ABSTRACT
Worldwide, medical waste handling is well
regulated to safeguard the health of humankind and the environment. However,
laxity, lack of adequate training and awareness in the execution of these rules
had been variedly reported placing workers and the environment at risk. This
work was carried out to assess the medical waste and the risk associated/management
in Birniwa General Hospital that increasingly receives a booming number of
patients daily. Specifically, the study sought to a) identify possible health
risk associated with the handling of medical waste in Birniwa General Hospital,
b) ascertain regulations and procedures regarding medical waste management and
to what extent it is applied, c) investigate the challenges/difficulties which
the hospital encounters in managing their medical waste. This research adopted
a descriptive research design which made use of questionnaire, interview and
observations as data collection methods. The population of the study comprised
of 36 doctors, 100 nurses, 22 medical laboratory scientists, 2 sanitary staff
and 14 cleaners, out of which eighty (80) were selected as the sample size for
the study using simple random sampling techniques. The collected data were
analyzed using frequency and percentages, which were presented in tables and
charts. The results of the findings revealed among others that, majority of the
respondents 80% are aware that, there are health risk associated with the improper
handling and management of medical waste which includes; Infections, contaminations,
injuries from sharp objects among others. They are aware of documented
regulations and procedures regarding the handling and management of the medical
waste in the hospital. Some of the provisions are placed on notice boards,
paste on doors inwards, laboratory, color markings of containers etc. The study
also revealed that lack of trained personnel, minimal law and enforcement,
inadequate medical materials and medical waste load are the challenges faced by
the hospital in managing their medical waste. The study concluded that a
majority of the stakeholders of the hospital are aware of the risks involved in
handling and managing their medical waste. The study recommends that; the
government should create higher institutions to train and also employ more
medical waste managers and sanitary officers, the government should also
provide sufficient medical waste materials, and periodic training on proper
medical waste handling and management for all staff should be organized.
CHAPTER ONE
1.1 Background to the Study
With an increase
in industrialization and growth in population, the inappropriate handling of
waste products in our society has become more acute (Read, 2008; Subhadarsini,
2015). Waste and its management can trace its roots back to the earliest stages
of civilization, ever since man cease being a hunter-gatherer and began forming
permanent settlements; there has been a build-up of waste products that have
required collection and disposal in one form or the other (Read, 2008).
Inappropriate management of waste leads to various pollution problems like air
pollution, water pollution and land pollution, which requires time management.
(Read, 2008).
One such type of
waste is bio-medical waste generated primarily from health care establishments
including hospitals, nursing homes, veterinary hospitals, clinics, general
practitioners, dispensaries, blood banks, animal houses and research institutes
(Chitnis et al., 2000). Healthcare waste or bio-medical wastes are the creators
of external cost or negative externality which may lead to the spread of various
infectious diseases like hepatitis, tuberculosis, bronchitis, HIV, etc.
(Mohandasundaram, 2003) as well as environmental degradation through the
production of chemical waste which alters the natural ecological environment of
bacteria.
Hospital is one of
the complex institutions, which is visited by people from every walk of life
(without any difference between age, gender, race and religion). Medical wastes
include all types of wastes produced by health facilities such as general
hospitals, medical centers and dispensaries. It represents a small number of
total residues generated in health care facilities. Such residues can
potentially transmit diseases and present an additional risk to the staff of
the healthcare facilities, patients and the community when the wastes are not
appropriately managed (Baveja et al., 2000; Da Silva, 2005).
The management of
medical waste is an emerging issue that is magnified by a lack of training,
awareness, and financial resources to support solutions. The collection and
disposal of this waste are of great importance as it can directly impact the
health risks to both public and Community Health (Abdulla et al., 2008).
In Nigeria, to the
best of my knowledge, concern about medical waste is at the infancy and has not
been adequately addressed. There is little documentation concerning medical
waste and risk management. This may be ascribed to economic social and
administrative reasons. This study evaluates medical waste management practices
in Birniwa General Hospital to identify the problems and contribute in the
planning of a suitable medical waste management system.
