TABLE OF CONTENTS
Content Page
Title Page i
Certification ii
Dedication iii
Acknowledgements iv
Abstract vi
Table of Contents vii
List of Tables xi
List of Figures xii
Abbreviations xiii
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study 1
1.2 Statement of the Problem 3
1.3. Objective of the Study 4
1.4 Research Questions 4
1.5 Hypothesis 4
1.6 Scope of the Study 4
1.7 Justification for the Study 4
1.8 Operational definition of terms 5
CHAPTER TWO: REVIEW OF LITERATURE
2.0 Introduction 7
2.1 Nature of healthcare waste 7
2.1.1 Sharps waste 11
2.1.2 Infectious waste 11
2.1.3 Pathological waste 11
2.1.4 Pharmaceutical waste 11
2.1.5 Chemical waste 12
2.1.6 Radioactive waste 12
2.2 Healthcare waste management 14
Content Page
2.3 Healthcare waste generation 15
2.3.1 Healthcare waste generation in developing countries 17
2.3.2 Healthcare waste generation in developed countries 18
2.4 Healthcare waste management practices 19
2.4.1 Segregation 19
2.4.2 Handling and collection 21
2.4.3 Storage 21
2.4.4 Transportation 22
2.4.5 Treatment and disposal 23
2.4.6 Training and education 25
2.5 Health waste management practices in developed countries 26
2.6 Healthcare waste management practices in developing countries 27
2.7 Potential impacts associated with healthcare waste 34
2.8 Acts and legislation on healthcare waste management 37
2.9 Theoretical Framework 40
2.10 Concept adopted for the study 42
2.10.1 Concept of cleanliness 42
CHAPTER THREE:
METHODOLOGY
3.0 Introduction 43
3.1 Research Design 43 3.2 Population 43
3.3 Sample size and sampling Technique 45
3.4 Research Instruments 47
3.5.1 Questionnaire 48
3.5.2 Field Observation 48
3.5.3 Validity and Reliability of Instrument 48
3.6 Method of Data Collection 48
3.6.1 Method of Data Analysis 49
3.7.1 Inclusion criteria 49
Content Page
3.7.2 Exclusion criteria 49
3.8 Ethical Consideration 49
3.8.1 Permission for the study 49
3.8.2 Post research benefits 49
CHAPTER FOUR: DATA
ANALYSIS, RESULTS AND
DISCUSSION OF FINDINGS
4.1 Results 50
4.2 Discussion 60
CHAPTER
FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
5.1 Summary 63
5.2 Conclusion 64
5.3 Recommendations 65
5.4
Limitation of the Study 65
5.5 Suggestion for further Studies 66
REFERENCES 67
APPENDICES 75
LIST OF TABLES
Table Page
2.1 Categories of healthcare waste 10
3.1 Numbers of healthcare facilities in the study area 44
3.2 Sample size of each healthcare facility in ASLG 47
4.1: Demographic Characteristics 51
4.2:
Types of Healthcare waste generated in each healthcare facility 52
4.3:Knowledge of respondents regarding Healthcare waste management and its Segregation 53
4.4:
Practice of healthcare waste management by health workers 54
4.5:
Practices of healthcare facility on final disposal of waste 55
4.6 Relationship between
the knowledge and practices of the respondents 58
4.7 Observation made by
Researcher on Healthcare Waste Management in
Abeokuta
SouthLocal Government. 59
LIST OF FIGURES
Figure Page
2.1Healthcare waste compositions 8
2.2 Categories of waste from healthcare facilities 13
2.3 Differentiation of Waste Management 16
2.4 Healthcare wastes with municipal waste in open dump 30
2.5
Burning of Healthcare waste with municipal waste in dumping site at Abeokuta 34
2.7 Conceptual Model 42
4.1 Level of practice of Healthcare Waste
Management 56
4.2 Knowledge of respondents on Healthcare
Waste Management 57
4.3Dustbin and Improvised sharp boxes for Segregation on site (Survey Data 2017) 78
4.4Open vehicle for transportation of healthcare
waste (HCW)(Survey Data 2017) 79
4.5Scavengers with waste at dump site (Survey Data
2017) 80
4.6Healthcare waste (HCW) at dump site with
municipal waste(Survey Data 2017) 81
ABBREVIATIONS
AIDS Acquired immune-deficiency syndrome
ASLG Abeokuta south local government
FDA Food and Drug Administration
HBV Hepatitis B Virus
HCW
Healthcare waste
HCWM Healthcare waste management
HCV Hepatitis C virus
HIV
Human immune deficiency virus
ICO Infection control officer
LG Local government
U.S.A United State America
WHO World Health Organization
CHAPTER ONE
INTRODUCTION
1.0 Background to the Study
