Healthcare waste management in different health facilities of Nepal

Objective

General Objective of this study is to assess the Health Care Waste Management in different Health facilities of the country in order to establish Health Care Waste Management as a part of Health Service Delivery System by developing practical Guideline for the whole country.

Methodology
1. Study area

Health Institutions (both public and privare) of Mountain, Hill and Plain area of the country.2. Study design

It is a cross -sectional descriptive study.3. Sampling Design

•        Sampling Universe

–       All public and private health institutions of the selected district

•        Sampling Frame

–       Record of health institutions in the DHO/ DPHO

•        Sample Size

–       More than 10 Health Institutions per districts, including public and private hospitals, PHC, HP, SHP, Nursing homes, medical shops etc.

•        Sampling technique

–       Purposive sampling was adopted for the selection of districts and Health Institutions were selected after discussion with DHO/DPHO4. Instrumentation:

–       Structured close and open ended questionnaires and observation checklist were used

Conclusion

•        Waste Management is not the priority area for most of the Health Institutions

•        No specific person allocated for waste management

•        Waste Handlers do not posses proper skill for Waste Management

•        Waste Handlers do not use proper protective measures during Waste Management

•        Attempt to segregate waste at source is found in large Health Institutions but there was not proper waste segregation in place

•        Some of the hospitals have Incinerators but not in proper use

•         Lack of regular maintenance of incinerator

•        Waste was found dispersed around incineration area and other areas as well

•        Lack of placenta pit in most of the Health Institutions with delivery services

•        Lack of space for waste disposal in some Health Institutions

•        Lack of specific rules and regulations for Waste Management cause further problem

•        large Health institutions are found interested in coordinated waste disposal system e.g. common incinerator or autoclaving but need central coordinating mechanism in place