Knowledge, attitudes, and practices of health care waste management among Zambian health care workers

Abstract

Poor management of health care waste poses a serious threat to the health of health care workers, patients and communities. In developing countries, adequate health care waste management (HCWM) is often a challenge. To address this, the Zambian Health Services Improvement Project with HCWM as a component, was implemented in five Zambian provinces (Luapula, Muchinga, Northern, North-Western and Western Provinces), under which this cross-sectional study was conducted to identify the knowledge, attitudes, and practices of health care workers on HCWM. Fifty government hospitals and health posts from five provinces in Zambia were included in the study. Data was collected using a mixed-methods approach, which included surveys with health care workers (n = 394), in-depth interviews (n = 47) with health officials at the provincial, district, and facility levels, and observational checklists (n = 86). Overall, knowledge of proper waste segregation was average (mean knowledge score 4.7/ 7). HCWM knowledge varied significantly by job position (p = 0.02) and not by facility level, years of service, nor prior training. Only 37.3% of respondents recalled having received any sort of HCWM training. Poor waste segregation practice was found as only 56.9% of the facilities used an infectious waste bag (yellow, red or orange bin liner) and a black bag for general waste. This study revealed that only 43% of facilities had a functional incinerator on site for infectious waste treatment. Needle sticks were alarmingly high with 31.3% of all respondents reporting a prior needle stick. The system of HCWM remains below national and international standards in health facilities in Zambia. It is imperative that all health care workers undergo comprehensive HCWM training and sufficient health care waste commodities are supplied to all health facility levels in Zambia.

Knowledge, attitude, and perceived practice of sanitary workers on healthcare waste management: A descriptive cross-sectional study in Dodoma region,Tanzania

“…11 The management of healthcare waste generation, treatment, storage, and disposal involves administrative agencies, managers, contractors in healthcare waste handling firms, and other stakeholders close to healthcare institutions. [12][13][14] The national health policy of Tanzania, for instance, has shown that sanitation difficulties have persisted as a public problem of concern that needs to be addressed appropriately despite innovative initiatives against environmental pollution and deforestation. 15 Managers, contractors, or bosses must carry out tasks like hiring sanitary health staff, buying equipment for handling healthcare waste, fostering a healthy and welcoming work environment, acquiring personal protective equipment, and guaranteeing and processing payments to their employers in order for healthcare waste handling to be effective.…”

“…25 Sanitary personnel gather and move medical waste from the source to disposal locations or incinerators using tools including wheelbarrows, wheel buckets, crates, and/or plastic bags. 14 Depending on the pace of healthcare waste generation and timetable, the processes may be performed daily or weekly. 26 Sanitary employees have gotten close to problems including the gathering, transportation, storage, treatment, and disposal of solid waste from sources including healthcare facilities despite being removed from the generation of healthcare waste.…”

“…25 Sanitary personnel gather and move medical waste from the source to disposal locations or incinerators using tools including wheelbarrows, wheel buckets, crates, and/or plastic bags. 14 Depending on the pace of healthcare waste generation and timetable, the processes may be performed daily or weekly. 26…”

“…A number of academic papers 31 , 34 – 36 have concentrated on and disseminated empirical data on the generation, collection, transport, and storage of healthcare waste among healthcare professionals. Also, some literature 14 , 37 , 38 has shown that auxiliary healthcare employees, such as sanitary workers, labor under inadequate conditions in situations where the management of healthcare waste has not received the attention and importance it requires. This includes Tanzania.…”