Win Ei Mon, Saw Yu Mon, Oo Kyi Lwin, Than Thet Mon, Cho Su Myat, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Occupational and Environmental Health Division, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar.
Nagoya J Med Sci. 2019 Feb;81(1):81-91. doi: 10.18999/nagjms.81.1.81.
Improper healthcare waste management (HCWM) poses a serious public health problem worldwide. Primary health centres (PHCs) provide public health and medical care services as the basic structural and functional units of healthcare services in Myanmar. However, no study has been conducted in Myanmar about HCWM at PHCs. This study aims to assess the practice of HCWM at PHCs in Mon State, Myanmar. A cross-sectional study was conducted in all ten townships in Mon State, Myanmar. In total, 93 PHCs (71 non-hospitals and 22 hospitals) were selected using simple random sampling. The observational checklist which was developed based on the World Health Organization's standard guideline procedure of HCWM was used to determine the practice of HCWM at PHCs. Binary logistic regression was used for final data analysis. The burning in pits method was used as the final disposal method of healthcare waste in 78.5% of PHCs. Non-hospital type PHC were more likely not to have colour coding system for HCWM (odds ratio [OR] 7.54; 95% confidence interval [CI] 2.15-26.52), did not have equipment for accidental spillage of healthcare waste (OR 3.92; 95% CI 1.3-11.77) and did not have separate staff for HCWM (OR 8.27; 95% CI 2.77-24.64), relative to hospitals. Non-hospital type PHCs practices poorly on the colour coding for waste segregation, assigning separate staff for HCWM, and possessing equipment for accidental spillage of healthcare waste than hospital type PHCs. The Ministry of Health and Sports should issue technical guidelines of safe HCWM as a compulsory policy for both hospitals and non-hospital type PHCs.
不当的医疗废物管理在全球范围内构成了严重的公共卫生问题。基层医疗中心(PHCs)作为缅甸医疗服务的基本结构和功能单元,提供公共卫生和医疗服务。然而,缅甸尚未针对基层医疗中心的医疗废物管理开展研究。本研究旨在评估缅甸孟邦基层医疗中心的医疗废物管理实践情况。在缅甸孟邦的所有十个镇区开展了一项横断面研究。总共通过简单随机抽样选取了93个基层医疗中心(71个非医院型和22个医院型)。基于世界卫生组织医疗废物管理标准指南程序制定的观察清单,用于确定基层医疗中心的医疗废物管理实践情况。采用二元逻辑回归进行最终数据分析。78.5%的基层医疗中心将坑烧法用作医疗废物的最终处置方法。相对于医院型基层医疗中心,非医院型基层医疗中心更有可能没有医疗废物管理的颜色编码系统(优势比[OR]7.54;95%置信区间[CI]2.15 - 26.52)、没有医疗废物意外泄漏的处理设备(OR 3.92;95% CI 1.3 - 11.77)以及没有专门负责医疗废物管理的工作人员(OR 8.27;95% CI 2.77 - 24.64)。非医院型基层医疗中心在医疗废物分类的颜色编码、配备专门负责医疗废物管理的工作人员以及拥有医疗废物意外泄漏处理设备方面,比医院型基层医疗中心做得更差。卫生与体育部应发布安全医疗废物管理的技术指南,作为医院和非医院型基层医疗中心的强制性政策。