Title: Planning and monitoring healthcare waste management
Course: Hygiene and Environmental Health Part 2 - Ethiopia (Full)

Planning and monitoring healthcare waste management

Managing the safe and proper disposal of healthcare waste is an essential part of infection protection and control for you (the healthcare worker), your clients/patients and the general public. In addition to meeting national and local guidelines on infection prevention, it helps you prevent nosocomial infections (i.e. healthcare facility/hospital acquired diseases).

Planning and preparation for proper waste disposal will help you ensure the availability and correct functioning of infection control facilities in the Health Post, including sanitising materials and hazardous healthcare waste management and disposal equipment. Forward planning can also help reduce the likelihood of accidents; for example, the chance of needlestick injury will be reduced if you always think ahead and have the sharps box close to you when you give an injection.

Table 23.1 is a template for waste management planning in the Health Post. It lists various waste management activities and indicates how often they should be done, the materials and equipment needed and who is responsible. You may wish to adapt this for your own Health Post and draw up your own management plan. Having a plan similar to this will help to ensure that waste is managed correctly.

Table 23.1  Example template for a Health Post waste management plan

Key: R = routinely (at a specific time, if possible); BP = before procedure; AP = after procedure; O = occasionally

Activity | When? | Equipment/materials needed | Who? | Comments
Handwashing | R, BP and AP | Water, soap, disinfectant/alcohol | Health Extension Practitioner | Sullage should be disposed of into a seepage pit
Disposing of sharps | R (when the safety box gets ¾ filled), AP | Safety box, incinerator, sharps pit | Health Extension Practitioner | Avoid needle recapping
Disposing general waste and solid infectious waste | R | Waste bin, incinerator, gloves, matches, burial pit | Health Extension Practitioner and others | Incinerate in a brick incinerator, or metal drum or burn in an open pit
Inspecting waste disposal facilities | O | Heavy-duty gloves, protective clothes | Health Extension Practitioner |
Sterilisation of instruments/materials | AP | Autoclave, indicator | Health Extension Practitioner | An indicator is a strip or tape that changes colour when the material/equipment reaches sterilising temperature
Disposal of liquid/semi-liquid infectious waste | AP | Placenta pit | Health Extension Practitioner | Pit should be fenced and locked
Disposal of expired drugs | O | List of drugs expired, reporting, disposal pit | Committee from district office, kebele and Health Extension Practitioner | You need to notify the committee if you have drugs that need to be disposed of
Cleaning the Health Post | R | Water, detergents, disinfectants, gloves, protective clothing, broom, mops, dustbin, etc. | Health Extension Practitioner and others |

You can monitor the management of healthcare waste at your Health Post and identify possible improvements that you could make by checking your current practices. For example:

- Could you reduce the amount of waste produced in your Health Post (waste minimisation)?
- Do you separate infectious from non-infectious waste?
- Is infectious waste packaged before disposal to reduce contact and exposure?
- Do you have adequate supplies of gloves, colour-coded bins and other waste management supplies?
- Is everyone at the Health Post properly trained in correct healthcare waste management procedures?

There may be other questions you can think of to include on your checklist.

Concluding note

We have now reached the end of the Hygiene and Environmental Health Module. In these 23 study sessions, you have been learning about personal and environmental hygiene, how to keep food hygienic, about the provision, use and treatment of safe water, and how to manage wastes in the household, community and healthcare facility.

As you know, poor hygienic and environmental health conditions are the major cause of illness and death in Ethiopia and other developing countries. It is our sincere hope that this Module, along with other Modules in this curriculum, will enable you to understand the concepts and principles of hygiene and environmental health. By putting these concepts and principles into practice, your community disease profile will improve significantly to a level that common infectious diseases that arise due to poor hygiene and environmental health, such as diarrhoea, intestinal parasites, malaria, pneumonia and TB, will not be major causes of morbidity or mortality in your area. Moreover, as well as learning about the protection of human health, you have also learned how to keep our environment safe.