfection. The most common treatment method used for HCW was incineration. Most HCW handlers had not received adequate training; did not wear PPE, and did not take precautionary measures, such as washing their hands and heavy duty gloves after handling HCW. The researcher developed a manual for effective HCW management and training of HCW handlers. Based on the findings, the study makes recommendations for policy, education, HCW management, including generation, segregation, storage, transportation and disposal, and further research.