Healthcare waste threatens the public health due to its contagious nature. Most healthcare facilities are located in the heart of the cities and therefore, healthcare waste that are not correctly managed can cause dangerous infection and pose potential threat to the nearby environment, health workers, patients and to the public (WHO, 2014). Dehghani, Azam, Changani and Fard (2008) noted that Healthcare Waste (HCW) if not appropriately managed can be a serious threat to human health due to their infectious attributes. Nigeria, one of developing countries, has health issues that are competing for limited resources; it is not amazing that healthcare waste management receives less attention and precedence than it merits (Stephen, & Elijah, 2011). Therefore, there is a serious challenge in developing countries, where there are no Institutional provisionsfor healthcare waste management. Clinical wastes are disposed openly in the dumpsite along with municipal waste and the practice make the members of the community gain access to it which may lead to outbreak of infectious diseases (Alagoz, Kocasay, Abah, & Ohimain, 2010) . Cheng, Sung, Yang, Lo, Chung and Li (2009) noted that as small as healthcare waste is in proportion to the total community waste, its management is considered an important issue worldwide. World Health Organization (2014) reported that 15% of total waste generated in the healthcare facility is hazardous and must be properly segregated at the point of generation to prevent the whole healthcare waste becoming 100% hazardous. The World Health Organization estimates that each year there are about 8 to 16 million new cases of Hepatitis B virus (HBV), 2.3 to 4.7 million cases of Hepatitis C virus (HCV) and 80,000 to 160,000 cases of human immune deficiency virus (HIV) due to unsafe injections disposal and mostly due to very poor waste management systems.
Across the globe, the
risk associated with Healthcare Waste (HCW) and its management has gained
tremendous attention from health practitioners and non practitioners. If
healthcare facilities know the types and quantities of clinical waste
generated, it will help them in planning, budgeting adequate revenue for the
management of hazardous waste (Bongayi, 2013). A study conducted by Olubukola
(2009) in two General hospitals at Lagos reported that due to lack of
quantification of healthcare waste, there was no waste reduction plan in the
hospitals.
This lack of plan for
healthcare waste management eventually leads to inadequate waste segregation at
point of use, collection, storage and final disposal. This poor healthcare
waste management practice creates health hazards for health workers, patients
and the environment. Identified gaps like lack of colour code bags for
segregation of healthcare waste at point of use, lack of guidelines on
segregation and disposal for health workers lead to poor healthcare waste
management in hospitals. The mismanagement of healthcare waste by healthcare
facilities does not pose health hazard to health workers and patients alone but
also to patients’ visitors and the community where they are improperly disposed
by contaminating the soil, air and water. Healthcare facilities are supposed to
protect the health of people in their environment, not to be a creator of
potential health hazard for them.
Furthermore, increase
in patient turned-out has increase the generation of healthcare waste. Mboguwe,
Mimereki and Magashula(2008) also reported that increase in population results
to increase in healthcare facilities that lead to increased healthcare waste
generation. It is expected that because of this increase, more attention should
be paid to and priority given to proper healthcare waste management in Abeokuta
South Local Government (ASLG). Management of healthcare waste continues to
present an array of challenges especially as economic situation of the country
deepen daily therefore, healthcare waste management has become a concern.
So
many studies have been conducted on healthcare waste management but little or
no work has been done concerning segregation of clinical waste which is a vital
aspect in healthcare waste management (Coker, Sangodoyin, Sridhar, Booth, Olomolaiye,
2009). Segregation of waste is crucial in healthcare waste management because
it is the first step in clinical waste management. Segregation of healthcare waste
helps in reduction of the quantity of waste that is hazardous. Once healthcare waste are segregated, collection
will be easy, proper storage will be done and disposal of infectious waste
carried out in the way that it will not
pose any harm to health workers, patients and the environment (WHO, 2014).
Proper management of healthcare waste depends on good organization, sufficient
funding and active participation of trained personnel. It was observed that
healthcare facilities were not spending resources on clinical waste management
Healthcare facility must allocate resources for colour coded bags and training
of generator of healthcare waste for proper segregation and disposal for its
sustainability. The intention of this study is to assess healthcare waste
management practices at health facilities in Abeokuta South Local Government.
1.2 Statement of the Problem
ASSESSMENT OF HEALTHCARE WASTE MANAGEMENT PRACTICES AMONG HEALTH WORKERS IN ABEOKUTA SOUTH LOCAL GOVERNMENT AREA, OGUN STATE, NIGERIA
