A Study on Small Clinics Waste Management Practice, Rules, Staff Knowledge, and Motivating Factor in a Rapidly Urbanizing Area

Measuring environmentally sustainable health care: a scoping review

Work to reduce environmental pollution from the health system is hampered by an absence of consensus on the definition of environmentally sustainable health care and the relevant measurement needed. This scoping review aims to encourage standardisation across sustainability efforts by examining how environmentally sustainable health care is defined and measured in current literature. We conducted a scoping review to identify candidate publications that included either a definition or description of environmentally sustainable health care or a measurement of the impact of health care on the environment. 328 publications were included in the final analysis. 52 publications included definitions or descriptions of environmentally sustainable health care. Results of the study highlight the heterogeneity in the current definition, measurement, and measurement calculation methods of environmentally sustainable health care in published literature. Work is needed to create more harmonised definitions and measurement to support progress and reduce environmental pollution from health care.

Waste audits in healthcare: A systematic review and description of best practices

Healthcare generates large amounts of waste, harming both environmental and human health. Waste audits are the standard method for measuring and characterizing waste. This is a systematic review of healthcare waste audits, describing their methods and informing more standardized auditing and reporting. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE, Embase, Inspec, Scopus and Web of Science Core Collection databases for published studies involving direct measurement of waste in medical facilities. We screened 2398 studies, identifying 156 studies for inclusion from 37 countries. Most were conducted to improve local waste sorting policies or practices, with fewer to inform policy development, increase waste diversion or reduce costs. Measurement was quantified mostly by weighing waste, with many also counting items or using interviews or surveys to compile data. Studies spanned single procedures, departments and hospitals, and multiple hospitals or health systems. Waste categories varied, with most including municipal solid waste or biohazardous waste, and others including sharps, recycling and other wastes. There were significant differences in methods and results between high- and low-income countries. The number of healthcare waste audits published has been increasing, with variable quality and general methodologic inconsistency. A greater emphasis on consistent performance and reporting standards would improve the quality, comparability and usefulness of healthcare waste audits.

Biomedical waste management associated with infectious diseases among health care professionals in apex hospitals of a typical south asian city

Biomedical waste from healthcare activities poses a higher hazard of infection and damage than other types of trash. The main objective of the study was to assess the awareness knowledge and practices of biomedical waste management (BMWM) among health care professionals in the health care units. The cross-sectional study was carried out to access the awareness, knowledge and practices of health care professionals for BMWM. Using a qualitative approach, the study was escorted in two Apex hospitals i.e. the Allied Hospital and the District Head Quarter Hospital, Faisalabad, Pakistan from August 5, 2019 to October 15, 2019. More than 90% of respondents knew the phrase BMWM, but just 35.4% had awareness about biomedical waste regulations. About 71.6% of the respondents were familiar with biomedical waste's color-coding segregation. The study concludes gap in the awareness, knowledge and practices for BMWM. The sanitary workers of the hospitals had no knowledge about BMWM and the BMWM/healthcare waste management rule 2005 established in Pakistan due to the lack of training regarding waste management and the segregation process. Some of the staff members were aware of the BMWM practices under the rules and regulations of Pakistan but were unable to implement at their work place. It is necessary to dispose of the biomedical waste according to the established terms and conditions of BMWM rules (2005) of Pakistan. Weak structure of BMWM was observed at the study sites due to the lack of training, liabilities and absence of penalties against improper biomedical waste disposal as violation of the rules and regulations. It's a dire need of the time to consider the biomedical waste as hazardous waste and make policies for its safe disposal and ensure the implementation of the policies in all the medical centers of Pakistan.

Developing an effectiveness index for biomedical waste management in Indian states using a composite indicators approach

The waste from healthcare facilities (HCFs) is most devastating as they induce health hazards and pollute the environment. The effective management of biomedical waste is an essential function of the state governments, depending on state policies and facilities in HCFs. The performance assessment at the state level provides explanatory information for the decision-makers to dispose of biomedical waste. Therefore, this paper aims to establish an effectiveness index for assessing the performance of biomedical waste management for the Indian states. The designed conceptual framework, which acts as the building block for the index, interlinks the technical, managerial, and sustainability dimensions. To assess the existing waste management practices, significant sub-indicators are analyzed for India's northern and southern states. The indicators are transformed into comparable units using the proportionate normalization technique. The weight to the respective indicators follows the entropy method and additive aggregation to form the indices for various states. The developed index allows comparing management practices among the states and highlights the alarming situation. Based on the magnitude of indices values, states are categorized as red, yellow, and green zones. The robustness of the model is validated by performing sensitivity analysis and the cluster analysis tests the reliability of indicators and categorization of states with the existing methodology. The analysis will be useful to the decision-makers of state pollution boards by providing special attention to capacity building and waste prevention technologies.

Capacity assessment and implementation analysis of common treatment facility for the management of infectious healthcare waste in rapidly urbanising city of Nepal

This study is one of the first systematic attempts to examine the possibility of a common treatment facility (CTF) to treat infectious healthcare waste (HCW) in Nepal. First, the survey was conducted in 14 healthcare facilities (HFs) ranging from health posts to large hospitals selected from 120 total HFs in Nepalgunj sub-metropolitan city (SMC), a rapidly urbanising city of Nepal to investigate the current practices of HCW management (HCWM) and to estimate the waste generation and characteristics in the different HFs. The result shows that the average unit waste generation rate for health posts, clinics, urban health centres, and hospitals was estimated at 1.397 kg day^-1, 1.608 kg day^-1, 0.178 kg day^-1 and 1.818 kg bed^-1 day^-1, respectively. Of the total 1242 kg day^-1 HCW generated in Nepalgunj SMC, 73% is infected in the current situation, but if fully sorted at source, only 32% of the waste will be infected. Based on these HCW generation data and fraction of infectious waste, including waste management practices, three different scenarios are proposed for the capacity assessment and designing implementation modality of the CTF to treat infectious waste from all HFs of Nepalgunj SMC as a case study where an integrated solid waste management facility including material recovery facility and sanitary landfill site for municipal solid waste management is already in operation. The different implementation analyses are discussed, and the best implementation arrangement has been recommended for the sustainability of the project. This approach can be replicated in other cities alone or regions with many neighbouring cities of Nepal and explores a workable solution for HCWM in the rapidly urbanising cities of developing countries to help them improve their condition.