Solid healthcare waste management in Anambra State of Nigeria: awareness and practice
Aim: This study aims at ascertaining the current healthcare waste management practices in Anambra State. It highlights the sources of healthcare waste, its classification, the hazards associated with it and the gold standard in its management. The specific objectives are: to determine current practice of healthcare waste segregation, storage, transportation, treatment and disposal methods; to assess healthcare workers perception of hazards posed to them by healthcare waste; to ascertain the presence of defined procedures for healthcare waste management in the healthcare facilities and to assess the availability and use of protective gear3s in the facilities. The study was done in registered primary and secondary healthcare facilities in all the three senatorial zones that made up Anambra State of Nigeria in 2008.
Methodology: Multistage sampling technique was used to select 47 facilities from a total of 958 registered healthcare facilities. A total of 265 healthcare staff were interviewed. The instruments used are semi structured interviewer administered questionnaires and observation check list.
Result: The healthcare staff is made up of mainly female literate nursing staff. Thirty two (60.01%) of the 47 facilities segregate waste. There are no colour-coded bags in all 47 (100%) of the facilities. All the facilities studied, 47 (100%), store their waste in the open outside the ward. Cleaners carry waste on their head or wheelbarrow in 26 (55.32%) of the facilities, 21 (44.68%) use open truck provided by the local environmental sanitation agency, Anambra State Environmental Sanitation Agency, (ANSEPA), as mode of transport of waste. Waste is disposed of in mixed form without treatment. There are no incinerators. Disposal is by burying, dumping in the sea or in the open to decompose, land fill and open burning. A total of 255 (96.23%) of the staff are aware of hazards of healthcare waste and 253 (94.47%) know that segregation can reduce the hazards. In 31 (65.96%) of the facilities there are clearly defined procedures for healthcare waste handling. In 39 facilities, (82.98%), there are protective gears and 38 (97.44%) of those that have the protective gears use them.
Conclusion: We concluded that the current healthcare waste management practice at the facility level is good but storage and disposal methods are crude. Means of transport may have negative effect on the good habit of waste segregation the facilities have. We recommend the setting up of an agency responsible for healthcare waste disposal parallel to the already existing environmental sanitation agency. Government should provide colour coded bags and containers and well defined procedures for waste management for all healthcare facilities in the state. More studies are needed to characterize the healthcare waste and to determine the management of hazardous waste from scattered sources like households, traditional healers homes, spiritual churches, home caregivers and patent medicine stores.
Key words: healthcare waste, segregation, infectious, disposal.