Center for Research and Innovation, Ateneo de Manila University-School of Medicine and Public Health, Pasig, Philippines.
Front Public Health. 2022 Aug 17;10:958241. doi: 10.3389/fpubh.2022.958241. eCollection 2022.
This study presents a comprehensive analysis on policies governing the management of COVID-19 waste in the Philippines, highlighting gaps in pre-existing policies and opportunities for further policy development and adaptation in the context of present and future public health emergencies. A hybrid search strategy and consultative process identified fifty (50) policy documents directly impacting the management of wastes (general domestic, healthcare, and household healthcare waste) released prior to and during the pandemic. Content analysis revealed comprehensive policy coverage on managing general domestic waste and healthcare waste. However, there remains a dearth in policies for managing household healthcare waste, an emerging category for waste generated by patients isolating at home or in isolation facilities. Applicable, pre-existing policies were neither adequate nor specific to this category, and may therefore be subjected to variable interpretation and mismanagement when applied to this novel waste category. Assessment using the modified Cradle-to-End-Of-Life (CTEOL) framework revealed adequate policy coverage across the waste lifecycle stages. However, policies on reducing waste generation were relatively minimal and outdated, and policy gaps in waste segregation led to downstream inefficiencies and introduction of environmental health risks in waste collection, treatment, and disposal. The internal validity of policies was also evaluated against eleven (11) criteria adapted from Rütten et al. and Cheung et al. The criteria analysis revealed strong fulfillment of ensuring policy accessibility, goal clarity, provision of human resources, and strength of policy background, but weak fulfillment of criteria on providing adequate financing, organizational capacity building, monitoring and evaluation, and encouragement of opportunities for public participation. We conclude that existing waste management policies in the Philippines leave much room for improvement to ensure effective management of COVID-19 waste from various settings and circumstances. Hence, these policies are expected to adapt and evolve over time, utilizing the best available technology and environmental practices. Integrated, region-wide waste management systems, involving both government and society, and strengthened by equitable provisional support are needed for effective waste management that is both inclusive and resilient in the face of present and future pandemics.
本研究对菲律宾管理 COVID-19 废物的政策进行了全面分析，重点关注了现有政策中的差距，以及在当前和未来公共卫生紧急情况下进一步制定和调整政策的机会。采用混合搜索策略和协商过程，确定了 50 份直接影响废物管理（一般家庭、医疗保健和家庭医疗保健废物）的政策文件，这些文件是在大流行之前和期间发布的。内容分析显示，在管理一般家庭废物和医疗废物方面，政策具有全面性。然而，在管理家庭医疗保健废物方面，政策仍然存在空白，这是一个由在家隔离或在隔离设施中隔离的患者产生的新兴废物类别。适用的现有政策对这一新型废物类别既不充分也不具体，因此在应用于这一新型废物类别时可能会导致不同的解释和管理不善。使用修改后的从摇篮到生命终结（CTEOL）框架进行评估显示，废物生命周期各个阶段都有足够的政策覆盖。然而，减少废物产生的政策相对较少且过时，废物分类方面的政策差距导致废物收集、处理和处置过程中的下游效率低下和引入环境健康风险。还根据 Rütten 等人和 Cheung 等人改编的十一项标准对政策的内在有效性进行了评估。标准分析显示，在确保政策可及性、目标明确性、提供人力资源以及政策背景力度方面得到了强有力的满足，但在提供充足资金、组织能力建设、监测和评估以及鼓励公众参与机会方面的满足程度较弱。我们的结论是，菲律宾现有的废物管理政策还有很大的改进空间，以确保从各种环境和情况下有效管理 COVID-19 废物。因此，这些政策预计将随着时间的推移进行调整和发展，利用最佳的现有技术和环境实践。需要建立综合的、区域范围的废物管理系统，包括政府和社会，并通过公平的临时支持来加强，以实现具有包容性和弹性的废物管理，以应对当前和未来的大流行。
