Effects of an incinerator project on a healthcare-waste management system

Khammaneechan, Patthanasak; Okanurak, Kamolnetr; Sithisarankul, Pornchai; Tantrakarnapa, Kraichat; Norramit, Poonsup

doi:10.1177/0734242x11411013

Cited by 10 publications

(5 citation statements)

References 11 publications

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“…In some cases, subsidies for services contracted to government may underestimate the costs of service provision. This is likely with waste management, which was contracted to the government hospital at substantially lower cost than found in other settings (see, e.g., [39,40]). For water and sanitation, utilities in LMICs charge tariffs substantially below full cost recovery [41].…”

Section: Discussionmentioning

confidence: 99%

Development and Application of Tools to Cost Delivery of Environmental Health Services in Healthcare Facilities: A Financial Analysis in Urban Malawi

Anderson

Cronk

Pak

et al. 2020

Preprint

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Background Environmental health services (EHS) in healthcare facilities (HCFs) are critical for providing a safe, functional healthcare environment, but little is known about their costs. Poor understanding of costs impedes progress towards universal access of EHS in HCFs. We developed frameworks of essential expenses that provide EHS and conducted an ex-post financial analysis of EHS in a network of medical research and training facilities in Lilongwe, Malawi serving an estimated 42,000 patients annually. Methods We estimated the cost of providing the following EHS: water, sanitation, hygiene, personal protective equipment use at the point of care, waste management, cleaning, laundry, and vector control. We developed frameworks of essential outputs and inputs for each EHS through review of international guidelines and standards, which we used to identify required expenses for EHS delivery and evaluate the completeness of costs data in our case study. For costing, we use a mixed-methods approach, applying qualitative interviews to understand facility context and review of electronic records to determine costs. We calculated initial costs to establish services and annual operations and maintenance.Results Available records contained little information on the upfront, capital costs associated with establishing EHS. Annual operations and maintenance totaled USD 220,427 for all EHS, although costs of essential inputs were missing from records. Annual operations and maintenance costs were highest for cleaning (USD 69,372) and waste management (USD 46,752).Discussion Missing expenses suggests that documented costs are substantial underestimates. Costs to establish services were missing predominantly because purchases pre-dated electronic records systems. Annual operations and maintenance costs are incomplete primarily because administrative records did not record sufficient detail to disaggregate and attribute expenses. Conclusions Electronic health information systems have potential to support efficient data collection. However, we found that existing records systems were decentralized and poorly suited to identify EHS costs. Our research suggests a need to better code and disaggregate EHS expenses to properly leverage records for costing. Frameworks developed in this study are a potential tool to develop more accurate estimates of the cost of providing EHS in HCFs.

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Section: Discussionmentioning

confidence: 99%

Development and Application of Tools to Cost Delivery of Environmental Health Services in Healthcare Facilities: A Financial Analysis in Urban Malawi

Anderson

Cronk

Pak

et al. 2020

Preprint

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“…In Ghana, many hospitals do not have any segregation or disposal programs for pharmaceutical waste and more than half of the population disposed of pharmaceutical waste through the MSW that ends up in the landfills or dump sites [51]. However, it has been proved that the segregation of HCW decreases the costs of its management in hospitals [52], so it should be considered in order to improve environmental, social and economic sustainability.…”

Section: Literature Reviewmentioning

confidence: 99%

Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals

Githinji,

Njogu,

Nganga

et al. 2024

OJAppS

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Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it's possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research.

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“…This framework outlines the activities required for waste management and categorizes the resource inputs required for each activity into the cost categories outlined in Table 3. We developed this example framework through a review of studies captured by the systematic review that describe resources used in waste management activities [39,49,51,[57][58][59][60][61][62][63][64][65][66][67][68][69]. We categorized these resources into cost categories, and then cross-referenced selected guidelines for waste management [42,70] to fill gaps.…”

Section: Costing Frameworkmentioning

confidence: 99%

Budgeting for Environmental Health Services in Healthcare Facilities: A Ten-Step Model for Planning and Costing

Anderson

Cronk

Best

et al. 2020

IJERPH

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Environmental health services (EHS) in healthcare facilities (HCFs) are critical for safe care provision, yet their availability in low- and middle-income countries is low. A poor understanding of costs hinders progress towards adequate provision. Methods are inconsistent and poorly documented in costing literature, suggesting opportunities to improve evidence. The goal of this research was to develop a model to guide budgeting for EHS in HCFs. Based on 47 studies selected through a systematic review, we identified discrete budgeting steps, developed codes to define each step, and ordered steps into a model. We identified good practices based on a review of additional selected guidelines for costing EHS and HCFs. Our model comprises ten steps in three phases: planning, data collection, and synthesis. Costing-stakeholders define the costing purpose, relevant EHS, and cost scope; assess the EHS delivery context; develop a costing plan; and identify data sources (planning). Stakeholders then execute their costing plan and evaluate the data quality (data collection). Finally, stakeholders calculate costs and disseminate findings (synthesis). We present three hypothetical costing examples and discuss good practices, including using costing frameworks, selecting appropriate indicators to measure the quantity and quality of EHS, and iterating planning and data collection to select appropriate costing approaches and identify data gaps.

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Effects of an incinerator project on a healthcare-waste management system

Cited by 10 publications

References 11 publications

Development and Application of Tools to Cost Delivery of Environmental Health Services in Healthcare Facilities: A Financial Analysis in Urban Malawi

Development and Application of Tools to Cost Delivery of Environmental Health Services in Healthcare Facilities: A Financial Analysis in Urban Malawi

Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals

Budgeting for Environmental Health Services in Healthcare Facilities: A Ten-Step Model for Planning and Costing

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