Omoleke Semeeh Akinwale, Usman Nura, Kanmodi Kehinde Kazeem, Ashiru Mustapha Mohammed
World Health Organization, Kebbi State Field Office, Birnin Kebbi, Kebbi State, Nigeria.
Department of Public Administration, Waziri Umaru Federal Polytechnic, Birnin Kebbi, Nigeria.
Public Health Pract (Oxf). 2021 Feb 11;2:100092. doi: 10.1016/j.puhip.2021.100092. eCollection 2021 Nov.
This study aims to examine medical waste management (MWM) practices and identify the challenges of optimal MWM at the primary healthcare (PHC) level in Kebbi State, Nigeria.
This study was a cross-sectional survey of 265 primary healthcare workers (PHCWs) and health facilities (HFs) in Kebbi State.
The study tool used was a questionnaire adapted from the WHO rapid assessment tool on MWM and water sanitation. Descriptive and inferential statistical analyses were conducted using SPSS version 20 software.
Data generated from 257 HWs were used in this study. Amidst other findings, only 65 (25%) HFs had MWM guideline or policy document; out of these 65HFs, only 19 (7%) of them had problem with its implementation. Only 42 (16%) HFs had a compensation package or a health insurance policy to take care of their health workers in case of MWM-associated hazards while 22 (9%) HFs had specific budgetary allocation for MWM. Only 105 (41%) HFs had trained staffers on MWM. Sharps, blood/body fluids and domestic wastes were the top three (3) wastes generated among the surveyed HFs. Medical waste treatment was on-site in 124 (48%) HFs and burn-and-bury method was the adopted method of medical waste disposal in 198 (77%) HFs. However, the majority (76%) of the surveyed HWs expressed dissatisfaction about the waste treatment practices adopted in their HFs.
Our study revealed a poor level of MWM practices in Kebbi State, Nigeria. The state government and partners need to urgently address the identified operational and policy gaps in MWM in Kebbi State, Nigeria. Furthermore, our study revealed the negative implication of fragmented governance and leadership structure at the PHC level on policy, practice and administration of medical waste management in the Kebbi State, Northwestern Nigeria. Addressing the gaps found in this study would contribute to the attainment of the United Nations Sustainable Development Goals in health and well-being, sustainable cities and communities and contribute to poverty eradication.
本研究旨在调查尼日利亚凯比州基层医疗保健（PHC）层面的医疗废物管理（MWM）实践，并确定优化医疗废物管理所面临的挑战。
本研究是对凯比州265名基层医疗保健工作者（PHCWs）和医疗机构（HFs）进行的横断面调查。
所使用的研究工具是一份根据世界卫生组织关于医疗废物管理和水卫生的快速评估工具改编的问卷。使用SPSS 20版软件进行描述性和推断性统计分析。
本研究采用了257名医疗保健工作者提供的数据。在其他调查结果中，只有65家（25%）医疗机构有医疗废物管理指南或政策文件；在这65家医疗机构中，只有19家（7%）在实施方面存在问题。只有42家（16%）医疗机构有补偿方案或健康保险政策，以便在发生与医疗废物管理相关的危害时照顾其医护人员，而22家（9%）医疗机构有医疗废物管理的专项预算拨款。只有105家（41%）医疗机构对其工作人员进行了医疗废物管理方面的培训。锐器、血液/体液和生活垃圾是接受调查的医疗机构中产生的三大主要废物。124家（48%）医疗机构在现场处理医疗废物，198家（77%）医疗机构采用焚烧掩埋法处理医疗废物。然而，大多数（76%）接受调查的医疗保健工作者对其所在医疗机构采用的废物处理做法表示不满。
我们的研究表明，尼日利亚凯比州的医疗废物管理实践水平较低。该州政府及其合作伙伴需要紧急解决在尼日利亚凯比州医疗废物管理方面发现的业务和政策差距。此外，我们的研究揭示了基层医疗保健层面治理和领导结构分散对尼日利亚西北部凯比州医疗废物管理的政策、实践和管理产生的负面影响。解决本研究中发现的差距将有助于实现联合国在健康与福祉、可持续城市和社区方面的可持续发展目标，并有助于消除贫困。
