Managing healthcare waste in Ghana: a comparative study of public and private hospitals

Anti-cancer drug waste disposal practices and wastewater management in hospitals: A Lebanese survey

INTRODUCTION

To achieve continuous environmental sustainability and protect the population's health, healthcare waste (in liquid or solid form) needs appropriate management and suitable treatment strategies before its final disposal in the environment in order to reduce its adverse impacts. This study aims to identify disparities in the waste management of anti-cancer drugs and the wastewater generated in Lebanese hospitals.

METHODS

Three questionnaires were designed to evaluate the level of knowledge, awareness and experience of hospital personnel regardless of their job levels. Data was collected in December 2019 from three departments of each participating hospital: pharmacy, oncology and maintenance departments. A descriptive analysis was conducted to summarise the survey results.

RESULTS

The results revealed a lack of transparency and awareness of the participants, with a high frequency of 'prefer not to say' responses when asked about the disposal methods of anti-cancer drugs and with only 5.7% of the participants in the pharmacy department sharing their disposal procedures. The same perception was deduced regarding hospitals' wastewater treatment, where responses were often contradicting, preventing making assumptions about the fate of hospital wastewater.

CONCLUSION

The results of this survey support the need to establish a more comprehensive waste management programme in Lebanon that would be maintained through regular training and supervision.

Healthcare Waste Segregation Practice and Associated Factors among Healthcare Professionals Working in Public and Private Hospitals, Dire Dawa, Eastern Ethiopia

Background

The key to the effective management of healthcare wastes is the segregation of the waste at the point of generation; no matter what final strategy for the treatment and disposal of wastes is selected, it is critical that waste streams are separated.

Objective

The aim of the study is to assess the practice of healthcare waste segregation and associated factors among healthcare workers at public and private hospitals in Dire Dawa, Eastern Ethiopia.

Methods

An institution-based cross-sectional study was conducted among 280 healthcare workers from public and private hospitals. Data were collected through self-administered structured questionnaires and observation checklists. Bivariate and multivariable logistic regression were used to identify factors associated with the practice of healthcare workers using SPSS (Statistical Package for Social Sciences) version 25.

Results

This study showed that 56.4% (95% CI: 43.7-60.2) study participants had good healthcare waste segregation practices. Working in a public hospital (AOR = 0.09, 95% CI: (0.03-0.23)), working less than 40 hours a week (AOR = 4.28, 95% CI: (2.11-8.68)), adequate knowledge on healthcare waste management (AOR = 2.42, 95% CI: (1.27-4.61)), ever trained on waste management ((AOR = 2.74, 95% CI: (1.15-6.53)), the presence of guidelines, instructive posters on healthcare waste segregation ((AOR = 8.21, 95% CI: (3.84-17.55)), and availability of color-coded waste bins ((AOR = 9.53, 95% CI: (4.52-20.10)) were factors significantly associated with healthcare waste segregation practices.

Conclusion

The study revealed that healthcare waste segregation practices were unacceptably poor. It is very crucial to address the identified factors through ongoing enforcement of healthcare waste management rules and regulations, by providing training, instructive posters around the work area, and making color-coded bins available.

Healthcare waste management in the Tamale Central Hospital, northern Ghana. An assessment before the emergence of the COVID-19 pandemic in Ghana

Healthcare waste (HCW) poses several environmental and public health challenges. However, much attention has not been given to its management. The present study sought to assess the healthcare waste management (HCWM) practices in the Tamale Central Hospital (TCH) by characterizing and measuring the quantities of waste generated and the associated implications. Observation of the value chain of healthcare waste management, waste quantification using a weighing scale (Top-pan-spring balance), and semi-structured interviews were used in the data collection. The study revealed that, except for sharps, there was no segregation of infectious and non-infectious waste, and healthcare waste was not treated before final disposal. The study showed that a daily record of 5.1 kg of sharps, 24.46 kg of infectious waste and 59.45 kg of general waste was generated. The maternity ward produced more general waste (14 kg), whereas the theatre generated the highest infectious waste (5.70 kg) and sharps (0.8 kg) daily. Generally, the maternity ward recorded the highest daily waste generation of 17.9 kg. The waste treatment method available in the hospital was incineration. However, the incinerator was found to be dysfunctional. Thus, an improvised method (dug pit) was used irrespective of the associated health and environmental implications. The study also revealed that the hospital did not quantify the amount of solid waste that was generated. Inadequate finance and lack of supervision were linked to the problem of poor healthcare waste management in the study area. Also, 82% of the workers mentioned that there was poor HCW segregation at the departments whereas 76% of the patients who received healthcare at the facility were unsatisfied with the HCWM practices. A strong linear relationship in the responses made was recorded. The healthcare waste management index showed that the HCWM practice at the facility was unsatisfactory as it was medium-ranked. The study, therefore, recommends that the hospital considers constructing an on-site waste treatment facility, segregate and quantify waste for effective allocation of resources for treating healthcare waste.

The Key Organizational Factors in Healthcare Waste Management Practices of Libyan Public Hospitals

This study aims to investigate factors contributing to healthcare waste management practices among Libyan public hospitals. The organizational culture and structure are proposed to have their effect upon hospital organizational units in charge of healthcare waste production by a theoretical review to develop two main hypotheses. Hence, this study used the stratified random sampling technique to select respondents such as top management officials, heads of departments, and administrators who work in all the hospitals located in the south of Libya, from whom data was collected. The data for the study was gathered via a survey questionnaire from Libyan public hospitals in the country’s southern region. A total of 210 questionnaires were distributed and 171 usable responses were received, yielding a 70% response rate. Though the findings of the study show some inconsistency, the two dimensions of the culture examined in this study are found to have a positive relationship and significant influence on the management practices of health waste. Besides, it shows the positive relationship between organizational structure and healthcare waste management practices (HWMP). However, the findings of this study suggested that nurses and cleaners’ practices should critically consider structure dimensions such as formalization as well as moderating variables such as hospital location and type of services supplied on the interactions to improve the management of healthcare waste in Libya’s public hospitals.

