Infectious Waste Management in General Hospitals in Lusaka, Zambia: Perspectives of Healthcare Workers
DOI:
https://doi.org/10.47941/je.2373Keywords:
Infectious Waste, Knowledge, Attitude, Policy ComplianceAbstract
Purpose: Poorly managed infectious waste was the cause of majority of accidents and exposures to infectious waste in general hospitals in Zambia. The overall aim of this study was to appraise infectious waste management in the five general hospitals in Lusaka, Zambia.
Methodology: An explorative qualitative study was conducted to assess infectious waste management in Lusaka, Zambia, nesting the perspectives of 21 healthcare workers drawn from five general hospitals in Lusaka district.
Findings: The results showed that, the state of infectious waste management in a cross-section of general hospitals in Zambia had fallen short of the World Health recommended standards. A myriad of contributing factors to poor waste management amplified included, lack of regular staff training, insufficient infectious waste management equipment and inadequate protective clothing for waste handling, stock out of colour- coded bin liners and bins was a common occurrence. Other key findings were, limited space for storing waste before disposal or transportation and the lack of awareness about segregation and waste management rules as well as the limited financial resources to procure standard infectious waste protection and disposal equipment.
Unique Contribution to Theory, Policy and Practice: The study recommended to conduct longitudinal studies across hospitals to establish the impact of waste management practices and its corresponding health risks, the government to effectively fund hospitals to enable them train health workers, procure adequate infectious waste management equipment among others in case of delayed supplies from or central supply chain and to sub contract the private sector or social entrepreneurs to manage waste on behalf of hospitals to address the current challenges facing the general hospitals while seeking for sustainable long term solutions. Furthermore, ZEMA should increase its operational capacity to enhance effective monitoring of Health Care Institutions over Health Care Waste compliance and surveillances.
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References
Akpan, V.E. and Olukanni, D.O., (2020). Hazardous waste Management: an African overview. Recycling, 5(3), p.15. https://doi.org/10.3390/recycling5030015
Al-Momani, H., Obaidat, M., Khazaleh, A., Muneizel, O., Afyouni, N.M. and Fayyad, S.M., (2019). Review of medical waste management in Jordanian health care organisations. British Journal of Healthcare Management, 25(8), pp.1-8. https://doi.org/10.12968/bjhc.2019.0041
Askarian M, Heidarpoor P, Assadian OWaste Manag. (2010). A total quality management approach to healthcare waste management in Namazi Hospital, Iran. https://doi.org/10.1016/j.wasman.2010.06.020
Braun, V. & Clarke, V. 2012. Thematic analysis.
Chen, X., Lin, J., Li, X. and Ma, Z., (2021). A novel framework for selecting sustainable healthcare waste treatment technologies under Z-number environment. Journal of the Operational Research Society, 72(9), pp.2032-2045. https://doi.org/10.1080/01605682.2020.1759382
Das, A.K., Islam, N., Billah, M. and Sarker, A., (2021). COVID-19 pandemic and healthcare solid waste management strategy–A mini-review. Science of the Total Environment, p.146220. https://doi.org/10.1016/j.scitotenv.2021.146220
Delmonico, D.V.D.G., Santos, H.H.D., Pinheiro, M.A., de Castro, R. and de Souza, R.M., (2018). Waste management barriers in developing country hospitals: Case study and AHP analysis. Waste Management & Research, 36(1), pp.48-58. https://doi.org/10.1177/0734242X17739972
