Healthcare Waste Management in Low Resource Countries - Nigerian Experience
AbstractBackground: Health care waste management (HCWM) is central to infection prevention and control (IPC) as poor management exposes health care workers, waste handlers, and communities to infections and injuries. A 2004 National injection safety (IS) and HCWM survey revealed that HCWM practices were grossly inadequate and included poor segregation as well as open, unsupervised dumping of waste. Aliyu et al (2006) documented that 26.5% of HCW in the Federal Capital Territory (FCT) was hazardous. Intervention: In-country capacity was built through advocacy, training, and supportive supervision by PEPFAR funded AIDSTAR-One (previously Making Medical Injections Safer) project, . Though political support differs across states, Lagos state leads in support towards strengthening their HCWM systems and conduct annual HCWM Summit to create awareness across the country to promote best practices. The 2004 survey showed 65% of health facilities (HF) demonstrated improper management of HCW, whereas a follow-up comparative study at AIDSTAR-One focal sites showed significant improvements including increase in facilities without presence of loose infectious waste, up from 50% to 70% after one year intervention. HFs with waste segregation in color coded bins at point of generation rose from 0% to 80% and loose sharps around facilities decreased from 74% to 66%. GIS mapping of HCW treatment equipment in Nigeria was conducted in 2012 to aid stakeholders in HCWM planning. Advocacy for national intervention resulted in approval of National HCWM Policy on the 4th of September 2013. Challenges: Approval process for the National HCWM Policy lengthy due to bureaucracy and unstable political climate. There is weak central direction in strengthening the HCWM systems at all levels, and segregation commodities are inadequate due to poor budgetary allocation. Conclusion: Healthcare waste management has shown a remarkable improvement and continued improvement is expected with the passage of the National HCWM Policy.
From Around the Globe
Copyright conditions: Copyright on any research article in the International Journal of Infection Control (IJIC) is retained by the author(s). Authors grant IJIC permission to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified. IJIC conforms to the Creative Commons Attribution License (http://creativecommons.org) as terms and conditions of publishing research articles. In summary, anyone is free: • to copy, distribute, and display the work; • to make derivative works; • to make commercial use of the work; as long as: • the original author must be given credit; • for any reuse or distribution, it must be made clear to others what the license terms of this work are; • any of these conditions can be waived if the authors gives permission. Statutory fair use and other rights are in no way affected by the above. Authors' certification: In submitting a manuscript to IJIC, authors are requested to certify that: • They are authorized by their co-authors to enter into these arrangements. • They warrant, on behalf of themselves and their co-authors, that: o the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights; o they are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to IJIC are not in breach of any other obligation. If the law requires that the article be published in the public domain, they will notify IJIC at the time of submission; o the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy; o they have taken due care to ensure the integrity of the article.