Analysis Of Health Care Waste Management Among Health Workers In Kanungu Town Council, Kanungu District In South Western Uganda: A Case Study Of Kanungu Health Centre IV

Abstract

The study was aimed at establishing the effect health care waste management among health workers. It was guided by the following objectives which were to identify the methods used to manage health wastes and to assess the effectiveness of the methods used to manage health waste. This study used a descriptive survey research design which utilized both qualitative research methods and quantitative approaches. A sample size of 67 respondents was used. Purposive and simple random sampling techniques were used in selecting samples. Data was collected using questionnaires, interviews and documentary review. Findings indicate that 40% of the respondents pointed out that health waste are stored in Pedal bins, 24% of the respondents pointed out black refuse plastic buckets, 18% of the respondents pointed out that red clinical waste plastic bag are used as a storage container for medical wastes while 14% cited black refuse plastic bag and only 4% of the medical facilities had standard metal dust bin. Generally, in all the surveyed healthcare facilities medical wastes are collected and stored in a common area awaiting disposal/treatment. It was observed that waste was not allowed to accumulate within the wards or treatment rooms, which is a good. It was furthermore reported that health waste is stored for a minimum of eight hours before disposal. It was observed that Pedal bins were used as temporary storage containers at both surveyed health posts and were used to transport clinical waste from point of generation to storage room are always cleaned and disinfected after use. However, the locations of the temporary storage receptacles are not secure and are accessible to both people and animals. It was reported that the regular mode of transport observed for transportation of medical waste to storage room in health facilities was indeed by red pedal bins. This was also supported by questionnaire respondents. It was reported by medical waste handlers that pedal rigid plastic bins are used to facilitate easier and safer waste transfer to the temporary storage room. According to the observation made by the researcher, these storage facilities were very few thus most of the wastes were mixed up in many health facilities. For example, many health centers ha one or two waste bins as shown in table 4.9 below and no health center more than three types of waste storage facilities. Effectiveness of health waste management in health facilities was reported in hospital compared to other health facilities because 30% of the respondents revealed that effectiveness of medical waste management was excellent in health centers, 40% indicated that it was very good, 20% indicated good while only 10% indicated poor. It was also indicated that 12% of respondents revealed that in clinics effectiveness of medical waste management was excellent followed by 20% who reported that it was very good, 20% indicated good, while 28% indicated poor. In health post, effectiveness in waste management was reported by 20% who revealed that it was excellent, 20% indicated very good, 30% indicated good while 30% revealed that it was poor. The above findings imply clinics and health posts do not have an effective management framework for collecting data on medical waste generated. Interview results reveal that all surveyed clinics and health posts do not keep or record any clinical waste management information. The study established that many waste handlers in health facilities did not have enough protective clothing because some workers were seen carrying medical wastes with bare hand while others used disposable gloves that are not strong enough to protect them. On the issue of waste treatment only incineration was used in some health centers but most of the leftovers at the incineration points show that it was in most cases incomplete. This causes risk to the waste handlers and the communities adjacent to health centers due to pollution. In addition, heap of medical wastes was commonly seen in the vicinity of different health centers meaning that dumping was also used to dispose of some wastes. This becomes a problem as many people were seen trying to scavenge through the rubbish looking for somethings that could be useable thus causing a threat to their lives and the environment in general. From findings effectiveness of health waste management in health facilities was reported in to be fair especially the hospital compared to other health facilities. This was attributed to the fact that they are better established in terms of space and equipment as they are government aided than other health facilities. The study recommendations that:  Clinics and health centers should have weighing facilities so as to have quantified statistics of clinical waste generated. This will assist them in making informed decisions regarding clinical waste generated and disposed of  Healthcare facilities should be benchmarked using a standard by which clinical waste may be measured in comparison to clinical waste management best practices at similar facilities. When benchmarks are established healthcare facilities will be able to monitor themselves and compare their performance with peer groups within the country, region or the whole world.  Documents pertaining to quantity of clinical waste generated and health care waste management practices in clinics/health post should be maintained and updated.  Proper training should be provided to healthcare workers, ancillary staff, patients and everyone involved in the clinical waste management process regarding appropriate segregation practices and potential hazards associated with improper procedures such as handling without personal protective equipment.  Healthcare facilities managers should ensure that adequate protective clothing is available and waste handlers wear full protective clothing at all times when handling clinical waste.