The sustainable management of
Healthcare Waste (HCW) has continued to generate increasing
public interest due to the health problems associated with
exposure of human beings to potentially hazardous wastes arising
from healthcare (Tudor et al., 2005; Ferreira, 2003; Da Silver
et al., 2005). Presently considerable gap exist with regard to
the assessment of healthcare waste management practices
particularly in Nigeria and in several other countries in sub
– Saharan Africa. The nature and quantity of healthcare waste
generated as well as institutional practices with regards to
sustainable methods of healthcare waste management, including
waste segregation and waste recycling are often poorly examined
and documented in several countries of the world despite the
health risks posed by the improper handling of HCW (Farzadika
et al., 2009; Oke, 2005). It is also of serious concern that
the level of awareness, particularly of health workers regarding
healthcare waste has not been adequately documented. HCW are a
special category of waste because they often contain materials
that may be harmful and can cause ill health to those exposed
to it. The World Health Organization estimates that each year
there are about 8 to 16 million new cases of Hepatitis B
virus (HBV), 2.3 to 4.7 million cases of Hepatitis C virus
(HCV) and 80,000 to 160,000 cases of human immune deficiency
virus (HIV) due to unsafe injections and mostly due to very
poor waste management systems (WHO, 1999; Townend and Cheeseman,
2005). In developing countries like Nigeria, where many health
concerns are competing for limited resources, it is not
surprising that the management of healthcare wastes has received
less attention and the priority it deserves. Unfortunately,
practical information on this important aspect of healthcare
management is inadequate and research on the public health
implications of inadequate management of healthcare wastes are
few and limited in scope. Although reliable records of the
quantity and nature of healthcare wastes and the management
techniques to adequately dispose of these wastes has remained a
challenge in many developing countries of the world, it is
believed that several hundreds of tones of healthcare waste are
deposited openly in waste dumps and surrounding environments,
often alongside with nonhazardous solid waste (Alagoz and
Kocasay, 2007; Abah and Ohimain, 2010). A near total absence
of institutional arrangements for HCW in Nigeria has been
reported by others (Coker et al., 1998). Various methodologies
have been used all over the world to assess and quantify
HCW. They include the use of physical observation,
questionnaire administration and quantification (Adegbita et al.,
2010; Olubukola, 2009; Phengxay et al., 2005), as well as
checklists (Townend and Cheeseman, 2005) and private and public
records (Coker et al., 2009). Recent studies in Nigeria has
estimated waste generation of between 0.562 to 0.670 kg/bed/day
(Longe and Williams, 2006) and as high as 1.68 kg/bed/day
(Olubunmi, 2009). As reported in the literature, there may
not be much of a difference in the way and manner wastes
generated in various health care institutions are managed in
Nigeria. A good example is given by the findings of the study
in Lagos by Olubukola which reported the similarity in waste
data and HCW management practices in two General hospitals,
characterized by a lack of waste minimization or waste
reduction strategies, poor waste segregation practices, lack of
instructive posters on waste segregation and disposal of HCW
with general waste (Olubukola, 2009).
1.2 Problem Statement
The mismanagement of healthcare
waste poses health risks to people and the environment by
contaminating the air, soil and water resources. Hospitals and
healthcare units are supposed to safeguard the health of the
community. However, healthcare wastes if not properly managed
can pose an even greater threat than the original diseases
themselves (PATH, 2009). There are a reasonable range of
treatment technologies available for healthcare wastes that may be
appropriate for third world countries, however, it is pertinent
that before any of these options are adopted, hospitals and
medical facilities will need to assess the problem and put
forward a management strategy that is suitable to their economic
circumstances and that can be sustained based on local
1.3 Objectives of the Study
The major objective of the study is
assessing waste management practice in Uyo Teaching Hospital. This is to
be achieved through the following specific objectives:
1. Assess the current waste
management practices in terms of type of wastes and quantities
of waste generated in the various units of a tertiary level
healthcare facility and the waste handling and disposal
2. Assess the level of awareness of health workers regarding HCW management.
3. Assess the level of compliance
with recommended best practices for the sustainable management of
healthcare wastes based on the United Nations Environmental
Programme/World Health Organization (UNEP/WHO, 2005) and the
Townend and Cheeseman 2005 guidelines.
1.4 Research Questions
(1) what is waste management?
(2) what are the existing waste management practice in Nigeria?
(3) how are waste managed in the health sector in Nigeria?
1.5 Significance of the Study
This study helps to identify the
gaps in current practices of healthcare waste in Nigeria
compared with international best practice and recommend ways of
bridging this gap considering the current economic and
technological realities in the country. Using a tertiary health
institution (Teaching Hospital) in Southern Nigerian state capital
of Uyo as a case study,
The research focus on Hospital Waste Management practices in Uyo Teaching Hospital.
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