Dewi, A. P. (2020). Experiences in Dealing with Medical Waste: A Meta-synthesis. Journal of Ecophysiology and Occupational Health, 100-107. https://doi.org/10.18311/jeoh/2020/25379
FC, Olaniyi, Ogola JS, and Tshitangano., (2018). A review of medical waste management in South Africa. Open Environmental Sciences, 10(1). http://dx.doi.org/10.2174/1876325101810010034
Fereja, W.M. and Chemeda, D.D., (2021). Status, characterization, and quantification of municipal solid waste as a measure towards effective solid waste management: The case of Dilla Town, Southern Ethiopia. Journal of the Air & Waste Management Association, (just- accepted). https://doi.org/10.1080/10962247.2021.1923585
Ferronato, N., Ragazzi, M., Torrez Elias, M.S., Gorritty Portillo, M.A., Guisbert Lizarazu, E.G. and Torretta, V., (2020). Application of healthcare waste indicators for assessing infectious waste management in Bolivia. Waste Management & Research, 38(1), pp.4-18. https://doi.org/10.1177/0734242X19883690
Gizalew Snr, E., Girma Snr, M., Haftu Snr, D., Churko, C., & Girma Snr, Z. (2021). Health-care waste management and risk factors among health professionals in public health facilities of south Omo Zone, South West Ethiopia, 2018. Journal of healthcare leadership, 119- 128. https://doi.org/10.2147/JHL.S300729
Govender, R.D., Olaifa, A. and Ross, A.J., (2018). Knowledge, attitudes and practices of healthcare workers about healthcare waste management at a district hospital in KwaZulu- Natal. South African Family Practice, 60(5), pp.137- 145.https://doi.org/10.1080/20786190.2018.1432137
Hangulu, Lydia, and Olagoke Akintola. "Health care waste management in community-based care: Experiences of community health workers in low resource communities in South Africa." BMC public health 17, no. 1 (2017): 1-10. https://doi.org/10.1186/s12889-017- 4378-5
Hariz, H.A., Dönmez, C.Ç. and Sennaroglu, B., (2017). Siting of a central healthcare waste incinerator using GIS-based Multi-Criteria Decision Analysis. Journal of Cleaner Production, 166, pp.1031-1042. https://doi.org/10.1016/j.jclepro.2017.08.091
Hassan, A.A., Tudor, T. and Vaccari, M., (2018). Healthcare waste management: A case study from Sudan. Environments, 5(8), p.89. https://doi.org/10.3390/environments5080089
https://openjicareport.jica.go.jp/pdf/12379566.pdf accessed on 21/10/2024 at 07:30
Joshi, H.D., Acharya, T., Dhakal, P., Ayer, R., Karki, K.B. and Dhimal, M., (2017). Health care waste management practice in health care institutions of Nepal. Journal of Nepal Health Research Council, 15(1), pp.7-11. https://nepjol.info/index.php/JNHRC/article/view/18006
Kampamba, M., Cheela, T., Hikaambo, C.N.A., Mudenda, S., Saini, K. and Chabalenge, B., (2021. Knowledge, attitude, and practices on disposal methods of expired and unused medicines among students in public academic institutions in Lusaka, Zambia. International Journal of Basic & Clinical Pharmacology, 10(7), p.774. https://dx.doi.org/10.18203/2319- 2003.ijbcp20212371
Kenny, C. and Priyadarshini, A., (2021), March. Review of Current Healthcare Waste Management Methods and Their Effect on Global Health. In Healthcare (Vol. 9, No. 3, p. 284). Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/healthcare9030284
Khobragade, D.S., (2019). Health care waste: Avoiding hazards to living and non living
Kumar, R., Shaikh, B.T., Somrongthong, R. and Chapman, R.S., (2015). Practices and challenges of infectious waste management: A qualitative descriptive study from tertiary care hospitals in Pakistan. Pakistan journal of medical sciences, 31(4), p.795.10. http://dx.doi.org/10.12669/pjms.314.7988
Kusilika, C., (2021). Improving Health Care Waste Management in Africa: Action Research on how can Staff of Makerere University Hospital be involved in overcoming their Occupational Hazards?. Student's Journal of Health Research Africa, 2(6), pp.16-16. https://doi.org/10.51168/sjhrafrica.v2i6.41
