Assessment of management of health-care wastes in non-government health care facilities in Nairobi province
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Date
2009-06Author
Ngari, Washington N
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Poor management of health care wastes exposes health care workers, waste handlers .
and the community to infections, toxic effects and injuries. Despite this inherent
hazardous nature of the health care wastes, their treatment and disposal remains
neglected and unattended within the urban municipal waste systems in Kenya. The
national healthcare waste management plan is yet to be implemented, consequently
leaving the management of the health care facilities (HCFs) without a reference on
how to manage their wastes.
The goal of this study was to provide data that can be used to improve HCWM by
analyzing the existing practices currently adopted by the health care facilities. The
general objective was to carry out a situation analysis on the management of health
care wastes in non- government health care facilities. This was a descriptive cross-sectional
study that assessed health care waste management (HCWM) in 24 nongovernmental
(12 mission and 12 private owned) HCFs in the Nairobi province. An
observation checklist was used to document the various elements of HCWM practiced
within the HCFs. It included the presence of a HCWM plan, a waste management
team, provision of personal protective equipment for the waste handlers, waste
segregation, waste colour coding, storage, safe transportation, treatment and disposal.
Structured questionnaires were used to elicit information on the knowledge, attitudes
and practices of the different cadres of health workers and waste handlers, and to
determine the management's contribution towards safe HCWM. Sixty five health care
workers, 24 waste handlers and 24 facility administrators were interviewed.
The study found that no facility had a HCWM plan and only 3 HCFs (12.5%) had a
waste management team headed by a waste management officer. Waste segregation
was found to be inadequate as no facility had a general waste category hence all the
wastes produced within these facilities are considered hazardous and have to be
treated prior to disposal. Waste storage facilities were not adequate as they are easily
accessible and not secure. Waste was transported manually in 21 facilities (88%),
putting the waste handlers at risk of injuries and infections. The only treatment
method found to be in use within the facilities is incineration and only 13 facilities
(54%) were found to have functioning incinerators. The incinerators are the De
Montfort type and there are no measures for emission control in place and can
therefore be source of air pollution putting the community at risk of disease. Private
collectors are used by two thirds of the facilities to dispose their wastes while the rest disposethem within their premises by means of a landfill or open pit. There was no
specific budget allocation for HCWM except in the cases where the services of
private waste collectors were used.
The knowledge of the health workers on HCWM was found to be inadequate, but
their attitude was found to be positive. Three quarters of the health workers re-cap
used needles, they have low immunization rates against tetanus and hepatitis B virus
andthe rate of needle prick injuries was low at 6% in the previous one month. Twenty
one facilities (88%) provide personal protection equipment (P.P.E.) for their waste
handlers and the waste handlers had high levels of compliance in the usage of the
P.P.E. Immunization status and needle prick injuries among the waste handlers were
also low.
These findings show that there is need to implement the national policy on HCWM so
as to improve and harmonize HCWM within the facilities.
Sponsorhip
University of NairobiPublisher
Department of Community Health, University of Nairobi
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