Waste management improvement strategies in the Uganda health sector: A case of Kiruddu Hospital, Kampala District Uganda

Abstract

The study examined improvement strategies to the health care waste management problems at Kiruddu Hospital. The objectives that guided the study included; to assess the existing situation in relation to Health Care Waste Management at Kiruddu Hospital; to suggest a framework for the management of Health Care Waste at Kiruddu Hospital; to conduct an independent survey of wastewater characteristics and propose a sustainable solution for the management of sewerage at Kiruddu Hospital; to formulate an operation and maintenance plan for the designed sewerage management system. A case study design was adopted for the study. A self-administered questionnaire and interview guide and Focus Group Discussions were used to collect data from the respondents. The findings on the existing situation in relation to health care waste management showed that waste containers were not uniforms in colour, shape, size and location, trash bags or containers were not labeled according to hospital ward/department and contents specified, signs were not available to instruct waste generators on proper disposal causing littering of wastes in the hospital, trash bins were not always lined with black bags for non-infectious dry waste, were not lined with green bags for non-infectious wet waste and were not always lined with yellow bag for infectious and pathological wastes. From the findings on the assessment of the framework for the management of health care waste at the hospital, there was disagreement that there was no presence of an organized HCWM committee, the hospital waste management plan was unavailable, annual waste management assessment was not being conducted and waste management policies were unclear. The health and safety practices at the hospital, workers were provided with appropriate Personal Protective Equipment (PPE) much as they were not given immunization regularly. The findings showed that the current structure of waste management at the hospital did not clearly provide for clear structures that are supposed to manage waste at the hospital, the hospital had not done a waste audit/ assessment over the last three years, had no internal system for auditing/ assessing the medical waste generated and did not perform any recycling of waste, there was no policy of reducing or phasing out PVC packaging and containers or reusing medical products and/or office supplies, employees were not given education program on hospital and medical waste which undermined their level of awareness and dedication to the projects implemented by the hospital. From the findings on the challenges facing health care waste management, the respondents revealed that some of the major challenges facing the health care waste management at the hospital included legislation gaps, poor financial base, inadequate competent personnel, poor segregation, handling & disposal practices and poor maintenance habits. It can be concluded that more still needed to be done to promote health care waste management to overcome the challenges faced by the hospital. Therefore, the study recommends that the management of the hospital should promote monitoring and evaluation of health care waste management, put in place effective training programmes and emphasis on effective communication.