Abstract
Medical Waste Risk Management is a serious concern in many developing countries due to the risks posed to human health and the environment. Poor management of medical waste exposes health care workers, waste handlers and the community to different risks as : infections, toxic effects and injuries. Risk Management is the identification, assessment, and prioritization of risks. In Dutse General Hospital, many efforts have been made by the government authorities in order to better manage the waste from healthcare units and department in the hospital. However most healthcare units do not comply with the principles stated in Jigawa State Hospital Management Board. In Dutse General Hospital, a total about 114 Kg of risky healthcare waste (RHCW) are produced each day. By using Preliminary Hazard Analysis (PHA) which is an assessment tools, our focus in this research is to assess the medical waste risks management that may occur due to the existence of hazardous elements in healthcare waste, to identify treatment modalities tailored to each adverse event and to characterize and prioritize these adverse event in terms of occurrence and severity scenario.
TABLE
OF CONTENTS
Cover Page - - - - - - - - i
Table of content - - - - - - - - - ii - v
Title page
- - - - - - - - iii
Approval page - - - - - - - - iv
Dedication - - - - - - - - v
Acknowledgement
- - - - - - - - vi
Table of Content - - - - - - - - vii
Abstract - - - - - - - - iix
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study - - - - - - - 1
1.2 Statement of the Problem - - - - - - - - 3
1.3 Objectives of the Study - - - - - - - - 4
1.4 Research Questions - - - - - - - - 4
1.5 Significance of the Study - - - - - - - - 5
1.6 Scope of the Study - - - - - - - - 5
1.7 Operational Definition of Term - - - - - - - 6
CHAPTER TWO: REVIEW OF RELATED LITERATURE
2.0 Introduction - - - - - - - - - 7
2.1 Overview of medical waste management - - - - - - 7
2.2 Concept of Medical Waste Management - - - - - 8
2.3 Classification of medical waste
- - - - - - 11
2.4 Theoretical framework of medical waste
management - - - - 13
2.5 Prevalence of medical waste - - - - - - - 16
2.6 Health effect of medical waste - - - - - - - - 16
2.7 Preventive measures of medical waste - - - - - - - 17
2.8 Radioactive waste - - - - - - - - - 18
2.9 Risk associated to medical waste - - - - - - - 20
2.10 Micro – Organisms associated with health care
waste - - - - - 20
2.11 Policies in handling medical waste - - - - - - 22
2.12 Empirical review - - - - - - - - - 25
2.12 Gaps in literature - - - - - - - - 27
CHAPTER THREE: METHODOLOGY
3.0 Introduction -
- - - - - - 30
3.1 Research Design - - - - - - 30
3.2 Population of the Study - - - - -
- - 30
3.3 Sample and Sampling Technique - - - - - - 30
3.4 Instrument for Data Collection - - - - - - 30
3.4.1 Questionnaire - - - - - - - - 31
3.5 Reliability and validity of the Instrument
- - - - - 31
3.6 Method of Data Analysis - - - - -
- 31
CHAPTER FOUR: RESULTS AND DISCUSSION
4.0 Introduction
- - - - - - - 33
4.1 Result - - - - - - - 33
Figure 4.1.1
Socio – demographic description of the respondents - - 33
Figure 4.2 Age
of the respondent - - - - - -
33
Figure 4.3 Sex
of the respondent - - - - - - - 34
Figure 4.4
Level of education of the respondents - - - - - 34
Figure 4.5
Profession of the respondents - - - - - - 35
Figure 4.6
Unit of the respondents - - - - - - 35
4.2 Discussion of the findings - - - - - - - - 37
4.2.1 Health risk associated with handling of
medical waste - - - - 37
Figure 4.7 Are
there risk associated with the handling of medical waste? - - 37
Figure 4.8
Risk associated with medical waste handling and management - - 38
4.2.2 Regulations and procedures regarding medical
waste management and to what extent its applied in the General Hospital Ringim
- - - - - - - 39
Figure 4.9
International regulations pertaining to the handling to medical waste - 39
Figure 4.10
Regulations related to medical waste in the hospital - - - 40
Figure 4.11
Rating the application of such regulations in the hospital - - 41
4.2.3 Challenges/difficulties encountered by the
Ringim General Hospital in managing their medical waste - - - - - - - - - - 42
Table
4.1 Challenges faced by the hospital in managing their medical waste - - 42
4.2.4
The extent to which medical waste is being managed in Ringim General Hospital - 43
4.2.4.1
Do you segregate medical waste? - - - - - - - 43
