A Whole Systems Approach to Hospital Waste Management in Rural Uganda

• Published in: Frontiers in public health 2019-06, Vol.7, p.136-136
• Main Authors: Kwikiriza, Stuart, Stewart, Alex G, Mutahunga, Birungi, Dobson, Andrew E, Wilkinson, Ewan
• Format: Article
• Language: English
• Subjects: compostable waste; hazardous waste; mixed methods; operational research; personal protective equipment; Public Health; SORT IT
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2019.00136

Safe waste management protects hospital staff, the public, and the local environment. The handling of hospital waste in Bwindi Community Hospital did not appear to conform to the hospital waste management plan, exhibiting poor waste segregation, transportation, storage, and disposal which could lead to environmental and occupational risks. We undertook a mixed-methods study. We used semi-structured interviews to assess the awareness of clinical and non-clinical staff of waste types, risks, good practice, and concerns about hospital waste management. We quantified waste production by five departments for 1 month. We assessed the standard of practice in segregation, onsite transportation, use of personal protective equipment, onsite storage of solid waste, and disposal of compostable waste and chemicals. Clinical staff had good awareness of waste (types, risk) overall, but the knowledge of non-clinical staff was much poorer. There was a general lack of insight into correct personal or departmental practice, resulting in incorrect segregation of clinical and compostable waste at source (>93% of time), and incorrect onsite transportation (94% of time). In 1 month the five departments produced 5,398 kg of hazardous and non-hazardous waste (12; 88%, respectively). Good practice included the correct use of sharps and vial boxes and keeping the clinical area clear of litter (90% of the time); placentae buried immediately (>80% of the time); gloves were worn everyday by waste handlers, but correct heavy-duty gloves