Oyekale Abayomi Samuel, Oyekale Tolulope Olayemi
Department of Agricultural Economics and Extension, North-West University Mafikeng Campus, Mmabatho, 2735, South Africa.
Institute of Food Security, Environmental Resources and Agricultural Research (IFSERAR), Federal University of Agriculture, Abeokuta, Nigeria.
BMC Public Health. 2017 Sep 25;17(1):740. doi: 10.1186/s12889-017-4794-6.
Adequate management of healthcare waste (HCW) is a prerequisite for efficient delivery of healthcare services. In Nigeria, there are several constraints militating against proper management of HCW. This is raising some environmental concerns among stakeholders in the health sector. In this study, we analyzed the practices of HCW management and determinants of risky/safe indices of HCW disposal.
The study used the 2013/2014 Service Delivery Indicator (SDI) data that were collected from 2480 healthcare facilities in Nigeria. Descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square (OLS) regression were used to analyze the data.
The results showed that 52.20% and 38.21% of the sampled healthcare facilities from Cross River and Bauchi states possessed guidelines for HCW management, respectively. Trainings on management of HCW were attended by 67.18% and 53.19% of the healthcare facilities from Cross River and Imo states, respectively. Also, 32.32% and 29.50% of healthcare facilities from rural and urban areas previously sent some of their staff members for trainings on HCW management, respectively. Sharp and non-sharp HCW were burnt in protected pits in 45.40% and 45.36% of all the sampled healthcare facilities, respectively. Incinerators were reported to be functional in only 2.06% of the total healthcare facilities. In Bauchi and Kebbi states, 23.58% and 21.05% of the healthcare facilities respectively burnt sharp HCW without any protection. Using PCA, computed risky indices for disposal of sharp HCW were highest in Bayelsa state (0.3070) and Kebbi state (0.2172), while indices of risky disposal of non-sharp HCW were highest in Bayelsa state (0.2868) and Osun state (0.2652). The OLS results showed that at 5% level of significance, possession of medical waste disposal guidelines, staff trainings on HCW management, traveling hours from the facilities to local headquarters and being located in rural areas significantly influenced indices of risky/safe medical waste disposal (p < 0.05).
The study concluded that there was low compliance with standard HCW management. It was recommended that possession of HCW management guidelines, staff training on HCW disposal and provision of requisite equipment for proper treatment of HCW would promote environmental safety in HCW disposal.
医疗废物的妥善管理是高效提供医疗服务的前提条件。在尼日利亚，存在若干不利于医疗废物妥善管理的制约因素。这在卫生部门的利益相关者中引发了一些环境方面的担忧。在本研究中，我们分析了医疗废物管理的做法以及医疗废物处置风险/安全指数的决定因素。
本研究使用了2013/2014年服务提供指标（SDI）数据，这些数据是从尼日利亚的2480家医疗机构收集的。使用描述性统计、主成分分析（PCA）和普通最小二乘法（OLS）回归对数据进行分析。
结果显示，来自克罗斯河州和包奇州的抽样医疗机构中，分别有52.20%和38.21%拥有医疗废物管理指南。来自克罗斯河州和伊莫州的医疗机构中，分别有67.18%和53.19%参加了医疗废物管理培训。此外，农村和城市地区的医疗机构中，分别有32.32%和29.50%此前曾派部分工作人员参加医疗废物管理培训。在所有抽样医疗机构中，分别有45.40%和45.36%的机构将锐器和非锐器医疗废物在有防护的坑中焚烧。据报告，仅2.06%的医疗机构的焚化炉可正常运行。在包奇州和凯比州，分别有23.58%和21.05%的医疗机构在没有任何防护的情况下焚烧锐器医疗废物。使用主成分分析得出，贝耶尔萨州（0.3070）和凯比州（0.2172）处置锐器医疗废物的计算风险指数最高，而贝耶尔萨州（0.2868）和奥孙州（0.2652）非锐器医疗废物的风险处置指数最高。普通最小二乘法结果显示，在5%的显著性水平下，拥有医疗废物处置指南、医疗废物管理的工作人员培训、从医疗机构到当地总部的行程时间以及位于农村地区对风险/安全医疗废物处置指数有显著影响（p < 0.05）。
该研究得出结论，医疗废物管理标准的合规性较低。建议拥有医疗废物管理指南、对医疗废物处置进行工作人员培训以及提供适当处理医疗废物的必要设备，将促进医疗废物处置中的环境安全。
