Solid medical waste management in Africa

Abstract

Increased awareness about inadequate management of solid medical waste (SMW) has led to increased independent surveys in African countries and yet published data remain scanty on the subject in Africa as compared to the rest of the world. To evaluate the overall compliance with World Health Organization (WHO)'s ten recommendations on SMW practices in Africa through a literature review, we conducted literature search using search terms as "medical waste OR clinical waste OR biomedical waste OR hospital waste OR healthcare waste OR hazardous waste AND Africa" in PubMed, African Journals Online, Web of Science, Proquest, Embase, Google scholar and Scopus. Additional articles were included from open google search. Articles were selected for inclusion if they described SMW management activities such as waste segregation, collection, transport (on-site and/or off-site), temporary storage, treatment and final disposal; were located in an African country and were written in English; or if written in a different language, had an English abstract with the relevant information. Evaluations were based on fifty eight (58) full text articles which were pooled together. The fifty eight (58) full text articles represented research undertaken in 20 countries. Overall, six countries (30%) broadly met half of the WHO's 10 recommendations. Based on the reviewed articles, the greatest compliance was shown with "daily collection of waste from the service areas" (100%). Areas of least compliance were "appropriate use of color codes" (18%) for labeling waste bins, "off-site conveyance" (16%) and "periodic training" (18%). In spite of growing awareness, SMW management in most African countries was sub-standard. Appropriate use of color codes, periodic training and off-site conveyance need to be addressed in terms of reporting and practice. Common challenges and unremarkable progress in SMW management in Africa raise a question about whether a unified approach should replace independent country efforts.

Healthcare waste management current status and potential challenges in Ethiopia: a systematic review

“…Probably this could be due to lack of the appropriate waste segregation utilities, lack of awareness or lack of enforcing laws and/or regulations. It is also a continent-wide problem by which a systematic review in the African region indicated that 47% of the studies mentioned the absence of waste segregation [52]. The proportion of hazardous HCW is varied in Ethiopia which ranged from 21 to 70% [14, 44].…”

Medical laboratory waste generation rate, management practices and associated factors in Addis Ababa, Ethiopia

“…A self-administered questionnaire ( S1 File ) developed by reviewing literature, articles, international and national biomedical waste management guidelines, and assessment tools [ 1 – 3 , 9 , 11 , 13 , 17 – 19 ] was used to assess biomedical waste management practices and related factors. The questionnaire consists of three sections: socio-demographic characteristics, laboratory professional knowledge of BMWM, healthcare facilities BMWM practice, and associated factors.…”

Proposed Solutions to Address the Challenges of Medical Waste Management in Health Facilities in Kamukunji Sub-County, Nairobi City County, Kenya

“…Interest in handling healthcare waste (HCW) sustainably has been growing due to public fears of the adverse health effects that could result from exposure to possibly hazardous waste that patients produce during medical treatment (Ali & Kuroiwa, 2018). There is a huge difference in how Sub-Saharan African countries handle healthcare waste management, and this difference is particularly significant (Emilia et al, 2015).…”

“…Without making significant investments in low-level health facilities, like health centers and dispensaries, higher-level medical institutions have managed to become adept at managing medical waste. All these problems require an examination of the current situation in the LLHFs (Banu et al, 2015;Emilia et al, 2015). Al-Emad (2016) asserts that the toxic nature of hospital waste poses grave concerns to environmental health.…”