Wachemo University College of Medicine and public health, Hossana, Ethiopia.
Department of Public Health, University of South Africa, College of Human Science, Pretoria, South Africa.
BMC Health Serv Res. 2024 Aug 26;24(1):985. doi: 10.1186/s12913-024-11444-8.
Healthcare waste is any waste generated by healthcare facilities that is considered potentially hazardous to health. Solid healthcare waste is categorized into infectious and non-infectious wastes. Infectious waste is material suspected of containing pathogens and potentially causing disease. Non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances, similar to household waste, i.e. plastic, papers and leftover foods. This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia. The setting was all health facilities found in Hossaena town.
A mixed-method study design was used. For the qualitative phase of this study, eight FGDs were conducted from 4 government health facilities, one FGD from each private health facility (which is 37 in number), and forty-five FGDs were conducted. Four FGDs were executed with cleaners; another four were only health care providers because using homogeneous groups promotes discussion. The remaining 37 FGDs in private health facilities were mixed from health professionals and cleaners because of the number of workers in the private facilities. For the quantitative phase, all health facilities and health facility workers who have direct contact with healthcare waste management practice participated in this study. Both qualitative and quantitative study participants were taken from the health facilities found in Hossaena town.
Seventeen (3.1%) health facility workers have hand washing facilities. Three hundred ninety-two (72.6%) of the participants agree on the availability of one or more personal protective equipment (PPE) in the facility ''the reason for the absence of some of the PPEs, like boots and goggles, and the shortage of disposable gloves owes to cost inflation from time to time and sometimes absent from the market''. The observational finding shows that colour-coded waste bins are available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. Two hundred seventy-one (50.2%) of the respondents were satisfied or agreed that satisfactory procedures are available in case of an accident. Only 220 (40.8%) respondents were vaccinated for the Hepatitis B virus.
Hand washing facilities, personal protective equipment and preventive vaccinations are not readily available for health workers. Solid waste segregation practices are poor and showed that solid waste management practices (SWMP) are below the acceptable level.
医疗废物是指医疗机构产生的任何被认为对健康有潜在危害的废物。固体废物医疗废物分为感染性和非感染性废物。感染性废物是指疑似含有病原体并可能导致疾病的物质。非感染性废物包括未接触过感染源、危险化学品或放射性物质的废物，类似于家庭废物，即塑料、纸张和剩余食物。本研究旨在调查埃塞俄比亚固体废物医疗废物管理实践，并制定改善固体废物医疗废物管理实践的指南。研究地点为霍萨纳镇所有的卫生机构。
采用混合方法研究设计。在本研究的定性阶段，从 4 家政府卫生机构、1 家私营卫生机构（共 37 家）各进行了 1 次小组讨论，共进行了 45 次小组讨论。4 次小组讨论是与清洁工一起进行的；另外 4 次小组讨论只与卫生保健提供者进行，因为使用同质性群体可以促进讨论。在私营卫生机构中，由于私营卫生机构的工作人员数量较多，其余 37 次小组讨论是由卫生专业人员和清洁工混合进行的。在定量阶段，所有直接参与医疗废物管理实践的卫生机构和卫生机构工作人员都参与了这项研究。定性和定量研究参与者均来自霍萨纳镇的卫生机构。
17 名（3.1%）卫生机构工作人员有洗手设施。392 名（72.6%）参与者同意在该设施内提供一种或多种个人防护设备（PPE）“某些 PPE 缺失的原因，如靴子和护目镜，以及一次性手套短缺，是由于不时的成本膨胀，有时市场上也没有这些物品”。观察结果显示，23 个（9.6%）房间有彩色编码垃圾桶。90%的尖锐容器可重复使用，100%的废物储存桶是可清洁的塑料桶。在 40 个（97.56%）卫生设施中，感染性废物每天从废物产生区收集到最终处置点。271 名（50.2%）受访者对事故发生时是否有满意的程序表示满意或同意。只有 220 名（40.8%）受访者接种了乙型肝炎病毒疫苗。
卫生工作者没有随时获得洗手设施、个人防护设备和预防接种。固体废物分类做法不佳，表明固体废物管理做法（SWMP）低于可接受水平。