Lemma, H., Dadi, D., Deti, M. and Fekadu, S., (2021). Biomedical Solid Waste Management System in Jimma Medical Center, Jimma Town, South Western Ethiopia. Risk Management and Healthcare Policy, 14, pp.4037-4049. https://doi.org/10.2147/RMHP.S315446
M'hango., 2021. A study to assess knowledge and practices of infection prevention and control among residents of mtendere township-lusaka district, zambia (doctoral dissertation, cavendish university). https://doi.org/10.1017/ash.2023.428
Makhura, R.R., Matlala, S.F. and Kekana, M.P., (2016). Medical waste disposal at a hospital in Mpumalanga Province, South Africa: Implications for training of healthcare professionals. South African Medical Journal, 106(11), pp.1096-1102. https://hdl.handle.net/10520/EJC198388
Mcintosh, M. J. & Morse, J. M. (2015). Situating and constructing diversity in semi-structured interviews. Global qualitative nursing research, 2, 2333393615597674. https://doi.org/10.1177/2333393615597674
Naderifar, M., Goli, H. and Ghaljaie, F., (2017). Snowball sampling: A purposeful method of sampling in qualitative research. Strides in Development of Medical Education, 14(3), pp.1-6. http://doi.org/10.5812/sdme.67670
Naz, S., Naqvi, S.M.Z.H., Jafry, S.I.A. and Asim, S., (2020). Knowledge, attitude and practice regarding management of health care waste among private dental practitioners. JPMA. The Journal of the Pakistan Medical Association, 70(7), pp.1259-1262. https://doi.org/10.5455/JPMA.22368
Nor Faiza, M.T., Hassan, N.A., Mohammad Farhan, R., Edre, M.A. and Rus, R.M., (2019). Solid waste: Its implication for health and risk of vector borne diseases. Journal of Wastes and Biomass Management (JWBM), 1(2), pp.14-17. http://doi.org/10.26480/jwbm.02.2019.14.17
Nor Faiza, M.T., Noor Artika, H. and Yusof, M.Z., (2019). Health Care Waste Management and Sustainable Development Goals in Malaysia. Journal of Wastes and Biomass Management, 1(1), pp.18-20. http://doi.org/10.26480/jwbm.01.2019.18.20
Odonkor, S.T. and Mahami, T., (2020). Healthcare waste management in Ghanaian hospitals: associated public health and environmental challenges. Waste Management & Research, 38(8), pp.831-839. https://doi.org/10.1177/0734242X20914748
Olaniyi, F.C., (2020). Development of Intervention Strategies for Management of Medical Waste in Vhembe District, South Africa (Doctoral dissertation). https://univendspace.univen.ac.za/server
Olaniyi, F.C., Ogola, J.S. and Tshitangano, T.G., (2021). Challenges of effective management of medical waste in low-resource settings: perception of healthcare workers in Vhembe district healthcare facilities, South Africa. Transactions of the Royal Society of South Africa, 76(1), pp.81-88. https://doi.org/10.1080/003591X.2021.1900949
Oroei, M., Momeni, M., Palenik, C.J., Danaei, M. and Askarian, M., (2014). A qualitative study of the causes of improper segregation of infectious waste at Nemazee Hospital, Shiraz, Iran. Journal of infection and public health, 7(3), pp.192-198. https://doi.org/10.1016/j.jiph.2014.01.005
Peng J, Wu X, Wang R, Li C, Zhang Q, Wei D. (2020). Medical waste management practice during the 2019–2020 novel coronavirus J Environ Health Sci Engineer pandemic: experience in a general hospital. Am J Infect Control, 48:918-921. 12. https://doi.org/10.1016/j.ajic.2020.05.035
Rai, N. and Thapa, B., (2015). A study on purposive sampling method in research. Kathmandu: Kathmandu School of Law, pp.1-12. https://d1wqtxts1xzle7.cloudfront.net/48403395/
Silva, A.I.L. and Gunawardena, U.A.D.P., (2019), November. Health Care Waste Management in Government Hospitals in Western Province: A Preliminary Analysis. In Proceedings of International Forestry and Environment Symposium. https://DOI.ORG/10.31357/fesympo.v24io.4325
