Assessment of Medical Waste Management Practices and Health Impacts in Selected Government and Private Hospitals in Kampala and Wakiso Districts, Uganda

Abstract

Medical waste include hazardous and infectious substances with a potential to cause human ill health and environment contamination. However,facilities in developing countries extensively lack proper waste segregation, collection, safe storage, transportation, and disposal mechanisms for effective management. This situation is further made worse by limited knowledge and ineffective occupational safety measures to protect health care staff against its impacts of medical waste. Therefore, the study aimed at assessing medical waste management practices and its health impacts in four selected government and private hospitals in Kampala and Wakiso districts. The objectives were to;(i) assess medical waste management practices;(ii)identify challenges faced in handling medical waste;(iii) evaluate the level of awareness of health care workers and waste handlers regarding medical waste impacts on human health and the environment;(iv) identify potential health risks, and the respective occupational safety measures taken to protect health care workers and waste handlers. Findings revealed poor waste management in government hospitals as compared to private hospitals.The study established that,healthcare workers in private hospitals stand more chances of getting vaccinated against Hepatitis B compared to their counterparts in government hospitals. Whether or not a healthcare worker was vaccinated, was found to be dependent on gender, type of hospital and designation,as reflected in results from the multivariate logistic regression analysis. The study also indicated that auxiliary staff (cleaners and waste handlers) are more likely to sustain injuries,especially in government hospital GH2 than doctors, laboratory staff and nurses,and are less likely to have received the vaccination. This suggests that designation has a significant influence on the likelihood of being vaccinated of Hepatitis B infection.Findings established that private hospitals have more staff trained in medical waste management compared to government hospitals.The above findings indicates that government hospitals are struggling to achieve effective waste management regarding segregation,suggesting to lack of sufficient funding, delay in supply of logistics, and trainings. These findings suggest that healthcare staff, patients, the general public and the environment are likely to face serious risks due to poor medical waste handling.Therefore, the study recommends more training in waste management, vaccination of staff irrespective of type of hospital, gender and designation, more funding,law enforcement and strict regulations regarding use of recommended personal protective gears especially in government hospital