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A STUDY ON WASTE DISPOSAL MANAGEMENT IN NIGERIA HOSPITALS AND SUGGESTED SAFE DISPOSAL APPROACH

Abstract:

The management of healthcare waste poses a significant challenge in Nigeria, with potential implications for public health and environmental sustainability. This study aims to assess the current practices of waste disposal in hospitals across Nigeria and proposes a comprehensive and safe disposal approach. The research employs a mixed-methods approach, combining surveys, interviews, and on-site observations to gather data from various healthcare facilities. The study investigates the types, quantities, and handling procedures of medical waste generated by healthcare facilities, as well as the awareness and compliance levels with existing waste disposal regulations. Additionally, the research explores the environmental impact of current waste management practices. The findings provide a detailed analysis of the existing waste disposal systems, revealing both strengths and weaknesses. Based on the assessment, the study proposes a holistic and sustainable waste disposal approach tailored to the Nigerian healthcare context. The suggested approach integrates efficient waste segregation, proper handling techniques, and the adoption of environmentally friendly disposal methods. Moreover, the study recommends targeted training programs for healthcare personnel to enhance awareness and compliance with waste management regulations. The research aims to contribute to the improvement of waste disposal practices in Nigerian hospitals, promoting public health safety and environmental stewardship.

Chapter One:

Introduction

1.1 Background

Healthcare waste management is a critical aspect of public health and environmental sustainability, particularly in developing countries like Nigeria. The improper disposal of medical waste in hospitals can lead to severe consequences, including the spread of infectious diseases, environmental pollution, and harm to healthcare workers and the community at large. Effective waste disposal practices are essential to mitigate these risks and ensure a safe healthcare environment. This study focuses on examining the current waste disposal management in Nigerian hospitals and proposes a comprehensive approach for safe and sustainable waste disposal.

The sustainable management of Healthcare Waste (HCW) has continued to generate increasing public interest due to the health problems associated with exposure of human beings to potentially hazardous wastes arising from healthcare (Tudor et al., 2005; Ferreira, 2003; Da Silver et al., 2005). Presently considerable gap exist with regard to the assessment of healthcare waste management practices particularly in Nigeria and in several other countries in sub – Saharan Africa. The nature and quantity of healthcare waste generated as well as institutional practices with regards to

sustainable   methods   of   healthcare  waste  management, including waste segregation and waste recycling are often poorly examined and documented in several countries of the world despite the health risks posed by the improper handling of HCW (Farzadika et al., 2009; Oke, 2005). It is also of serious concern that the level of awareness, particularly of health workers regarding healthcare waste has not been adequately documented.

HCW are a special category of waste because they often contain materials that may be harmful and can cause ill health to those exposed to it. A number of studies have indicated that the inappropriate handling and disposal of healthcare waste poses health risks to health workers who may be directly exposed and to people near health facilities, particularly children and scavengers who may become exposed to infectious

wastes and a higher  risk  of  diseases  like  hepatitis  and HIV/AIDS (Adegbita et al., 2010; Coker et al., 2009, PATH, 2009; Oke, 2008; WHO, 2002, 1999). 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 and mostly due to very poor waste management systems (WHO, 1999; Townend and Cheeseman, 2005). In developing countries like Nigeria, where many health concerns are competing for limited resources, it is not surprising that the management of healthcare wastes has received less attention and the priority it deserves. Unfortunately, practical information on this important aspect of healthcare management is inadequate and research on the public health implications of inadequate management of healthcare wastes are few and limited in scope.

Although reliable records of the quantity and nature of healthcare wastes and the management techniques to adequately dispose of these wastes has remained a challenge in many developing countries of the world, it is believed that several hundreds of tones of healthcare waste are deposited openly in waste dumps and surrounding environments, often alongside with nonhazardous solid waste (Alagoz and Kocasay, 2007; Abah and Ohimain, 2010). A near total absence of institutional arrangements for HCW in Nigeria has been reported by others (Coker et al., 1998).

Various methodologies have been used all over the world to assess and quantify HCW.  They include the use of physical observation, questionnaire administration and quantification (Adegbita et al., 2010; Olubukola, 2009; Phengxay et al., 2005), as well as checklists (Townend and Cheeseman, 2005) and private and public records (Coker et al., 2009). Recent studies in Nigeria has estimated waste generation of between 0.562 to 0.670 kg/bed/day (Longe and Williams, 2006) and as high as 1.68 kg/bed/day (Olubunmi, 2009).  As reported in the literature, there may not be much of a difference in the way and manner wastes generated in various health care institutions are managed in Nigeria. A good example is given by the findings of the study in Lagos by Olubukola which reported the similarity in waste data and HCW management practices in two General hospitals, characterized by a lack of waste minimization or waste reduction strategies, poor waste segregation practices, lack of instructive posters on waste segregation and disposal of HCW with general waste (Olubukola, 2009).

The mismanagement of healthcare waste poses health risks to people and the environment by contaminating the air, soil and water resources. Hospitals and healthcare units are supposed to safeguard the health of the community. However, healthcare wastes if not properly managed can pose an even greater threat than the original diseases themselves (PATH, 2009). There are a reasonable range of treatment technologies available for healthcare   wastes   that  may   be  appropriate  for  third world countries, however, it is pertinent that before any of these options are adopted, hospitals and medical facilities will need to assess the problem and put forward a management strategy that is suitable to their economic circumstances and that can be sustained based on local technology.

1.2 Statement of the Problem

Nigeria, like many developing nations, faces challenges in healthcare waste management. Limited resources, inadequate infrastructure, and a lack of awareness contribute to suboptimal waste disposal practices in hospitals. The improper segregation, handling, and disposal of medical waste can result in health hazards and environmental degradation. There is a pressing need to assess the existing waste management systems in Nigerian hospitals, identify gaps, and recommend viable solutions to ensure the safe and responsible disposal of healthcare waste.

1.3 Objectives of the Study

The primary objectives of this study are as follows:

To assess the current waste disposal practices in hospitals across Nigeria.

To identify the types and quantities of medical waste generated by healthcare facilities.

To evaluate the awareness and compliance levels of healthcare personnel with existing waste disposal regulations.

To investigate the environmental impact of current healthcare waste management practices.

To propose a comprehensive and safe waste disposal approach tailored to the Nigerian healthcare context.

1.4 Research Questions

What are the existing waste disposal practices in hospitals across Nigeria?

What types and quantities of medical waste are generated by healthcare facilities in Nigeria?

To what extent are healthcare personnel aware of and compliant with waste disposal regulations?

What is the environmental impact of current healthcare waste management practices?

What are the components of a comprehensive and safe waste disposal approach for Nigerian hospitals?

1.5 Significance of the Study

This study holds significance for various stakeholders, including healthcare administrators, policymakers, environmentalists, and the general public. By providing insights into the current waste disposal practices and suggesting safe disposal approaches, the study aims to contribute to improved public health outcomes, reduced environmental pollution, and enhanced occupational safety for healthcare workers.

1.6 Scope of the Study

The study will focus on hospitals and healthcare facilities across Nigeria, considering variations in waste disposal practices among different regions. The assessment will encompass the types and quantities of medical waste generated, existing disposal systems, and the level of awareness and compliance with waste management regulations among healthcare personnel.

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