Silva, Thais, Renata Maciel, Lourdinha Florencio, and Simone Machado Santos. "Strategies for the improvement of home medical waste management during the COVID-19 pandemic." Journal of the Air & Waste Management Association just-accepted (2021). https://doi.org/10.1080/10962247.2021.1982794
Sim, J., Saunders, B., Waterfield, J. and Kingstone, T., (2018). Can sample size in qualitative research be determined a priori? International Journal of Social Research Methodology, 21(5), pp.619-634. https://doi.org/10.1080/13645579.2018.1454643
Thakur, V., (2021). Framework for PESTEL dimensions of sustainable healthcare waste management: Learnings from COVID-19 outbreak. Journal of cleaner production, 287, p.125562. https://doi.org/10.1016/j.jclepro.2020.125562
Thakur, V., Mangla, S.K. and Tiwari, B., (2021). Managing healthcare waste for sustainable environmental development: A hybrid decision approach. Business Strategy and the Environment, 30(1), pp.357-373. https://doi.org/10.1002/bse.2625
Tope, A.O., Olufemi, A.O., Kehinde, A.B. and Omolola, F.F., (2018). Healthcare waste management practices and risk perception of healthcare workers in private healthcare facilities in an urban community in Nigeria. African Journal of Environmental Science and Technology, 12(9), pp.305-311. https://doi.org/10.5897/AJEST2018.2534
Tsakona, M., Anagnostopoulou, E. and Gidarakos, E., (2007). Hospital waste management and toxicity evaluation: a case study. Waste management, 27(7), pp.912-920. https://doi.org/10.1016/j.wasman.2006.04.019
Vaismoradi, M., Jones, J., Turunen, H. & Snelgrove, S. (2016). Theme development in qualitative content analysis and thematic analysis. http://dx.doi.org/10.543/jnep.v6n5p100
Wang J, Shen J, Ye D, Yan X, Zhang Y, Yang W, Li X, Wang J, Zhang L, Pan L. (2020). Disinfection technology of hospital wastes and wastewater: suggestions for disinfection strategy during coronavirus disease 2019 (COVID-19) pandemic in China. Environ Pollut.:114665. https://doi.org/10.1016/j.envpol.2020.114665
Wichapa, N. and Khokhajaikiat, P., (2018). Solving a multi-objective location routing problem for infectious waste disposal using hybrid goal programming and hybrid genetic algorithm. International Journal of Industrial Engineering Computations, 9(1), pp.75- 98.10.5267/j.ijiec.2017.4.003 http://dx.doi.org/10.5267/j.ijiec.2017.4.003
World Health Organization, (2015). National Health- Care Waste Management plan 2015-2019. http://dspace.unza.zm/handle/123456789/5434
World Health Organization, (2015). Status of health-care waste management in selected countries of the Western Pacific Region. https://iris.who.int/handle/10665/208230
World Health Organization, (2015). Water, sanitation and hygiene in health care facilities: status in low and middle income countries and way forward. https://iris.who.int/bitstream/handle/10665/154588/9789241508476_eng.pdf
World Health Organization, (2017). Safe management of waste from health care activities: A summary. https://www.who.int/publications/i/item/WHO-FWC-WSH-17.05
World Health Organization, (2019). National Health-Care Waste Management plan 2019-2024. https://www.moh.gov.zm
Yazie, T.D., Tebeje, M.G. and Chufa, K.A., (2019). Healthcare waste management current status and potential challenges in Ethiopia: a systematic review. BMC research notes, 12(1), pp.1-7. https://doi.org/10.1186/s13104-019-4316-y
Zand, A.D. and Heir, A.V., (2021). Emanating challenges in urban and healthcare waste management in Isfahan, Iran after the outbreak of COVID-19. Environmental Technology, 42(2), pp.329-336. https://doi.org/10.1080/09593330.2020.1866082
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