Factors affecting implementation of centralized waste management system in private healthcare facilities in Nairobi County
It is estimated that half the world's population is at occupational, environmental or public health risk from poorly treated medical waste and this problem is particularly serious in the developing world where improvements in healthcare services are not matched by strengthening of the waste management infrastructure. Successful implementation of centralized waste management could be used to address this problem. The researcher looked at various literature reviews on implementation of centralized waste management system and found out that in Kenya private healthcare facilities account for about 36% of health care waste volume generated. Whereas provincial and district hospitals act as centralized waste treatment facilities for public sector, there is no structured centralized waste management system for the private healthcare facilities in Kenya despite its many benefits. The concept of centralized waste management system has been successfully documented in private healthcare sector settings in India and some developed countries. The researcher also established that there are no documented studies on factors affecting centralized waste . management system in private healthcare facilities in Nairobi County. This study therefore was to examine factors affecting implementation of centralized waste management system in the private healthcare facilities in Nairobi County. The study adopted descriptive research design and purposive sampling of private healthcare facilities that have their waste centrally treated at the Nairobi Women's Hospital Ngong' Road branch. The researcher used both qualitative and quantitative sampling methods and data was collected using both personal interviews and drop and pick procedure. Data was analyzed and presented using descriptive and inferential statistical techniques. The study found out that there was positive correlation among all factors affecting implementation of centralized waste management system under study. The significant p-values observed between Availability of finance and Revenue stream was JJ= 0.958 was the highest followed by that between Technical preparedness and Availability of finance at p=0.949. Government policy and regulations, and Technical preparedness also had a strong correlation with significant at p-value of p=O.905. The regression results revealed that there is a positive relationship between the dependent variable and independent variables with a coefficient of determination (R2) of R2 = 0.843, implying that the independent variables (Availability of finance, Revenue stream, Technical preparedness, Government policy and regulation, Management of healthcare facility) could explain 84.3% of variation on the dependent variable (implementation of centralized waste management system). From the study findings the most significant factor that influence implementation of centralized waste management system in private healthcare facilities in Nairobi County was Management of health care facility with un standardized. Beta coefficient of j3 =0.753, followed by Availability of finance (J3 = 0.575), Technical preparedness (j3 = 0.251), Revenue stream (J3 = 0.17), and Government policy and regulation (/3= 0.131). Further, it was observed that majority (65%) of health care facilities under study did not have any form of waste treatment equipment and majority (81 %) of waste handlers were not insured against any injuries arising from handling of healthcare waste. It also emerged that majority (94.6%) of the respondents interviewed were not aware of existence of policy and regulatory enforcement for waste management. The study recommends that healthcare facilities should ensure their healthcare workers and waste handlers are properly insured against injury arising from handling healthcare waste. Finance institutions and the government should address finance factors affecting implementation of centralized waste management in Nairobi County. The study also recommends the need for all stakeholders including healthcare managers, the Government, the National Environment Management Authority (NEMA) and other regulatory authorities, to ensure awareness and compliance with waste management policies and regulations in private healthcare facilities in Nairobi County.