A study conducted on Existing Situations of Hospitals HCWM Systems in Addis Ababa City

Abstract

Introduction Globally, healthcare institutions provide medical care comprising of diagnostic, therapeutic, research, and rehabilitative services in an attempt to manage health problems and protect the public from different health risks. In the process of performing these activities, health facilities generally generate hazardous waste that could be potentially harmful to health care workers, the public and the environment (1, 2). The generated waste from health facilities is categorized in to two categories: general (non-hazardous) and hazardous waste. General wastes does not pose risk of injury or infections under a conditions they are generated. Their nature is generally similar to household related wastes. Hazardous Waste is any unwanted material that is believed to be deleterious to human safety or health or the environment (3). Moreover, the hazardous waste includes infectious health-care waste, chemical, toxic or pharmaceutical waste, including cytotoxic drugs (antineoplastics), sharps (e.g. needles, scalpels), radioactive waste; and other hazardous waste (4).

HCW management includes all activities involved in waste generation, segregation, transportation, storage, treatment and final disposal of all types of waste generated in the HCFs. MW handling is a hazardous activity which requires a high standard of training. It calls for specific training that depends on the nature of the work in the hospital, the hazards and possibility of worker exposure, and the responsibilities of individual workers [5]. The lack of segregation between HW and non-HW, an absence of rules and regulations applying to the collection of waste and the on-site transport to a temporary storage location, a lack of proper waste treatment, disposal of MW along with municipal garbage, insufficient human and financial resources, insufficient personal protective equipment (PPE) and lack of knowledge about the proper use of such equipment are among the factors contributing to poor HCW management [6].

HCW generation depends on numerous factors such as type of health care facilities (HCF), hospital specialization, available waste segregation options, seasonal variation, the number of hospital beds, and proportion of patients treated on a daily basis [7]. There are various estimates regarding to hazardous and non-hazardous constituents of healthcare waste. According to a World Health Organization (WHO) related reports and studies, around 85% of hospital wastes are non-hazardous, 10% are infectious (hence, biological hazardous), and the remaining 5% are toxic chemicals, pharmaceutical and radioactive wastes (8). This traditional estimate, however, is not consistent for many developing countries. The proportion for hazardous waste varied from country to country and holds true only when proper segregation and separation of waste is practiced (9).

According to Addis Ababa Bureau of Health (10), there are 49 private and government/public hospitals, 175 health posts, 135 higher clinics, 275 medium clinics, 162 lower clinics, 108 special clinics and 33 laboratories in Addis Ababa. Though there are seasonal variations and other determining factors to quantify HCW, health care facilities in Addis Ababa estimated to produce 6 million kg of waste per year out of which 1.2 million is estimated to be hazardous medical waste (11).