Abstract:
The purpose of this study was to investigate solid health care waste management
practices in the health sector in order to develop guidelines for improving solid health
care waste management practice. The setting is all health facilities found in
Hossaena town. A convergent mixed-methods study design was used. For the
quantitative part of this study a census method of study, which is all health care
facilities found in the town was studied. All health facilities and health facility workers
(540 in number) who are available in the study health facilities and having a role in
HCW management practice were included in the quantitative phase of this study.
Qualitative research sampling is purposive and relies on different methods. For the
purpose of this study, small purposeful samples were used. The researcher of this
study purposefully selected the research participants who have experienced the solid
health care waste practice or key concept being explored in this study. One hospital,
three government health centres, 17 medium clinics, 19 small clinics, and one
surgical centre participated in this study. Both samples were drawn from the same
population. The quantitative part of the study included all health facility staff who play
a role in the practise of health care waste management
In the qualitative phase of the data collection open-ended interviews, focus group
discussions, and analysis of visual materials were used. Questionnaires were used
for the quantitative phase.
The data were analysed quantitatively by using relevant statistical tools. Descriptive
statistics and Pearson correlation tests were used for the bivariate associations to
assess the relationships between independent and dependent variables and analysis of variance to compare health care waste generation rates by the type of health
facilities. In most of the variables, percentages and means were used to report the
findings with a 95% confidence interval. Open-ended responses and focused group
findings were undertaken by quantifying and coding the data to provide a thematic
narrative explanation.
These guidelines were designed and developed based on the study findings and the
current knowledge available and reviewed in the literature. The purpose of these
guidelines is to show the gap on SHCWMP and to provide the scientific
recommendation to health facility workers, health facility managers, and regulatory
bodies. The objectives of these guidelines are to improve and maintain public health
safety by: Minimising solid HCW generation rate and impacts on the surrounding
environment. These guidelines were developed based on the world health
organization recommendation of the guide line development process and findings of
this study and the extensive literature review. The final guidelines were tested and
the comments from practical users were evaluated and incorporated into the
guideline. In the light of the finding of this research, there are several gaps regarding
proper SHCWM practice. Colour coded waste bins should be available, adequate
awareness and training programmes for health facility workers, patients and visitors
should be provided.
Result: Health care waste segregation practice was not implemented in 78% of the
health facilities. The qualitative observation asserted that inappropriate segregation
practice was observed in 98.3% of the solid health care waste containers. The main
problem that was encountered in the effective management of solid health care
waste management practice was a lack of awareness and commitment.
Observational findings revealed that in 97.6% of the health facilities, infectious
wastes are collected daily. Pre-treatment before disposal was not practised. All
health facilities used incineration by using brick or barrel incinerators, and all are not
meet the minimum standards solid health care waste management. The qualitative
observation shows that 97.6% of the health facilities were not using the colour-coded
waste bin, which leads to the mixing of infectious and non-infectious waste.
Focus group participant recommend that ‘’providing waste management training and
creating awareness are the two aspects to improve SHCW segregation practice.
health facility must avail all the necessary supplies that used for SHCWMP, punishment for those violating the rule of SHCWMP, Mask, disposable gloves and
changing gowns are a critical shortage at all health facilities’’
Conclusions: Lack of knowledge, absence of training and orientation, lack of
protective vaccinations, and inappropriately constructed incinerators are the leading
causes of inappropriate solid health care waste management practice.
