A Study of Solid Medical Waste at the Community Level: Generation and Collection in Households, among Traditional Birth Attendants and Chemical Shop Vendors, and Impacts on Health
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Date
2016-03
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University of Ghana
Abstract
Background: Solid waste generated from activities involving health protection, medical diagnosis and treatment, known as solid medical waste (SMW), is increasing in households due to home based care, treatment of chronic diseases, shortened lengths of hospital stay, and home management of illnesses such as malaria. The hazardous properties of SMW require specific management to minimize potential harm to human health and the environment, which is often undertaken in healthcare facilities. However, little is known about the characteristics and management of SMW from non-traditional settings in the community.
Objective: To investigate the management of solid medical waste in a district in the Greater Accra Region of Ghana, focusing on households, traditional birth attendants (TBAs) and chemical shop vendors (CSVs).
Methods: A descriptive, exploratory, mixed methods study, comprising a 3-staged study design was conducted in Ga South Municipal Assembly. The first stage explored collection, disposal, and harm from SMW in 600 households using questionnaires followed by interviews with private waste contractors and focus group discussions (FGDs) with adult members of households. In the second stage, household solid waste (HSW) was collected in dry and wet seasons from 60 households and manually segregated to obtain the SMW components. These were weighed and percentage composition calculated. The third stage explored stakeholder perspectives regarding segregation of SMW at source as a management option, using FGDs. Seasonal differences and relationships with SMW generation were evaluated, while qualitative data were analyzed using a thematic approach. Results: Household production and per capita generation of SMW were 7.26 x 10-3kg/household/day and 1.77 x 10-3kg/person/day respectively. Medicinal waste and sharp waste comprised 98% and 2% of SMW respectively. Daily per capita generation of SMW was significantly higher in the wet season than in the dry season (z = 3.129, p = 0.002). Harm due to SMW was reported by 4.8% of households and mostly involved sharps. Barriers to segregation of SMW at source included lack of community education, storage facilities and logistics, time consumption and cost.
Conclusion: Although the quantity of SMW in HSW is low, its composition, largely of medicinal waste, and a smaller proportion of sharps conferred on it some hazardous properties. Community education and logistic support for segregation at source might improve SMW management in the community.
Description
Thesis(PHD)-University of Ghana, 2016
Keywords
Solid Medical Waste, Community Level