Modelling the performance of waste management services in Ghana’s public hospitals

Purpose

The purpose of this paper is to explore and establish key performance indicators that could be considered towards improving the delivery of waste management (WM) services in public hospitals.

Design/methodology/approach

An exploratory sequential mixed-methods approach was adopted for this study. This involved two phases of data collection and analysis. Specifically, interviews in selected case studies hospitals and a general questionnaire survey. Partial least squares structural equation modelling was used to model the relationships among the performance variables. An expanded balanced scorecard typology was used to categorize performance variables.

Findings

The results demonstrate that quality and internal business strategic indicators have a significant influence on WM performance. By implication, public hospital managers would be well advised to invest resources in improving internal business operations, learning and growths, as well as prioritizing finance in the process of managing healthcare waste.

Practical implications

The developed WM structural model can be used to identify performance indicators that can be incorporated into public hospitals’ WM strategy to improve performance leading to a decent healthcare environment.

Originality/value

The majority of studies have centered on the knowledge and practices of healthcare WM. This study extends the knowledge of healthcare WM literature from the perspective of FM performance measurement. The developed model of the study is invaluable to many developing countries that are faced with the challenge of improving WM practices.

Operating room greening initiatives - the old, the new, and the way forward: A narrative review

Healthcare waste is a rampant issue in Australian hospitals. The operating room (OR) contributes disproportionately to total hospital waste. There has been considerable research in the literature concentrating on strategies to improve OR and hospital waste accumulation, in an attempt to provide guidance and direction on how to reduce the healthcare ecological footprint. We reviewed the literature for leading greening initiatives currently utilised in the OR in Australia and internationally. This narrative literature review focuses on the trend of OR greening initiatives over the last 25 years, comparing different innovative approaches, the successes and setbacks, and the financial implications of initiatives. A variety of measures that hospital management, surgeons, anaesthetists, nurses and other healthcare personnel can take to reduce the ecological footprint of their healthcare facility are outlined. Greening initiatives include reducing, recycling, reusing, rethinking and researching, as well as novel technology and smarter architectural design. We also evaluated the barriers to improving waste management, which include lack of leadership, misconceptions among staff, and an overall resistance to change. In conclusion, in a world where greenhouse gas emissions cause unprecedented climate change and landfill space is finite, it is incumbent upon hospitals to help reduce the environmental impact of their facility. Reducing pollution and greenhouse gas emissions would moderate the incidence of human disease, save money for the healthcare system and society as a whole, and contribute to a safer and healthier world we all would like to live in.

Assessment of Healthcare Waste Management Paradigms and Its Suitable Treatment Alternative: A Case Study

The management and treatment of healthcare waste (HCW) are of great concern owing to its potential hazard to human health and the environment, particularly in developing countries. Nowadays, various technological alternatives are gaining momentum as efficient and favorable waste management options across the world. However, selecting a suitable technology as well as an effective waste management approach for the treatment of HCW is still a challenging task for the municipal authorities. This study renders a comprehensive analysis of healthcare waste management (HCWM) practices and the technological options for its better management through a case study in Khulna, the southwestern division of Bangladesh. A number of healthcare establishments (HCEs) in the study area were selected and a questionnaire survey, as well as field investigations, was performed to find out the present status of HCWM and its limitations. An assessment of different technological alternatives was also carried out using Sustainability Assessment of Technologies (SAT) methodology which could pave the way for treating hazardous waste more efficiently in the Khulna metropolitan area. The study revealed that the overall HCW generation rate and hazardous HCW generation rate in Khulna city were 0.90 kg bed^-1 day^-1 and 0.18 kg bed^-1 day^-1, respectively. Assessment of management system revealed that 56% (n = 38) of workers did not receive any form of training in the handling of hazardous waste. Around 54% (n = 47) of them did not use any safety equipment or clothing. It has been found from the study that, among different technological alternatives based on the final score, incineration was the most suitable option for the treatment of hazardous waste in Khulna. Finally, some guidelines have been put forward to improve its existing management practices.

Healthcare waste management research: A structured analysis and review (2005-2014)

The importance of healthcare waste management in preserving the environment and protecting the public cannot be denied. Past research has dealt with various issues in healthcare waste management and disposal, which spreads over various journals, pipeline research disciplines and research communities. Hence, this article analyses this scattered knowledge in a systematic manner, considering the period between January 2005 and July 2014. The purpose of this study is to: (i) identify the trends in healthcare waste management literature regarding journals published; (ii) main topics of research in healthcare waste management; (iii) methodologies used in healthcare waste management research; (iv) areas most frequently researched by researchers; and (v) determine the scope of future research in healthcare waste management. To this end, the authors conducted a systematic review of 176 articles on healthcare waste management taken from the following eight esteemed journals: International Journal of Environmental Health Research, International Journal of Healthcare Quality Assurance, Journal of Environmental Management, Journal of Hazardous Material, Journal of Material Cycles and Waste Management, Resources, Conservations and Recycling, Waste Management, and Waste Management & Research. The authors have applied both quantitative and qualitative approaches for analysis, and results will be useful in the following ways: (i) results will show importance of healthcare waste management in healthcare operations; (ii) findings will give a comparative view of the various publications; (c) study will shed light on future research areas.