Figure 4.12 Medical waste segregation - - - - - - - 43
Table 4.2 Types of medical waste being segregated in the Ringim General
Hospital - 43
Table 4.3 Types of containers that medical waste are being
collected in Ringim - 44
Figure 4.13 Medical waste pre – treatment in Ringim
General Hospital - - 47
4.3
Discussion of the findings - - - - - - - - 48
CHAPTER FIVE: SUMMARY, CONCLUSION AND
RECOMMENDATION
5.0 Introduction
- - - - - - - 49
5.1 Summary of findings - - - - - -
49
5.1.1 Summary of findings for specific objectives
one - - - 49
5.1.2 Summary of findings for specific objectives
two - - - 49
5.1.3 Summary of findings for specific objectives
three - -
- - 50
5.2 Conclusion - - - - - - - - - 50
5.3 Recommendations - - - - - - - - - 50
5.4 Suggested areas for further research - - - - - - - 52
CHAPTER ONE
INTRODUCTION
1.1
Background of the Study
Pregnancy is one of the most
critical and unique period in a woman’s life cycle. It is regarded as a
“welcome event” or successful womanhood. A woman’s body changes dramatically
during pregnancy, hence there is a strong need balance these changes with an
adequate and nutritious diet. Pregnancy is often accompanied by a variety of
nutritionally lined problems with symptoms that are sometimes very unpleasant
and difficult to tolerance. Cravings and aversions, which refer to a strong
desire and strong dislike for certain food respectively, are common during
pregnancy with complications such as nausea and vomiting. These complications
may cause not only discomfort during pregnancy but also interfere with the
dietary intake of the pregnant women and sometimes causing serious problems
(Berg, 2011). Also, unsatisfactory
maternal nutrition, has been reported to result from inadequate dietary in
takes during pregnancy which have been attributed to ignorance and
superstition. All human beings need a balanced amount of nutrient for proper
functioning of the body system. Nutrition is a fundamental pillar of human
life, health and development throughout the entire life span (Berg, 2011).
There are about 40 different nutrients that are essential for
health. If any one of these is deficient in the diet the person will not be
fully healthy and able to resist the agents of disease malnutrition is now a
problem in both poor and rich countries. In developed countries, obesity is
rapidly becoming more widespread, bringing with it an epidemic of diet related
non-communicable disease (NCDs) such as diabetes and heart disease, which
increase care costs and reduce productivity. In developing countries, while widespread
under nutrition and micro-nutrient deficiency persist, obesity is also fast
emerging as a problem (EFMoH, 2007).
In Nigeria, nutritional disorder are among the main causes of
morbidity and mortality. The major problems are protein energy malnutrition and
micronutrient deficiencies such as vitamin A, iron, and iodine twenty seven
percent of women in Nigeria are undernourished with a body mass index (BMI) of
less than the 18.5 cut off point and only four percent are obese with BMI of
more than 25.0. Nigeria is among sub-Sahara countries with the highest
proportion of malnourished women. Pregnancy is a time of increased energy and
nutrient needs for a woman in order to meet the needs of the growing fetus and
of maternal tissue associated with pregnancy. Proper dietary balance is
necessary to ensure sufficient energy intake for adequate growth of fetus
without drawing on mother’s own tissue to maintain her pregnancy (Idowu, 2007).
The poor health and nutrition of women and the lack of care that
contributes to their death in pregnancy and child birth also compromise the
health and survival of the infants and children they leave behind (USAID,
2011). Under nutrition’s most damaging effect on the fetus occurs during
pregnancy and in the first two years of life, and the effects of this early
damage on health, brain development, intelligence, educability, and
productivity are largely irreversible. The pregnant and lactating women’s diet
should include a substantial increase in calories, protein, calcium, folic
acid, iodine and iron. Pregnant women at particular risk for nutritional
deficiencies are adolescents, underweight women, obese women, women with
chronic nutritional problems, women who smoke or ingest alcohol or drugs, low
income women, and women with chronic illness such as diabetes or anemia
(Nelson, 2014).
