SOLID MEDICAL WASTE MANAGEMENT PRACTICES AT THE UNIVERSITY HOSPITAL, KNUST, KUMASI

ABSTRACT
Effective management of solid medical waste (SMW) is an important issue confronting many developing countries including Ghana. Ghana has many health facilities of which the University Hospital, KNUST, Kumasi (UH-KNUST) forms part. This research took place between November 2015 and February 2016 at the UH-KNUST, a Level C District Hospital, with an average daily out-patient attendance of 325 patients. Data for the study were gathered from both primary and secondary sources. Primary data was collected through segregation, quantification and weighing of solid medical waste (SMW) generated. Questionnaires were also employed in obtaining primary data. The Hospital generates non-hazardous (general) and hazardous (infectious, pharmaceutical, pathological, heavy metal and sharp) wastes which are currently co-disposed into skip containers on-site. UH-KNUST treats only their sharp waste using incineration, without air pollution control device. Quantities of waste generated were measured twice daily using plastic bags, cardboard boxes and buckets of known weights and a weighing scale. A total of 5422.0 kg and 4262.2 kg of non-hazardous and hazardous wastes respectively were generated within the 16-week study period. Quantities of specific SMW generated in all wards/units were statistically different. The existing management practices, which serves as basis for providing sustainable management measures to issues of waste handling and disposal at the Hospital were identified. This was done by personal observations and administering of questionnaires to waste handlers and healthcare staff. Limitations identified include: inadequate education/sensitization of healthcare personnel and waste handlers, lack of hospital waste management department and policy, non-adherence to segregation of waste, and no documentation of waste generated and waste handling procedures. Sustainable management measures such as effective and regular sensitization of all healthcare workers and patients on the importance of segregation and the risks involved in poor handling of SMW among others were recommended to reduce the negative impacts of improper management of SMW on human health and environmental resources. A waste management plan was developed for the UH-KNUST to serve as a guideline in managing its SMW. Putting these measures in place will address the various health and environmental issues identified at the UH-KNUST.


CHAPTER ONE
INTRODUCTION
1.1       Background
Rapid industrialisation, coupled with population growth, high standard of living and economic development has hastened the rate of solid waste generation worldwide (Minghua et al., 2009). Management of solid waste is one of the most difficult issues that the world faces. Huge quantities of solid wastes are generated each day by human activities (Mohee and Bundhoo, 2015). Management of these solid wastes especially its disposal is a very essential problem confronting most developing countries (Van Beukering et al., 1999) including Ghana. As discussed by Hosetti (2006) solid wastes can be grouped as: agricultural waste from fields and farms; institutional waste from offices, schools and colleges; municipal waste; commercial waste from markets, hotels and medical facilities and residential waste from households. It also includes waste from sources such as construction and demolition, industrial and treatment plant sites (Tchobanoglous et al., 1993).

Osei-Mensah et al. (2014) alludes to solid waste management (SWM) as the source separation, proper collection, sorting, transportation, storage, treatment, recycling and disposal of solid waste. The management must be done in an environmentally sustainable manner by considering most appropriate practices of nature conservation, public health delivery, aesthetics beautification, and engineering (Puopiel, 2010; Nyankson, 2013). Recently, poor management of solid waste, mainly domestic, industrial and commercial wastes (Puopiel, 2010) has raised lots of concerns regarding their significant health and environmental related issues (Da Silva et al., 2005; Mensah, 2012). In Ghana, less consideration has been given to various solid wastes including solid medical waste (SMW). As observed by Mensah (2012), the consequences of poor management of SMW is environmentally damaging and threatens human life. Some of the waste-related diseases include dysentery, typhoid and malaria (Akter, 2000; Puopiel, 2010). Environmentally, water, air and soil are polluted if SMW is not properly managed (Hosetti, 2006). The aesthetic value of the immediate environment is also decreased.