1.2 Statement of the Problem
First world
countries have developed appreciable systems of waste management that are from
proper sorting and collection at the source, transportation and disposal to
ensure the protection of stakeholders in the Hospital. Unfortunately, in
developing countries, medical waste management is one of the major problems confronting
healthcare stakeholders. The World Health Organization (WHO, 1999) reported
that in most parts of Africa lagging in health facilities, the waste stream is
often mixed-up from collection to transportation than to disposal. This poses
serious threats to those working in these institutions. This could be the case
in medical facilities in Nigeria and Birniwa General Hospital in particular
with limited financial resources. In most areas, there is less consideration of
the risks involved while handling medical wastes, by the government, healthcare
personnel and the general public (FMoH, 2006). This often forces different
bodies to develop adaptable regulations in the management of medical wastes.
1.3 Objectives of the Study
1.3.1 The main objective
The main objective
is to examine the current medical waste management practice within the Birniwa
General Hospital and the risk associated, with poor handling.
1.3.2 Specific objectives
1) To identify
possible health risk associated with the handling of medical waste in Birniwa
General Hospital
2) To ascertain
regulations and procedures regarding medical waste management and to what
extent it's applied in the Birniwa General Hospital
3) To investigate
the challenges/difficulties which the Hospital encounters in managing their
medical waste.
1.4
Research Questions
Several research questions are formulated
for achieving the study objectives, as follow:
1. What
is the current medical waste management practice in Birniwa General Hospital?
2. What
is the possible health risks associated with the handling of medical waste in Birniwa
General Hospital?
3. Are
there documented regulations and policies related to medical waste management
at the Hospital?
4. To
what extent do these regulations and procedures apply in Birniwa General
Hospital?
5. What
are the challenges/difficulties which the Hospital encounters in managing their
medical waste?
1.5 Significance of the Study
Healthcare
waste management is one of the major challenges in developing countries, as
well as Nigeria where healthcare waste is said to be poorly managed, despite
these challenges, minimal empirical studies exist in this field. The study is
highly significant to the Hospital as it will increase awareness and also the
safety of employees and reduces sharps injury potential, along with the cost of
direct and indirect treatment as a result. The study will be of great
importance to the Nigeria health care system as a whole. To the best of our
knowledge, there are minimal documentation and information pertaining to
medical waste management in the country which shows that this has been
neglected, little or no policies and regulation to back the practice of proper
medical waste management, this work if acknowledge by the Ministry of Health
could foster and help nationwide policies and regulation to be formulated and
adopted, that will govern all health facilities in Nigeria. The study also
considers as a source of information for subsequent researchers especially in
the area of medical waste management, students and other paramedical health
researchers will find it helpful to review the literature and make relevant
recommendations and also fill the gaps.
1.6
Scope of the Study
This work covered
the Birniwa General Hospital in Jigawa State geographically. The study also
covers the staff, sanitary officers, patients, medical and other health practitioners
of the Hospital in order to assess the medical waste management of the
Hospital. The study started from April to end of July 2024. The BGH serves as a
referral to the district and health centers. A study that covers this Hospital
will depict what the peripherals practice. As a referral hospital, others have
to emulate their example. In this area, there are also private hospitals and
PHC centers but the General Hospital Birniwa being the state-owned is a
referral to all other hospitals. Thus they need to represent and be exemplary
to the others. My study on medical waste management will cover mostly the
various health units that deal a lot with medical waste management. These will
include the accident and emergency department where all emergencies pass
through before being transferred to the specialist and later wards, the theatre
where most surgical operations are being carried out, thus, lots of medical
waste which needs to be managed properly, the maternity department, laboratory,
wound dressing and injection room, the surgical and medical ward and dialysis
center.
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