Healthcare waste management in the Tamale Central Hospital, northern Ghana. An assessment before the emergence of the COVID-19 pandemic in Ghana

Abstract

Healthcare waste (HCW) poses several environmental and public health challenges. However, much attention has not been given to its management. The present study sought to assess the healthcare waste management (HCWM) practices in the Tamale Central Hospital (TCH) by characterizing and measuring the quantities of waste generated and the associated implications. Observation of the value chain of healthcare waste management, waste quantification using a weighing scale (Top-pan-spring balance), and semi-structured interviews were used in the data collection. The study revealed that, except for sharps, there was no segregation of infectious and non-infectious waste, and healthcare waste was not treated before final disposal. The study showed that a daily record of 5.1 kg of sharps, 24.46 kg of infectious waste and 59.45 kg of general waste was generated. The maternity ward produced more general waste (14 kg), whereas the theatre generated the highest infectious waste (5.70 kg) and sharps (0.8 kg) daily. Generally, the maternity ward recorded the highest daily waste generation of 17.9 kg. The waste treatment method available in the hospital was incineration. However, the incinerator was found to be dysfunctional. Thus, an improvised method (dug pit) was used irrespective of the associated health and environmental implications. The study also revealed that the hospital did not quantify the amount of solid waste that was generated. Inadequate finance and lack of supervision were linked to the problem of poor healthcare waste management in the study area. Also, 82% of the workers mentioned that there was poor HCW segregation at the departments whereas 76% of the patients who received healthcare at the facility were unsatisfied with the HCWM practices. A strong linear relationship in the responses made was recorded. The healthcare waste management index showed that the HCWM practice at the facility was unsatisfactory as it was medium-ranked. The study, therefore, recommends that the hospital considers constructing an on-site waste treatment facility, segregate and quantify waste for effective allocation of resources for treating healthcare waste.

Analysis of healthcare waste management in hospitals of Belo Horizonte, Brazil

“…Maternities were also identified as major waste generator in Ribeiro et al ( 2020 ) study (Table 3 ). This may be attributed to maternities’ wards, since they are identified as major sources of infectious waste, although it be noted that the majority of HCW, in this location, can be classified as general waste with the implementation of proper segregation strategies (Abanyie et al 2021 ; Sawyerr et al 2017 ; Nemathaga et al 2008 ; Alani et al 2019 ).…”

“…Among all hospitals, the H22 can be highlighted, as hazardous waste represents close to 64% of the waste generated. This can be related to frequent reports of inadequate segregation in health facilities, sometimes associated with lack of training and qualification of employees working in waste management, mainly in developing countries, such as Brazil (Abanyie et al 2021 ; ANVISA, 2018 ; Boreli et al 2018 ; Farzadkia et al 2018 ; Khan et al 2019 ; Macedo and Oliveira, 2020 ; Ream et al 2016 ).…”

“…A large part this waste that undergoes double treatment could only be incinerated, a technology that has some advantages over the others, such as the reduction in volume and the possibility of using energy from burning (Blahuskova et al 2019 ; Makarichi et al 2018 . On the other hand, if incineration is not carried out with adequate environmental controls to reduce air pollutants, this technology can emit pollutants that persist in the environment and can bring health problems due to degradation of air quality (Abanyie et al, 2021 ; Ansari et al, 2019 ).…”

How Should Regulations Help Health Care Organizations Manage Waste?

“…Such a lack of global oversight produces methods of dealing with health care waste that fall short of agreed-upon international standards, especially in developing countries. 11,12,13,14,15,16 Furthermore, because developing countries lack the resources to properly deal with health care waste, they are disproportionately impacted by the waste's negative consequences, further highlighting global health equity concerns. 8,17,18,19 This inequity is compounded by the fact that, because of the aforementioned structural inequalities built into the Basel Convention, low-income and developing countries frequently absorb and handle the waste of developed and highincome countries as well.…”

Health-care waste management practices: The case of Ho Teaching Hospital in Ghana

“…Although a significant number of researches has been conducted on management of hospital wastes globally, few of such studies have been carried out in Ghana [ 15 ]. Most of these studies investigated into the generation rate of medical wastes and the waste management practices in health-care facilities located in different regions in Ghana [ [15] , [16] , [17] ]. Presently, there is no documentation on medical waste management in the Volta Region of Ghana which is one of the sixteen [ 16 ] administrative regions of the country.…”