Due to their potentially hazardous or unusual features, special waste like SMW (Uriarte, 2008) which comprises of hazardous and infectious materials, sharp objects and other forms of waste generated from hospitals, clinics, laboratories, pharmacies, maternity homes and dental/veterinary clinics need to be treated and disposed separately and should not be mixed with municipal solid waste (Blackman, 2001). A more thorough but economical approach is required to effectively manage the challenges posed by SMW, by managing the different portions of the SMW stream based on their physical, chemical and biological characteristics. Hence, the need for effective segregation of the waste stream.

1.2       Problem Statement
The UH-KNUST forms part of the major hospitals in the Kumasi Metropolis. In the last few years, the UH-KNUST has developed both in infrastructure and administration receiving patients from the University community and over 30 nearby communities. There is a growing perception that, standard practices by the WHO, EPA Ghana and the MLGRD are not observed. This suggests that the existing SMW management practices present occupational hazard to waste management workers and healthcare staff, health risk to patients, hospital staff and the surrounding communities and a potential source of pollution to environmental resources such as air, soil and water. For instance, there have been cases of needle-stick injuries, a situation that can lead to the transmission of infectious diseases. Unfortunately, information on the quantities, characteristics and handling of SMW generated during the provision of healthcare services at the UH-KNUST have not been reported. The situation calls for investigation into the SMW management practices at the UH-KNUST. Hence, the research seeks to examine the practices in place for the management of SMW at the UH-KNUST and provide sustainable measures for lapses if any by answering the following questions:

What are the quantities and composition of SMW generated in the wards/units of the Hospital?

What are the existing management practices for SMW?

Are there any limitations in the current management practices?

1.3       Justification
Taking into consideration the risks, both on human health (patients, hospital staff and nearby communities) and the environment, the rapid increase in the generation of SMW is alarming (Airlina, 2015). Ghana’s EPA and the MLGRD acknowledge the urgent need for proper waste management wherever it is economically viable as well as provides a positive influence on the environment (Osei-Mensah et al., 2014). Knowledge in the existing management practices at the UH-KNUST, as aimed by the study, will help ascertain the degree of adherence to standard practices and the necessary steps taken to address any shortfalls associated with the effective management of SMW. This will serve as a baseline data for effective decision-making and provision of sustainable strategies for the management of SMW.


1.4       Aim and Objectives
The aim of the study is to examine the SMW management practices at the UH-KNUST and the related health, occupational and environmental risks.

Specific objectives are to:

* determine the quantity and composition of SMW generated in the UH-KNUST within the period of study;

* identify existing management measures in place for SMW and

* propose sustainable management strategies in solving issues related to the management of SMW.

1.5       Scope of Study
The study was carried out at the UH-KNUST in the Ashanti Region of Ghana. Samples of SMW from all the wards and units of the Hospital were collected for analysis within the study period. These included all the Theatre, Dental and Eye clinics, the General OPD with the emergency and casualty unit, Administration, Pharmacy, Laboratory, X-Ray and Scan unit, the Public Health Unit (PHU) and all five wards namely Children’s, Maternity, Otumfuo Osei Tutu Medical Centre (VIP ward), Male and Female wards. The study covered the sources of SMW generation, its composition, management practices through to the final disposal on-site (at the hospital premises). Waste such as human excreta was exempted from the study. The activities of the waste management firms from when the waste is collected on-site to its final disposal site (off-site) was also excluded from this study.

1.6       Structure of the Thesis
The study was organized in five (5) chapters. The first chapter gives a general introduction about the research work. It provides an overview of the problem of SMW management at the UH-KNUST and gives reasons for the study. In chapter two, relevant literature regarding SMW management is reviewed, thus, the sources, categories and processes of SMW management. Chapter three focuses on the materials and methods employed in the collection and interpretation of data for the research work including personal observations, questionnaire administration and weighing of SMW. The chapter gives a very brief description of the study area. In chapter four, the findings are presented using tables, pictures and figures. Analysis of the work is also given in chapter four. Chapter five concludes the study with a summary of the entire research findings and recommendations.

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Item Type: Ghanaian Project Material  |  Attribute: 92 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH50  |  Delivery: Within 30Mins.
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