Development of healthcare waste management in Serbia and challenges in the improvement of the quality of healthcare services

Abstract

Proper Healthcare Waste Management (HCWM) was introduced in the Republic of Serbia in 2007 with the support of the European Union. Since then, the amounts of waste treated, prior to landfill, have steadily increased and more and more healthcare institutions adopted HCWM systems. In parallel large numbers of healthcare workers were trained in proper HCWM. This study quantifies the progress made. The study analysed the period 2009 to 2012 using three methods of data collection. On basis of data collected, it has been established that with a population of just over seven million, Serbia generates between 4,500 and 5,000 tonnes of infectious waste on an annual basis of which some 20% originates from the treatment of outpatients , 75% from the treatment of in-patients and 5% from micro-biological laboratory tests. While in 2009 only one third of this waste was treated prior to disposal, this fraction has increased to two thirds in 2011. The data also show that more than 90% of healthcare facilities have developed individual healthcare waste management plans up from less than 20% in 2009. In every healthcare facility there are at least 2 people trained in healthcare waste management, and in total there are approximately 3000 staff members who received formal HCWM training provided through the Institute for Public Health. Healthcare waste management is continuously improving in the Republic of Serbia and is well established in more than 85% of healthcare facilities. There are still issues to be improved especially regarding treatment on healthcare waste other than infectious waste.

Knowledge and attitudes on medical waste management among Belgrade medical and dental students

“…A quarter of all MW in Serbia is hazardous, and infectious MW is the largest part of it [3,4]. Annual production of infectious waste in Serbia is between 4,500 and 5,000 tons [5]. Since 2006, the national system for safe MW management has been put into place and all infectious MW has been sterilized.…”

Generation and management of medical waste in Serbia: A review

“…Analizom dostupnih podataka, monitoringom, metodom slučajnog uzorka, anketiranjem, tumačenjem i ekstrapolacijom dobijenih rezultata, procenjena je dinamika stvaranja MO uz dovoljnu pouzdanost za dalje planiranje upravljanja. Tokom prve faze projekta dobijeni su rezultati generisanja infektivnog otpada, procenjenog na 5000 tona [15], od čega 20% potiče od ambulantnog, 75% od bolničkog lečenja i 5% od mikrobioloških testova [15]. U nastavku istraživanja procenjeno je i totalno godišnje generisanje farmaceutskog i hemijskog MO, koje prvom fazom nije bilo obuhvaćeno [15].…”

“…Tokom prve faze projekta dobijeni su rezultati generisanja infektivnog otpada, procenjenog na 5000 tona [15], od čega 20% potiče od ambulantnog, 75% od bolničkog lečenja i 5% od mikrobioloških testova [15]. U nastavku istraživanja procenjeno je i totalno godišnje generisanje farmaceutskog i hemijskog MO, koje prvom fazom nije bilo obuhvaćeno [15].…”

“…Količine generisanog MO u Srbiji tokom jedne godine dobijene su analizom svih relevantnih faktora i prikupljenih podataka prema vrsti MO:  Ukupna godišnja proizvodnja infektivnog otpada procenjena je na osnovu broja zdravstvenih ustanova, broja kreveta i prosečne zauzetosti [15].  Ukupna količina generisanog farmaceutskog otpada procenjuje se na osnovu broja zdravstvenih ustanova državnog sektora i broja državnih apoteka, kao i na osnovu broja ovakvih ustanova u privatnom sektoru [16].…”

“…Prema gore navedenim pokazateljima, procenjena je ukupna godišnja proizvodnja MO po kategorijama:  Godišnja proizvodnja infektivnog otpada u Srbiji, kako je već rečeno, procenjuje se na 4500 do 5.000 tona [15]. Za svrhe planiranja, korišćena je procenjena godišnja stopa proizvodnje od 5.000 tona, kao konstanta u periodu planiranja do 2025. godine.…”