1.2
Statement of the Problem
Adequate nutrition during pregnancy is essential for the health of
both the mother and the developing fetus. Poor nutritional literacy among
pregnant women can result in inadequate nutrient intake, which is linked to
various adverse maternal and fetal outcomes, including low birth weight,
preterm delivery, and increased risk of maternal complications (World Health
Organization, 2016). Despite the significance of nutritional knowledge, studies
have shown that many pregnant women, particularly in developing regions, lack
adequate nutritional literacy, which impedes their ability to make informed
dietary choices (Abubakar et al., 2020).
In Nigeria, malnutrition remains a major public health concern,
contributing to high maternal and infant mortality rates (National Population
Commission & ICF, 2019). Pregnant women in Dutse, Jigawa State, may face
additional challenges due to limited access to quality healthcare and
educational resources. This could further hinder their understanding of key
nutritional concepts such as the importance of micronutrients like folic acid
and iron during pregnancy (Aliyu et al., 2019).
The lack of targeted nutritional education during antenatal care
services exacerbates this problem, leaving many pregnant women unaware of the
specific nutritional requirements that could ensure healthier pregnancies
(Idris et al., 2018).
1.3
Objective of the Study
The general objective of this research is to assess the nutritional
literacy among pregnancy women attending antenatal care in maternity of Dutse
General Hospital Jigawa State. Specific objective includes:
1. To assess
knowledge of pregnant women with regard to nutritional literacy among Dutse
General Hospital Jigawa State.
2. To examine
attitude of pregnant women toward nutritional literacy in Dutse General
Hospital Jigawa State.
3. To identify
dietary practice among pregnant women in Dutse General Hospital Jigawa State.
1.4
Research Question
1.
What is the level of knowledge of pregnant women with regard to
nutritional literacy among Dutse general hospital Jigawa State?
2.
What is the attitude of pregnant women toward nutritional literacy
in Dutse General Hospital Jigawa State?
3.
What are the dietary practices among pregnant women in Dutse
General Hospital Jigawa State?
1.4.1
Hypothesis
H1:
There is significance difference on knowledge of pregnant women with regard to
nutritional literacy in Dutse based on location?
H0:
There is no significance difference on knowledge of pregnant women with regard
to nutritional literacy in Dutse based on location?
H1:
There is significance difference in the attitude of pregnant women toward
nutritional literacy in Dutse LGA based location.
H0:
There is no significance difference in the attitude of pregnant women toward
nutritional literacy in Dutse LGA based location.
H1:
There is significance difference on dietary practice of pregnant women with
regard to nutritional literacy in Dutse based on location?
Ho: There is no
significance difference in the dietary practice of pregnant women toward
nutritional literacy in Dutse LGA based location.
1.5
Significance of the Study
Malnutrition literacy in pregnancy
is associated with a host of adverse maternal and infant outcomes, including
gestational diabetes, pre-eclampsia, and preterm birth with over-nutrition;
small for gestational age (SGA), low birth weight (LBW), and neonatal death
with under-nutrition. Therefore the finding of this descriptive cross sectional
study will contribute in filling the gap in understanding the knowledge,
attitude and practice regarding maternal among pregnant women attending ANC
clinics in the study area.
The results of the study will inform design of the nutrition
education intervention strategies targeting pregnant women “due to their
importance in reproductive and productive role in the society. Besides the
health providers and Nigerian Ministry of Health, others who are interest in
the field of maternal health in general will benefit from this research.
1.6
Scope of the Study
The study was limited to all pregnancy women attending antenatal
clinic in Dutse General Hospital Jigawa State.
1.7
Operational Definitions of Terms
ü Antenatal Clinic: It
is where pregnant women are given different diagnosis/treatment during
pregnancy and cares are being given.
ü Pregnancy: This
is a period during which a women carrier a developing fetus normally in the
uterus.
ü Antenatal Care: Antenatal
care (ANC) is a medical and general care that is provided to pregnant woman
during pregnancy based on local situation.
ü Nutrition: Is
the selection of foods and preparation of foods, and their ingestion to be
assimilated by the body.
ü Malnutrition: Is
refers to the excessive intake of food, especially in unbalanced proportions or
lack of proper nutrition, caused by not having enough to eat, not eating enough
of the right things or being unable to use the food that one does eat.
ü Literacy: It
refers to an individual’s understanding of nutrition, including the
intellectual ability to remember and recall food and nutrition-related
terminology, specific pieces of information and facts.
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