Challenges Facing Home-Based Caregivers in the Management of Health Care Risk Waste

Abstract

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

The need for a balanced hospital-based care (HBC) and home- and community-based care (HCBC) approach for mitigating COVID-19 pandemic in sub-Saharan Africa

“…Additionally, HCBC will need a new cadre of community staff with the spirit of humanity and COVID-19 patients attended to irrespective of their income and medical covers. Despite the need for rapid widespread campaign and implementation of HCBC in countries in SSA during COVID-19 pandemic, there are certain healthcare issues and challenges [ 9 , 11 , 12 ] that could potentially impede its adoption. Adoption of HCBC may be limited by: i) working poverty and lack of basic sanitation facilities and supporting infrastructures, ii) little, delayed, and slow efforts by the stakeholders in healthcare in adopting HCB, iii) shortages and unequal distribution of trained staff, iv) frequent periodic supply shortages and stock-outs of vital medicines and limited medical equipment, v) high burden of disease epidemics, vi) unwillingness of COVID-19 patients and their contacts to be enrolled in HCBC due to stigma against COVID-19, vii) looming and cascading concerns about the possibility of adverse health outcomes during the COVID-19 management period, viii) safety of home- and community-based carers, which may limit the amount of work performed by community HCWs, ix) conflict between modern medicine and alternative medicine, including traditional medicine, x) difficulty in establishing a balancing HCBC and HBC as well as COVID-19 countermeasures, xi) environmental hazards due to poor hygiene and IPC measures, and healthcare risk mismanagement, xii) poor-record keeping which might compromise patient care and its continuum, xiii) different COVID-19 patient needs, and increased patient needs and expectation, xiv) lack of education and training for COVID-19 patients and community HCWs, xv) possibility of medical litigation due to patient negligence, xvi) ailing economy and limited funding parallel with management and leadership crisis.…”