Assessment of biomedical waste management in Accra Metropolitan Health-Care facilities

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2004-11-22
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Biomedical Waste (BMW) management is a global issue and its inadequacies are of growing concern in Ghana. BMW has increased both qualitatively and quantitatively over the years with its attendant public, occupational and environmental health consequences as well as increased disposal cost and nosocomial infections, and all persons are at risk. A descriptive study with current cross-sectional design was employed to assess the current situation in the health-care facilities and to make recommendation for the improvement of BMW management in the metropolis. Eighty (80) out of 256 hospitals, polyclinics, health centers and clinics (maternity homes and clinical laboratories excluded) were stratified into the six sub-metropolitan areas then into public and private facilities. The public hospitals and polyclinics were purposively selected whilst the private hospitals, health centers and clinics were systematically selected. Interview guide was used to interview representatives of the selected facilities. The data obtained were post coded and analyzed using EPI-INFO statistical package. The study results revealed that BMW in Accra Metro health-care facilities were inadequately and inappropriately managed. Pathological, Radioactive, Pharmaceutical, Chemical and Infectious wastes, and Sharps are the types of waste generated with the last two types generated most. Majority of the clinics (68.7%) generated less than 26kg/day waste and 13.8% facilities mostly hospitals, generated more than 100 kg/day of waste. About 9-10 tonnes of HCW are collected weekly as compared to 1200 tonnes of municipal waste daily. Low rank (100%), untrained (72.5%), not well organized (72.5%), insufficiently protected (75.0%) and less motivated personnel, mainly orderlies (10.0%) and cleaners (90.0%) handle BMW in the facilities. The study showed that there are no specific regulations or policy and effective means of control for BMW management in the metropolis but one facility had a guidelines document and another had waste management plan. BMW management in public health-care facility is comparatively better than private ones. The MHMT is recommended to use this result among others as a basis to develop safe and cost-effective BMW management guidelines for the metropolis. Each facility should prepare its own waste management plan, which should reflect in the budgetary reports for financial support. Education and in-service training for waste handling staff should be made mandatory and it should be conducted at sub-metro level for the benefits of the private facilities as well. The Director-General of GHS of the MOH should press for the formulation of BMW management policy to provide legal controls and empower the regulatory agency to apply pressure for their implementation and monitoring.
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A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of Master of Science, 2004
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